151 A Human-Centered Design Approach to Develop Oral Health Nursing Interventions in Patients with a Psychotic Disorder Lastly, in line with MHNs’ holistic professional profiles [18], most MHNs indicated they considered the issue of oral health in patients with a psychotic disorder important, but in practice took little responsibility for this role. These personas show nuanced differences that should be considered when developing interventions because they will encourage MHNs to reflect on what they are doing and to take professional leadership. The results of this study showed the need for role clarification [45] and professional leadership. Professional behavior is defined as personal leadership, such as acting proactively, role modeling, taking initiative, self-reflection, showing assertiveness or courage, and being focused on good cooperation [58]. Each MHN should be able to recognize and reflect from their professional leadership on what kind of information or skill needs they have to act better. This fits into the professional nursing profiles. The question of how MHNs can take a professional leadership role and take responsibility for their role as MHNs is highly relevant in this regard, but this question cannot be answered based on this study alone. Further research among MHNs regarding MHN professional leadership related to maintaining and increasing oral health in patients with a psychotic disorder is indicated. Strength and Limitations of this Study A strength of our study was the use of an HCD approach with a rigorous yet flexible research process, leaving ample room for adaptation; this provided an in-depth understanding of the attitudes and perspectives, and the barriers, needs, and suggestions, of MHNs. Therefore, the MHNs were engaged in the entire process and all stages of this project. Our personas are the first personas regarding oral health in MHNs that were validated and can be used to serve as an empathic handover in the following phases of the design process to develop oral health interventions. Additionally, these personas can serve as stand-ins for MHNs when team members have to make design decisions [59]. Within this design, we used two iterations (the first iteration was to develop the personas, while the second iteration was to validate the personas), and we used various populations and methods for triangulation, which helped to validate the findings by combining different methods, which is important to prevent fundamental biases that arise from the use of a single method (as in more traditional qualitative research). The wide variety of sources we used in this study, as well as the persona validation which provided a rigorous check on personas, increased the ecological 5
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