Challenges in co-designing an intervention to increase mobility in older patients: a qualitative study

Jeanette Kirk*, Thomas Bandholm, Ove Andersen, Rasmus Skov Husted, Tine Tjørnhøj-Thomsen, Per Nilsen, Mette Merete Pedersen

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Purpose: The aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase mobility in older medical patients admitted to two medical departments at two hospitals in Denmark. Design/methodology/approach: The study used a qualitative design to investigate the challenges of co-designing an intervention in five workshops involving health professionals, patients and relatives. “Challenges” are understood as “situations of being faced with something that needs great mental or physical effort in order to be done successfully and therefore tests a person's ability” (Cambridge Dictionary). Thematic content analysis was conducted with a background in the analytical question: “What key challenges arise in the material in relation to the co-design process?”. Findings: Two key challenges were identified: engagement and facilitation. These consisted of five sub-themes: recruiting patients and relatives, involving physicians, adjusting to a new researcher role, utilizing contextual knowledge and handling ethical dilemmas. Research limitations/implications: The population of patients and relatives participating in the workshops was small, which likely affected the co-design process. Practical implications: Researchers who want to use co-design must be prepared for the extra time required and the need for skills concerning engagement, communication, facilitation, negotiation and resolution of conflict. Time is also required for ethical discussions and considerations concerning different types of knowledge creation. Originality/value: Engaging stakeholders in co-design processes is increasingly encouraged. This study documents the key challenges in such processes and reports practical implications.

TidsskriftJournal of Health Organization and Management
Udgave nummer9
Sider (fra-til)140-162
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
The Danish Data Protection Agency (AHH-2016-080, I-Suite no. 05078) approved the study, which was funded by the Velux Foundations (F-21835-01-04-03), the Association of Danish Physiotherapists (PD-2018-30-10) and the Capital Region of Denmark (P-2018-2-11). The project adheres to the directives of the Declaration of Helsinki (). Anonymity was achieved by assigning stakeholders a code instead of using their full names in the field notes. The researchers maintained a confidential file of identifiers tied to the stakeholders' backgrounds, so that the workshop data (recordings and transcripts) could be coded as a basis for in-depth analysis. Before participating in the workshops, all stakeholders were informed about the aim of the study and were assured that participation was voluntary and that they and the results would be pseudo-anonymized. Because the head and frontline managers had approved the health professionals' participation in the workshop, written informed consent was not obtained from them; written informed consent was obtained from the patients and relatives. All stakeholders were given the opportunity to withdraw from being followed in their daily work, but none of the stakeholders did so.

Funding Information:
Funding was provided by Velux Foundation (Lauritz William Foundation) grant number [00013449], . The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Publisher Copyright:
© 2021, Jeanette Kirk, Thomas Bandholm, Ove Andersen, Rasmus Skov Husted, Tine Tjørnhøj-Thomsen, Per Nilsen and Mette Merete Pedersen.


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