| Objectives:Based on the design thinking method and the "tower of experience" theory,a virtual simulation platform for health education of diabetic retinopathy was constructed with the needs and preferences of diabetic patients as the center.Based on this platform,health education for diabetic patients was conducted,so as to explore its availability and application effect in diabetic patients.Methods:1.Platform construction:The design thinking method including empathy,definition,conception of scheme,prototyping and testing is adopted to guide the design process of the virtual simulation platform for health education of diabetic retinopathy.At the same time,the"tower of experience" theory is adopted to guide the content presentation form of the platform.At the empathy stage,through qualitative interview,we learned about the needs and expectations of diabetic patients on the platform;At the definition stage,persona were used to define the characteristics of diabetic patients;At the conception stage,brainstorm method is used to integrate functional framework;At the prototype stage,the script and materials are handed over to technicians to complete the prototype production;At the test stage,the prototype of the test platform for heuristic evaluation and patient interview was used.According to the test results,the iteration was completed in collaboration with technical personnel to form the final version of the virtual simulation platform for health education of diabetic retinopathy.2.Quasi-experiment:72 patients with diabetes who were hospitalized in the endocrinology department of a Grade-A tertiary hospital in Jinan,Shandong Province from August to December 2022 were selected by convenient sampling method for the preliminary experimental study.According to the order of admission time,the first 36 diabetic patients were the control group and the last 36 were the intervention group.The control group received routine health education,while the intervention group received virtual simulation platform of health education for diabetic retinopathy,including symptoms simulation experience,ocular structure,abnormal fundus changes,screening and prevention knowledge,diet,exercise,real cases,etc.Before intervention,general data,knowledge of diabetic retinopathy,attitude and behavior questionnaires were collected from the intervention group and the control group.After intervention,the simulator sickness questionnaire,system usability scale and satisfaction questionnaire were collected in the intervention group.Questionnaires on knowledge,attitude and behavior of diabetic retinopathy in the intervention group and the control group were collected one and three months after intervention.SPSS 22.0 statistical software was used for analysis.The methods included descriptive statistics,independent sample t test,Chi-square test,Fisher exact probability method,and so on.The two-sided test level α=0.05,P<0.05 was considered statistically significant.3.Qualitative research:Objective sampling method and maximum variation sampling strategy were adopted to select 16 diabetic patients who had used this platform for interviews from October to December 2022.Semi-structured in-depth interview method was used to collect data,and the interview data were imported into Nvivo 12.0 software for data analysis.Braun and Clarke’s six-stage thematic analysis method was used to analyze the data,including:(1)Getting familiar with the data;(2)Generating initial codes;(3)Searching for themes;(4)Reviewing themes;(5)Defining and naming themes;(6)Producting the report.Results:1.A virtual simulation platform for health education of diabetic retinopathy was constructed,which mainly includes health education contents such as symptom simulation experience,ocular structure knowledge,abnormal fundus changes,screening and prevention knowledge,diet,exercise,real cases,etc.,and includes diversified forms such as immersive simulation experience,three-dimensional ocular structure,animation,pictures,and virtual scenes.2.A total of 69 diabetic patients completed this study,including 34 in the control group and 35 in the intervention group.The results showed as follows:(1)Baseline data such as age,sex and per capita monthly family income were comparable between the two groups(P>0.05).(2)Before intervention,there was no significant difference in knowledge,attitude and behavior scores of diabetic retinopathy between the two groups(P>0.05);One month after intervention,there were statistically significant differences in knowledge,attitude and behavior scores of diabetic retinopathy between the two groups(P<0.05);Three months after intervention,there were statistically significant differences in knowledge,attitude and behavior scores related to diabetic retinopathy between the two groups(P<0.05).(3)The total score of the system availability scale was(90.71±7.24),the total score of the simulator disease questionnaire was(0.53±1.85),and the satisfaction score was(66.49 ±4.33).3.A total of 3 themes and 10 sub-themes are extracted,which are as follows:Theme 1:unique experience of virtual simulation platform(novel,vivid and interesting learning style,experiential learning,transformation of disease perspective,easy and acceptable operation);Theme 2:Improving the effectiveness of health education(promoting knowledge understanding and retention,increasing awareness of disease prevention,with promotion potential);Theme 3:Problems and challenges(adverse reactions,comfort issues,lack of sense of reality).Conclusions:1.With diabetes patients as the center,this study applied design thinking and "tower of experience" theory to the construction process of a virtual simulation platform for health education of diabetic retinopathy,realizing the joint participation of patients and multidisciplinary developers in the construction of the platform.2.Health education for diabetic patients was conducted based on the virtual simulation platform for diabetic retinopathy health education.The results showed that this platform could meet the needs of diabetic patients to learn diabetic retinopathy knowledge,and had good usability and satisfaction evaluation,which could effectively promote patients’ understanding of disease knowledge and improve their attitude and behavior towards the disease.3.The virtual simulation platform for health education of diabetic retinopathy is novel,vivid and interesting,and the unique learning experience of immersive role experience has enriched the form of health education.It is welcomed by patients,has great application potential,and is worth further promotion. |
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