129 A Human-Centered Design Approach to Develop Oral Health Nursing Interventions in Patients with a Psychotic Disorder Methods Study Design For this study, a qualitative, descriptive, interpretative design was conducted to gain insight into the attitudes, barriers and needs of MHNs regarding oral health in patients with a psychotic disorder. To determine the contributions to practice, a human-centered design (HCD) approach was adopted. An HCD approach is a co-creative, iterative, and creative approach with non-linear steps to problem-solving to provide tailor-made solutions for severe problems [25]. This participatory and iterative HCD approach differed from other methods by empathizing with MHNs from the start of the project and working in co-creation with MHNs to develop a deeper understanding of their needs and, therefore, design more suitable interventions and give them a decisive voice in solution directions [26,27]. One widely applied HCD approach for innovative design projects is the Double Diamond (DD) framework, which was developed by the Design Council [28]. This DD framework guides problem-solving thinking in the HCD design process. The current study focused on the first, exploratory, steps in this process (the “discover” and “define” phases of the DD framework) aimed at one major task: the intervention must address the key issues of the problem, and thus, the needs of the end users [28]. The iterative stages in the research process are shown in Figure 1. The participation of MHNs throughout the design process has several purposes: (a) at the start, the participation of MHNs helped us to explore the context of mental health professionals, including their worldviews and needs; (b) the MHNs could participate in constructing and/or utilizing prototypes; (c) the MHNs could give feedback in user tests; and (d) the MHNs could give insight into the system in which an intervention should be implemented and the needs of MHNs in caring for patients with a psychotic disorder [29–31]. Population In one of the first steps (step 1a), we conducted contextual interviews (Figure 1). To achieve maximum variation in our sample, a representative sample of participants was selected by the research team [32] based on their knowledge, years of experience with patients with a psychotic disorder in all stages [33], and affinity with oral health. In this step, various levels of MHNs were included: bachelor’s-level mental health nurses, bachelor’s students of mental health nursing, master’s-level advanced nurse practitioners, students of the master’s degree of advanced nurse 5
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