Ellen Anna Andreassen Jaatun

Designing a reliable pain drawing tool: avoiding interaction flaws by better tailoring to patients' impairments

AbstractPatients with advanced cancer are influenced by the disease itself and by treatment side effects, both of which may have great impact on their lives. One of the most distressing symptoms is pain. However, pain in cancer patients can in most cases be relieved if the patient is able to communicate the nature and severity of the problem to the healthcare professionals through an effective assessment process. The main goal of this paper is to help form an understanding of central patient characteristics that should be taken into account when designing pain assessment tools for patients with advanced cancer. Traditionally, pain has been assessed by paper-based questionnaires and pain drawings. An iterative study was conducted based on repeated cycles of usability testing of a computerized pain body map for communicating pain by advanced cancer patients. Our aim was to provide a patient interface that most patients were able to interact with, collecting valuable, granular pain information with a minimum of strain on the patient. Through this process, we identified and solved design issues related to the sickest and frailest cancer patients. We further created a web-based solution for collecting individual pain drawings for evaluation by clinicians. The concept was appreciated by the patients, and the information provided was considered valuable by physicians. The main contribution of this paper is a list of suggestions to guide the design of an interactive tool for patients with advanced cancer.

Proceed with Caution: Transition from Paper to Computerized Pain Body Maps☆

Abstract Patients with advanced-stage cancer often have a high symptom burden and reduced functional status, implying that the patients themselves should be involved in development and testing of interactive assessment tools. This paper reports on an assessment of use of a pain tool, which led to changes in both medium and program in order to adapt to the patients’ needs and abilities. Our study shows how a change in medium for pain assessment from paper via laptop to iPad affects the interaction with the tool on important aspects of use. We also show how changes of medium affect the readability of the output for health care workers. We achieved better results with an iPad-based pain assessment tool developed through user-centered design compared to both a paper-based and conventional laptop-based tool.

An improved digital pain body map

Designing for the sickest and frailest cancer patients requires an even higher level of user involvement than traditional software development. This paper reports on design and evaluation of a pain assessment tool, where changes of the deployment platform from paper, via laptop to iPad affect the interaction with the tool. We also show how changes of medium affect the readability of the output for health care workers. We found that using the iPad platform and an iterative user centered development process produced the most suitable pain assessment tool for this patient group.

Service innovation from the edges: enhanced by telemedicine decision support

Abstract Increased prevalence of diabetes creates a need for improved care. Diabetes, as a chronic disease in which the patient is a central asset for effective care, is relevant as an illustrative example for also other chronic diseases that are on the rise globally. Such diseases demand localised co-produced healthcare services that respond to the need for integrated health care. The aim of the current paper was to investigate how telemedicine may facilitate patient consultations that improve quality, efficiency and patient involvement. Patient consultations facilitated by telemedicine were evaluated by the means of qualitative questionnaires to specialist, general practitioner and patients. The questionnaires revealed that the patient consultations improved quality of health care and saved time and cost. Findings suggest that such tripartite consultations may lead to outcomes where patients are empowered to take a more active role, the general practitioner increases his knowledge and competence, and the specialist is able to have a more holistic approach grounded in an understanding of patient history and local context. The support of telemedicine strengthens the consultations in terms of synchronous communication with visual clues and reduces time spent on the consultation by the specialist and travel time and cost for the patient. The contribution of this paper is to demonstrate how telemedicine can provide improved patient consultations by altering the established system of healthcare delivery.

Users' perceptions on digital visualization of neuropathic cancer-related pain

Quality pain management implies a thorough pain assessment with structured communication between patients and healthcare providers. Pain distribution is an important dimension of cancer pain. Assessment of pain distribution is commonly performed on a pain body map. This study explores how a computerized pain body map may function as a communication tool and visualize pain in patients with advanced cancer. In previous studies, we have developed a tablet-based computerized pain body map for use in cancer patients. The aim of this study was to adapt the computerized pain body map program to patients with neuropathic cancer-related pain, and to develop a separate interface for healthcare providers. We also wanted to investigate the perceived usefulness of this system among patients and healthcare providers. Both patients and healthcare providers perceived that the visualization of pain in the computerized pain body map system had potential to be a positive contribution to clinical pain management, and to improve collaboration between healthcare providers.

Advanced Healthcare Services Enabled by a Computerized Pain Body Map

Pain Body Maps are promising tools for patients with advanced cancer. We briefly present Computerised Pain Body Maps from the literature, and contrast them with our own CPBM specifically designed for this patient group. Furthermore, we ponder the fact that current CPBMs do not really offer any more functionality than the paper PBMs, but show how a fully-functioning CPBM system is a prerequisite to many innovations in pain management.