JMIR Publications

ABSTRACT

Background:

Digital health technologies are increasingly reshaping nursing practice, yet many digital interventions remain poorly aligned with patients’ needs, clinical workflows, and real-world implementation contexts. The Double Diamond Model offers a structured co-design framework for integrating multi-stakeholder perspectives into digital health development, but its applications in digital nursing and digital health have not been systematically mapped.

Objective:

This review aimed to examine how the Double Diamond Model has been applied in digital healthcare and to explore its implications for person-centered nursing practice.

Methods:

A scoping review with bibliometric analysis was conducted following the Joanna Briggs Institute guidelines and reported according to the PRISMA-ScR checklist. The protocol was registered in the OSF Registries. Eligibility criteria were developed using the Population–Concept–Context framework. A three-stage search strategy was used, including a preliminary PubMed search to identify keywords and index terms, a comprehensive search of PubMed, Web of Science, Embase, Ovid, and IEEE Xplore Digital Library, and manual screening of reference lists from included studies. The final database search was conducted on 26 December 2025. All records were managed and screened in Rayyan by two independent reviewers. Bibliometric data were cleaned and standardized using Microsoft Excel 2019 and analyzed with VOSviewer. Data were independently extracted using a predefined template, and discrepancies were resolved through consensus.

Results:

Thirty-seven studies were included. The Double Diamond Model was applied across clinical, community, home-based, and context-specific digital healthcare settings to support patient-centered digital health design. Across the four stages, the Discover stage focused on identifying patients’ lived experiences, unmet needs, self-management challenges, accessibility issues, and care-related barriers, while also incorporating perspectives from caregivers and healthcare professionals. The Define stage synthesized these findings into prioritized patient needs, design requirements, behavioral targets, and service specifications. The Develop stage translated patient-derived insights into co-designed digital health interventions, mobile applications, dashboards, communication tools, educational resources, and decision-support components. The Deliver stage emphasized usability, acceptability, feasibility, stakeholder validation, and final refinement to enhance real-world applicability. The main outputs were categorized as service pathway optimization, digital health interventions and health education strategies, and mobile applications or digital platforms. Overall, patient and caregiver involvement was central to aligning digital health solutions with real-world care needs, clinical workflows, and person-centered nursing practice.

Conclusions:

The Double Diamond Model provides a structured, iterative, and patient-centered approach to digital health design. It supports the development of usable and context-sensitive digital health solutions and may contribute to advancing person-centered nursing practice.