共同设计针对从事社区喉切除术护理的医疗专业人员的原型教育与培训干预：一项基于经验共同设计的研究。

文献信息

中文摘要

引言： 证据表明，喉切除术患者通常认为社区医疗专业人员的知识水平不如医院临床医生。一些人还表示感觉自己比在家支持他们的专业人员更有技能。这突显了医疗专业人员教育和培训方面的巨大差距，对喉切除术患者具有重要的安全影响，包括对护理信心降低、对医疗专业人员的不信任以及护理连续性的风险。为解决这一问题，本研究描述了为社区医疗专业人员共同设计原型教育与培训包的过程。
方法： 基于经验共同设计的原则，并以医学研究理事会复杂干预开发指南为基础，我们开展了优先事项确定活动，随后与喉切除术患者、家庭成员和医疗专业人员进行了三次迭代研讨会，以开发原型教育与培训包。一位数字专家支持了所有研讨会。采用内容分析和主题分析相结合的方法分析研讨会数据。
结果： 28名参与者参加了优先事项确定活动和研讨会：8名喉切除术患者、5名家庭成员和15名医疗专业人员。所有参与者一致认为，开发基于社区的数字化教育和培训解决方案是最优先的需求。共同设计了初步方案理论、逻辑模型和原型教育与培训包。教育与培训原型包括十个商定的内容主题（例如解剖学、沟通），以及设计和实施考虑因素。
结论： 通过与关键利益相关者的平等合作，设计了一个原型教育与培训包。下一阶段是实施，包括内容/支持资源的共同制作和数字平台的构建，以及完善。
生活经验贡献： 生活经验贯穿整个研究，塑造了其方向和实施。具有生活经验的人士作为研究指导小组成员参与，为整体研究设计提供信息，并确保其从一开始就具有相关性。一个专门的患者和公众参与小组支持了项目的关键阶段，包括制定参与者招募策略、创建共同设计资源以及规划共同设计研讨会。他们的见解也为结果分析和最终原型的完善提供了信息，确保干预措施始终扎根于直接受影响者的现实、优先事项和专业知识。喉切除术患者及其家属也参与了原型的共同设计。

英文摘要

INTRODUCTION: Evidence indicates that people with a laryngectomy often perceive community healthcare professionals as less knowledgeable than hospital-based clinicians. Some individuals also report feeling more skilled than the professionals supporting them at home. This highlights a substantial gap in healthcare professional education and training, with significant safety implications for people with a laryngectomy, including reduced confidence in care, mistrust in healthcare professionals, and risks to continuity of care. To address this, the present research describes co-design of a prototype education and training package for community healthcare professionals.
METHODS: Informed by the principles of Experience Based Co-Design and underpinned by the Medical Research Council's guidance for Complex Intervention Development we ran prioritisation events followed by three iterative workshops with people with a laryngectomy, family members and healthcare professionals to develop the prototype education and training package. A digital expert supported all workshops. A combination of content and thematic analysis was used to analyse workshop data.
RESULTS: Twenty-eight participants took part in the prioritisation events and workshops: eight people with a laryngectomy, five family members and fifteen healthcare professionals. All participants agreed the highest priority need for developing a digital solution to community-based education and training. Preliminary programme theory, logic model and prototype education and training package were collaboratively designed. The education and training prototype includes ten agreed content topics (e.g. anatomy, communication), as well as design and implementation considerations.
CONCLUSION: Through equal partnership working with key stakeholders, a prototype education and training package has been designed. The next stage is operationalisation, including co-production of content/supporting resources and building of the digital platform, and refinement.
LIVED EXPERIENCE CONTRIBUTION: Lived experience was embedded throughout the study, shaping both its direction and delivery. Individuals with lived experience contributed as members of the research steering group, informing the overall study design and ensuring its relevance from the outset. A dedicated patient and public involvement group supported key stages of the project, including the development of the participant recruitment strategy, creation of resources for co-design, and planning of the co‑design workshops. Their insights also informed the analysis of findings and the refinement of the final prototype, ensuring that the intervention remained grounded in the realities, priorities, and expertise of those directly affected. People with a laryngectomy and their families also took part in co-designing the prototype.