Conceptualizing a Nursing Model for Integration of Patient Engagement Into Perinatal Digital Health Development and Quality Assurance: A Critical Interpretive Synthesis.

Abstract

This study examines current assumptions of digital transformation research in the perinatal context and constructs a nursing model through a critical interpretive synthesis. Perinatal digital transformation research is discussed and found to be lacking grounding in nursing concepts; nursing theory was integrated by examining data through the lenses of Woman- and Family-Centered Care (Person-centered Perinatal Care) and by applying Donabedian's Frame of quality assurance into the conceptual matrix. Here, iterative data collection occurred, initially through a scoping review examining the nature and range of perinatal digital health systems. Purposive sampling of empirical studies was conducted to saturate the data pool with all four attributes of patient engagement (access, personalization, therapeutic alliance, and commitment). Participatory action theory supported an abductive stage of analysis and informed pragmatic construction of the model. The model encompasses: (1) person-centered intervention mapping; (2) integration of process evaluation through stakeholder and user consultation; and (3) co-creation during real-life testing. The steps of the model are constructed to align with best practices in participatory action research, while holding nursing models as the foundational theoretical basis. This grounding in nursing theory will support a nursing lens for future action research related to the development of perinatal digital health systems.