JMIR Publications

ABSTRACT

Background:

Moderate to severe postoperative pain in children is common. Increased pediatric day surgeries have shifted postoperative pain management predominantly to the home setting. Smartphone technology has the potential to overcome barriers to pain care by increasing access to self-management. However, “pain apps” generally lack scientific evidence and are highly underutilized due to lack of involvement of end-users in their development. Thus, an evidence-based pain self-management smartphone app that incorporates the needs and perspective of children and adolescents (end-users) has potential to improve postoperative pain management.

Objective:

This paper describes how the principles of user-centered design are being applied to the development of iCanCope PostOp, a smartphone-based pain self-management app for children and adolescents after surgery. Specifically, it presents two completed phases of the user-centered design process (concept generation and ideation) for the iCanCope PostOp app.

Methods:

Phase 1 was a needs assessment from the perspective of 19 children and adolescents who had undergone day surgery, 19 parents, and 32 multidisciplinary healthcare providers using semi-structured interviews and focus groups. Data were summarized using qualitative analysis. Phase 2 developed a pain care algorithm for the app using Delphi surveys and a two-day in-person design workshop with 11 multidisciplinary pediatric postoperative pain experts and 2 people with lived experience with postoperative pain.

Results:

Phase 1 identified self-management challenges to postoperative pain management and recovery, limited available resources and reliance on medications as a predominant postoperative pain management strategy, and shared responsibility of postoperative pain care by children and adolescents, parents, and healthcare providers. Key app functions of tracking pain, pain self-management strategies, and goal setting were identified as priorities. Phase 2 led to the successful and efficient generation of a complete preliminary pain care algorithm for the iCanCope PostOp app, including clinically relevant inputs for feasible assessment and reassessment of pain and function, as well as a catalogue of pain management advice to be pushed to end-users.

Conclusions:

The concept ideation and generation phases of the user-centred design approach were successfully completed for iCanCope PostOp. Next steps will include design finalization, app development (iOS/Android), evaluation through a randomized controlled trial, and subsequent implementation of iCanCope PostOp in clinical care. Clinical Trial: N/A