{"doi":"10.1093/jamia/ocab033","title":"Feeling better on hemodialysis: user-centered design requirements for promoting patient involvement in the prevention of treatment complications","abstract":"OBJECTIVE: Hemodialysis patients frequently experience dialysis therapy sessions complicated by intradialytic hypotension (IDH), a major patient safety concern. We investigate user-centered design requirements for a theory-informed, peer mentoring-based, informatics intervention to activate patients toward IDH prevention. METHODS: We conducted observations (156 hours) and interviews (n = 28) with patients in 3 hemodialysis clinics, followed by 9 focus groups (including participatory design activities) with patients (n = 17). Inductive and deductive analyses resulted in themes and design principles linked to constructs from social, cognitive, and self-determination theories. RESULTS: Hemodialysis patients want an informatics intervention for IDH prevention that collapses distance between patients, peers, and family; harnesses patients' strength of character and resolve in all parts of their life; respects and supports patients' individual needs, preferences, and choices; and links \"feeling better on dialysis\" to becoming more involved in IDH prevention. Related design principles included designing for: depth of interpersonal connections; positivity; individual choice and initiative; and comprehension of connections and possible actions. DISCUSSION: Findings advance the design of informatics interventions by presenting design requirements for outpatient safety and addressing key design opportunities for informatics to support patient involvement; these include incorporation of behavior change theories. Results also demonstrate the meaning of design choices for hemodialysis patients in the context of their experiences; this may have applicability to other populations with serious illnesses. CONCLUSION: The resulting patient-facing informatics intervention will be evaluated in a pragmatic cluster-randomized controlled trial in 28 hemodialysis facilities in 4 US regions.","journal":"Journal of the American Medical Informatics Association","year":2021,"id":174465,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":23,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9656,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":713970,"name":"Leah Brand Hein","orcid":"0000-0002-7465-0642","position":1,"is_corresponding":false},{"id":713971,"name":"Zhaoxian Hu","orcid":"0000-0002-5339-4942","position":2,"is_corresponding":false},{"id":265839,"name":"Rajiv Saran","orcid":"0000-0001-7317-8756","position":3,"is_corresponding":false},{"id":713972,"name":"Marissa Argentina","orcid":"0000-0003-1974-626X","position":4,"is_corresponding":false},{"id":265844,"name":"Jennifer L. Bragg‐Gresham","orcid":"0000-0002-9069-9489","position":5,"is_corresponding":false},{"id":377019,"name":"Sarah L. Krein","orcid":"0000-0003-2111-8131","position":6,"is_corresponding":false},{"id":246510,"name":"Brenda W. Gillespie","orcid":"0000-0003-4488-0612","position":7,"is_corresponding":false},{"id":274509,"name":"Kai Zheng","orcid":"0000-0003-4121-4948","position":8,"is_corresponding":false},{"id":625647,"name":"Tiffany C. Veinot","orcid":"0000-0003-1200-9515","position":9,"is_corresponding":false},{"id":713969,"name":"Matthew Willis","orcid":"0000-0002-9120-7319","position":0,"is_corresponding":true}],"reference_count":105,"raw_metadata":null,"created_at":"2026-07-18T23:47:06.584146Z","pmid":"34117493","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}