Development of a computer-based system for continence health promotion

doi:10.1016/j.outlook.2004.04.014

Nursing Outlook

Volume 52, Issue 5, September–October 2004, Pages 241-247

https://doi.org/10.1016/j.outlook.2004.04.014 Get rights and content

Computer-based systems (CBS) can provide information to help individuals analyze their health care needs and make decisions about management of health problems. This article discusses the development of a CBS that delivers an individualized educational intervention for continence health promotion. System development included cycles of prototype design, testing, analysis, and redesign. Knowledge acquisition, representation methods, and design decisions are discussed. Participants completed 4 rounds of usability testing and a pilot test, which resulted in enhancements to both the CBS and the expert system feature that produced individualized feedback. This iterative design process involved users throughout system development. User involvement resulted in a tutorial to explain navigation and other features of the CBS, graphics to enhance the written message, and clarification of continence-related content. The procedures resulted in an informative, usable product; they can be used to develop systems that provide information about symptom self-management for other health conditions.

Section snippets

Knowledge engineering

Durkin¹⁶ described knowledge engineering as the process of building an expert system that includes (1) assessment, (2) knowledge acquisition, (3) design, and (4) testing. These phases of building the CBS for continence health promotion will be discussed sequentially, but development of a system is an iterative process and overlap occurs in the execution of individual phases. When the phases of knowledge engineering are applied, a system is partially built, tested, and revised; a basic prototype

Discussion

The development of a CBS for continence health promotion was guided by a model of knowledge engineering that included formative and summative evaluation by users. Using this approach to system development gathers information that is deemed important in the literature by both expert clinicians and women experiencing continence problems. Offering information that users want and presenting it in ways that make sense to them can effectively guide the content and design of a CBS.¹ The premise

Conclusions

The knowledge-engineering procedures followed in development of the CBS for continence health promotion resulted in a product that was usable and informative. These procedures can be used to develop systems that provide information about symptom self-management for other health conditions. Whereas this system was on computers without Internet connection, placement of this or similar systems on the Internet would make self-management health information available to a greater number of women.

Alice R. Boyington is an Assistant Professor at the School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.

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Alice R. Boyington is an Assistant Professor at the School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Barbara M. Wildemuth is a Professor at the School of Information and Library Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Molly C. Dougherty is a Frances Hill Fox Professor of Nursing at the School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Elizabeth Palena Hall is a Web designer at Lockheed Martin Information Technology, U.S. Government Accounting Office Contractor.

: Supported by research grant No. 1 K01 NR00125 (A Knowledge-Based System for Continence) from the National Institute for Nursing Research, National Institutes of Health (1999-2003).

View full text

Development of a computer-based system for continence health promotion

Section snippets

Knowledge engineering

Discussion

Conclusions

Am J Prev Med

Nurs Outlook

An intelligent interactive system for delivering individualized information to patients

Artif Intell Med

The development and pilot testing of a multimedia CD-ROM for diabetes education

Diabetes Educ

The Michigan health kiosk: cancer info on the go

J Natl Cancer Inst

Decision support and expert system

Urinary incontinence in adults: acute and chronic management. Clinical practice guideline, No. 2, 1996 update

A randomized trial of behavioral management for continence with older rural women

Res Nurs Health

Efficacy of bladder training in older women with urinary incontinence

JAMA

Nursing for continence

Urinary continence: prevention focused research

Dietary caffeine, fluid intake and urinary incontinence in older rural women

Int Urogynecol J Pelvic Floor Dysfunct

Urinary incontinencetreatments, interventions, and outcomes

Clin Nurse Spec

The prevalence, frequency and impact of urinary incontinence on older women and their communication with their primary care physicians [abstract]

Int Urogynecol J Pelvic Floor Dysfunct

Evaluation and treatment of urinary incontinenceReport of a physician survey

Arch Fam Med

Expert systems: design and development

The urinary incontinence sourcebook