An ontology guided practice support tool for palliative severe pain management.

摘要

One of the primary goals of palliative care is management of symptoms such as pain. Palliative clinicians experience difficulty in severe pain management (SPM) and therefore there is a need for enhanced approaches to SPM. This dissertation attempts to fulfill that need by applying informatics based approaches to SPM. The dissertation was done in three phases: conceptualization, construction and testing. Conceptualization developed a practice support framework and set of informatics based tools for palliative SPM, construction implemented the informatics based tools as a computer based practice support tool and testing performed usability testing on the computer based tool.;This dissertation makes contributions to the fields of health informatics and palliative care. For health informatics it illustrates how to apply qualitative research methods to capture and organize knowledge around a complex healthcare domain area. The dissertation also illustrates how to use that knowledge to extend existing work on ontology based information system (IS) design by using that knowledge to develop a set of empirically derived informatics based solutions and then implementing the solutions as a computer based tool. The dissertation makes a contribution to palliative SPM by identifying practice support needs for SPM including linkages between research and practice, promotion of a common SPM vocabulary, and an approach to information handling to help manage the complexity of SPM.;The results show that qualitative methods can be used to capture and understand the practice support needs for palliative SPM, which include a number of processes and information to support SPM. The practice support needs were then used to develop a set of informatics based solutions consisting of an ontology, a set of problem solving methods and an empirically derived vocabulary for palliative SPM. The informatics based solutions then became the design requirements for a computer based tool that provided comprehensive practice support for palliative SPM. The testing phase of the research used usability testing to test the functionality of the computer based tool. Usability testing was favorable to the question of how well does the computer based tool provide practice support for palliative SPM.