Publications

Background: Improving communication and information services for people receiving a joint (knee or hip) arthroplasty (TJA) should account for differences between patients. A survey study of 191 participants identified three subgroups of TJA patients with distinctive clinical, psychological, and communication characteristics.

Purpose: Complementing this segmentation, this study assessed individual preferences regarding communication and information provision in TJA.

Methods: 19 Patients participated in generative sessions, creating objects describing their TJA patient experience and their hopes for the future of TJA. Qualitative data was analysed through an inductive approach.

Results: Some participants wanted full information, others valued this less. Participants also reported different support needs, for instance at hospital discharge or during rehabilitation. Moreover, participants’ preferences for a social connection with care providers differed.

Conclusions: An individual patient’s mind-set, and their social support needs, in combination with their physical condition and medical history, should guide the provision of tailored services.

To achieve optimal patient-centered care for people undergoing a Total Hip Arthroplasty (THA), communication should ideally be tailored. In previous studies, three clusters of patients or patient ‘profiles’ were identified based on communication preferences and clinical and psychological characteristics as a starting point for tailored communication in orthopedics. This study aimed to formulate initial guidelines for the design of tailored communication and information provision based on these roles. Two design cases were each evaluated as storyboards with twelve patients (three, seven, and two patients of each role, respectively). Generic and functionality-specific preferences were indicated by participants for both design proposals. Similarities in feedback per role provided the basis for generating an initial set of role-specific guidelines, that can be used to design tailored information and communication solutions.

Objective: Tailored communication and information provision is expected to contribute to patient-centred care (PCC) in total hip arthroplasty (THA). In previous research, three subgroups of THA patients were identified that are similar in their clinical, psychological, and communication characteristics. Preliminary subgroup-specific design guidelines were also formulated. Using these insights as a starting point, a theoretical framework was developed for tailored information provision and communication using digital applications. This study aims to refine the framework as well as subgroup-specific design guidelines for digital applications.

Methods: This study uses a Research through Design (RtD) approach, generating insights both from the development and evaluation of prototypes in the early design stage. Paper-based prototypes will be made for each subgroup and evaluated with patients and care providers. Semi-structured interviews are held with participants exploring their experiences with the prototype. A quasi-experiment with a non-random control cohort is used to validate the qualitative findings. Post-surgery consultations with and without prototype are videotaped and scored using a structured instrument.

Results: A design diary will be used to summarize design decisions and considerations. Feedback from participants is analysed inductively. Adaptations in subgroup-specific guidelines will be based on comparison of verbal feedback and descriptive statistics from consultations with and without prototype.

Conclusions: Although mixed-method feasibility studies of digital health interventions are common, this protocol also considers the utility of the early design process and the designer’s perspective for realizing PCC and tailored care.

Objective: In previous research, three profiles of total hip arthroplasty (THA) patients were identified based on similarities in clinical, psychological, and communication characteristics. This study investigated the use of these profiles in a tailored information tool, which is expected to contribute to patient-centred care and communication (PCC).

Methods: This study used a Research through Design (RtD) approach, generating insights from the development and evaluation of prototypes. Paper-based prototypes were developed for each profile, including features for expectations management and self-monitoring. Semi-structured interviews with participants explored their experiences with the prototypes. To validate these findings, consultations with and without prototype were videotaped and compared using a structured instrument.

Results: In the design process, variations in content and framing for each profile were realized to a limited extent. Beyond this point, patient feedback was needed.

The evaluation revealed profile-related differences in preferences: The optimistic profile recommended positive, but strict information and checklists; the managing profile preferred a Q&A format for information and detailed recommendations on pain and activity levels; and the modest profile wanted stories from other patients and more room for writing down experiences. The impact of the prototypes on PCC during post-surgery consultations was most likely absent.

Conclusions: In the early stages of developing tailored information tools based on patient profiles, it is complicated to define relevant functions for tailoring and develop profile-specific variations of these functions. The profile-specific guidelines in this study can guide future design iterations. In general low-fidelity prototypes and several early iterations are recommended.

After a Total Hip Arthroplasty (THA), post-discharge contact moments with care providers may be scarce. Online resources may offer support, but Human Factors Engineering methods are needed to tailor these resources to patients’ varying post-surgery information needs. In order to evaluate tailored components in a web application and to refine guidelines for tailored Information and Communication Technology (ICT) in healthcare, the authors developed a tailored web application for THA patients. The web application informs THA patients about recommended activity levels in the first months after surgery using individualized thresholds based on daily step counts. The feedback given by the application is designed in three variants that match characteristics from three different THA patient subgroups (profiles) defined in previous research. To investigate the use and evaluation of this application, a small-scale qualitative study (20 patients, 3 care providers) will be conducted. Results will include qualitative feedback from patients and care providers, as well as metrics describing participants’ use of the application. This paper discusses the study methodology, including the application used.