| 1. |
- Engvall, Gunn, 1955-, et al.
(författare)
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Children's experiences and responses towards an intervention for psychological preparation for radiotherapy.
- 2018
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Ingår i: Radiation Oncology. - : Springer Science and Business Media LLC. - 1748-717X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Children can experience distress when undergoing radiotherapy as a reaction to being scared of and unfamiliar with the procedure. The aim was to evaluate children's experiences and responses towards an intervention for psychological preparation for radiotherapy.METHODS: A case control design with qualitative content analysis of semi-structured interviews and statistical analysis of anxiety ratings were used for evaluating a strategy for psychological preparation and distraction. Fifty-seven children aged 2 to 18 years and their parents participated - 30 children in the baseline group and 27 in the intervention group. Child interviews were performed and the child and their parents rated the child's anxiety.RESULTS: The intervention was most appropriate for the younger children, who enjoyed the digital story, the stuffed animal and training with their parents. There were some technical problems and the digital story was not detailed enough to fit exactly with various cancer diagnoses. Children described suggestions for improvement of the intervention. The ratings of the child's anxiety during radiation treatment showed no differences between the baseline group and the intervention group.CONCLUSIONS: The children of all the age groups experienced their interventions as positive. The strength of the intervention was that it encouraged interaction within the family and provided an opportunity for siblings and peers to take part in what the child was going through. Future research on children's experiences to interventions should be encouraged. The intervention and the technical solutions could improve by further development.
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| 2. |
- Engvall, Gunn, et al.
(författare)
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It Is Tough and Tiring but It Works - Children's Experiences of Undergoing Radiotherapy
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- Approximately 300 children ages 0 to 18 are diagnosed with cancer in Sweden every year, and 80 to 90 of them undergo radiotherapy treatment. The aim was to describe children's experiences of preparing for and undergoing radiotherapy, and furthermore to describe children's suggestions for improvement. Thirteen children between the ages of 5 and 15 with various cancer diagnoses were interviewed. Data was analyzed using qualitative content analysis. The findings revealed five categories: positive and negative experiences with hospital stays and practical arrangements; age-appropriate information, communication, and guidance to various degrees; struggle with emotions; use of distraction and other suitable coping strategies; and children's suggestions for improvement during radiotherapy. An overarching theme emerged: "It is tough and tiring but it works". Some key areas were: explanatory visits, the need for information and communication, being afraid, discomfort and suffering, the need for media distraction, dealing with emotions, and the need for support. A systematic, family-centered preparation program could possible help families prepare and individualized distraction during radiotherapy could contribute to reducing distress. Further studies with interventions could clarify successful programs.
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| 3. |
- Mullaney, Tara, 1980-
(författare)
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Designing for enduring product relationships
- 2010
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Ingår i: Proceedings of the 7th International Conference on Design and Emotion. - 9780615406664
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Konferensbidrag (refereegranskat)abstract
- How can we design products that forge durable emotional connections with their users? This paper takes a close look at human-product interactions, and uses this information to identify four important design principles that can help facilitate user engagement and attachment. A product that facilitates meaningful interactions with users, is capable of changing and evolving through use, actively responds to its environment, and awakens memories through sensory inputs will form a stronger emotional attachment with its user than a static, inanimate one. Understanding the dynamic properties of materials and technology, and integrating them appropriately into a product's design will engender the formation of sustainable and emotionally engaging connections. Designing for enduring human-object relationships requires that we step away from the constraints of industry and create new models of production, consumption, and repair that support the longevity of our attachments with these objects.
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| 4. |
- Mullaney, Tara, 1980-
(författare)
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Emotional wellbeing and radiotherapy : a methodological approach to improving the patient experience
- 2011
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Ingår i: Procedings of the Second Conference on Creativity and Innovation in Design. - New York, NY, USA : ACM. - 9781450307543 ; , s. 435-436
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Konferensbidrag (refereegranskat)abstract
- Medical technological advances have been instrumental in improving the physical health of many individuals over the past 50 years. However, the impact that a patient’s care experience has on their emotional health has just begun to be explored. Using quantitative, qualitative, and design research methods, I am researching stress, anxiety, and perceptions of care in cancer patients undergoing radiation therapy. This 3-tiered methodological approach allows me to create a holistic understanding of the patient experience. Based upon insights gained from this data, I am implementing design interventions within this environment to evaluate their ability to improve the patient experience.
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| 5. |
- Mullaney, Tara, et al.
(författare)
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Positional acts : using a kinect sensor to reconfigure patient roles within radiotherapy treatment
- 2014
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Ingår i: Proceedings of the 8th International Conference on Tangible, Embedded and Embodied Interaction. - New York, NY, USA : ACM. ; , s. 93-96
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Konferensbidrag (refereegranskat)abstract
- With many medical procedures done today, patients are forced to act as passive recipients of care, while nurses and doctors are actively involved in the process of diagnosis or treatment. In this paper, we focus upon patient positioning for radiotherapy treatment, looking at the immobilization and positioning techniques used, and the role of the patient in this process. Our desire to engage patients in the positioning process led to the creation of an experimental positioning system which can enable patients to self-position themselves for treatment. Utilizing the body tracking and skeletal data capabilities of a Kinect™ sensor, our prototype provides visualizations of where an individual's body is in relation to the desired position, and when these two positions have become correctly aligned. Testing demonstrated how our prototype could be used to actively engage patients in the positioning process together with care providers, in a mutually empowering and supportive way.
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| 6. |
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| 7. |
- Mullaney, Tara, 1980-, et al.
(författare)
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System, site, patient : A three-tiered methodological approach to constructing holistic understanding of the user through design research
- 2012
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Ingår i: Proceedings of the Design Research Society International Conference.
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Konferensbidrag (refereegranskat)abstract
- This paper argues that the methods and methodologies used to conduct user research often provide a singular view of the user. It aims to demonstrate that by combining the strengths of three different research methodologies into a structured, correlative research platform we can create a rich, more holistic understanding of our users. Using a three-tiered methodological approach to research the cancer patient experience, we investigated patient anxiety and the emotional impact that curative radiation therapy has on these individuals. Our methodology, comprised of methods taken from quantitative, qualitative, and design research approaches, was designed to construct a research platform that would allow us to gather quantifiable data about our patient population while also using more qualitative approaches to gain a deeper understanding of the individuals’ patient experience. We used patient questionnaires as our quantitative method, user observations and interviews as our qualitative methods, and design probe kits as our design method. Each method was chosen because of its ability to provide us with a different perspective on the patients’ clinical experience. By structuring these methods around the same shared research question, we were able to find correlative relationships between the data collected from each, despite their different methodological approaches. This paper demonstrates that our three-tiered methodology provides a deep understanding of the user experience, from a systems level view down to that of the patient. In conclusion, this paper argues that it is important for design researches to select methods that build upon each other and provide different perspectives of the user, in order to create a holistic understanding of the user experience.
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| 8. |
- Mullaney, Tara, 1980-, et al.
(författare)
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The influence of a department's psychosocial climate and treatment environment on cancer patients' anxiety during radiotherapy
- 2016
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 20, s. 113-118
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The objective of this study is to determine whether there is a relationship between cancer patients' perceptions of the person-centeredness of their treatment experience and their anxiety levels during treatment.METHOD: A questionnaire was distributed to adult cancer patients going through external beam radiotherapy (RT) with curative intent at a university hospital in Sweden (n = 892), which included two surveys, the State Trait Anxiety Inventory-state specific questions (STAI-S), and the Patient-centered Climate Questionnaire (PCQ) and additional treatment-specific questions. Eligible patients were provided with the questionnaire on their seventh day of RT by an RT-nurse.RESULTS: Statistical analysis showed a significant negative relationship between STAI-S scores and PCQ scores, and a significant positive relationship between the Treatment Environment questions and the STAI-S scores. Multivariate regression modeling found the PCQ subscale of safety to have the strongest negative association with STAI-S scores, showing that a climate of safety can significantly decrease patient situational anxiety levels. On the other hand, difficulty tolerating the overall treatment experience, worry about the treatment equipment, or feelings of isolation or claustrophobia within the treatment room all significantly factor into increases in patient-reported situational anxiety levels.CONCLUSION: Both the treatment environment and the psychosocial climate of the RT clinic significantly impact cancer patient state anxiety levels. These findings suggest that actively employing a person-centered approach during RT, and designing the treatment environment to be more attentive to the patient experience can both play a significant role in decreasing patient situational anxiety during treatment.
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| 9. |
- Mullaney, Tara, 1980-
(författare)
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Thinking beyond the Cure : a constructive design research investigation into the patient experience of radiotherapy
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This constructive design research dissertation aims to understand how design can be used as part of a composite research approach to generate knowledge about how complex phenomena are composed through their interactions and relationships with various actors, both human and non-human. It has done this by investigating a single phenomenon, the patient experience of radiotherapy.Through the purposeful selection and application of methods, theories, and existing research from design, nursing, and STS, this thesis utilizes a mixed-method approach comprised of qualitative, quantitative methods, and design experimentation, across multiple research sites and patient populations, in three research projects – PERT, DUMBO, and POIS – to generate rich and layered knowledge of the patient experience. Experience prototypes are used to challenge, through intervention or provocation, the relationships between the various radiotherapy actors identified through the empirical methods. Together, the research generated in PERT, DUMBO, and POIS construct a map of the networked, interdependent actors which shape the patient’s emotional experience of radiotherapy: the staff, technology, information, environment, and institutions. It also calls attention to the problematic relationship between radiotherapy patients and the technologies used to treat them, which can lead to anxiety, worry, and fear.This thesis offers contributions related to both improving patient experience and designing for complex social issues. First, this research suggests that individuals, other than primary users, need to be acknowledged in the design of medical technologies. It proposes calling attention to patients by naming them as interactors in their relationships with the aforementioned technologies, removing them from the role of implicated actor. Second, this thesis problematizes treating the actors within a network as independent entities, which medical research and user-centered design often does, and calls for a new type of design practice which attends to these networked relationships. Third, this thesis suggests two ways in which design research practice should be shifted methodologically if it wants to engage with and design for complex social issues like patient experience; widening the researcher’s perspective on the issue through the use of a composite methodology, and having the researcher maintain this scope by remaining closely connected to their research context. The implications of this work concern how design research, design education, and design practice might shift their approaches to fully acknowledge and attend to the complexity of systems like healthcare.
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| 10. |
- Mullaney, Tara, et al.
(författare)
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Thinking beyond the cure : a case for human-centered design in cancer care
- 2012
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Ingår i: International Journal of Design. - : Chinese Institute of Design. - 1991-3761 .- 1994-036X. ; 6:3, s. 27-39
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we explore how human-centered design can expand the solution space surrounding patient experience in healthcare, looking specifically at patient emotional wellbeing. The findings presented here are taken from our ethnographic research of cancer patients undergoing radiotherapy treatment; we investigated these individuals' emotional experiences during their time in the treatment facility. Building upon previous findings within the field of nursing concerned with the prevalence of anxiety in cancer patients and the importance of person-centered care, we implement a human-centered design research approach to investigate the situational triggers of patient anxiety within the radiotherapy treatment experience. Through 'quick ethnography', we recognize that the fixation technology used within radiotherapy is a key trigger for anxiety in patients. Application of theory from the field of science and technology studies to our analysis of this technologically-mediated anxiety suggests that the fixation device confines the patient to a passive, disempowered role within its interactions due to it being embedded with the socially scripted 'sick role'. Summarizing our insights, we find that human-centered design is capable of looking holistically at patient experience to discover new solutions spaces for mediating and preventing situational anxiety, and turning person-centered care within Radiotherapy into a pre-emptive practice instead of a responsive one.
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| 11. |
- Mullaney, Tara, 1980-, et al.
(författare)
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Wellbeing in healthcare environments : a human-centered design research approach to improving the cancer patient experience during radiation therapy
- 2011
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Ingår i: Proceedings of the 1st European Conference on Design 4 Health 2011. - Sheffield Hallam University, Art & Design Research Centre. - 9781843873525 ; , s. 255-265
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Konferensbidrag (refereegranskat)abstract
- Healthcare and medical products are often designed with the singular focus of providing the best treatment available to patients. However, research has shown that this treatment-based approach does not result in quality care. There are many factors that play into making a healthcare experience patient-centered, and this paper explores the use of human-centered design research to understand this experience. This paper presents a case-study of a Radiotherapy Department at a University Hospital, where we used patient survey, observational, and narrative data to gain awareness into the patient experience during radiation therapy. Our research shows how the current radiotherapy environment is anxiety provoking to the patient, and how insights gained from the written and visual stories of the patients’ experiences were used to develop a design solution that improves the patient view in the treatment room with the intent to make this space more patient-centered and inviting. In conclusion, this paper argues that designing for the patient experience and their emotional wellbeing is a crucial aspect of any healthcare service.
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| 12. |
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| 13. |
- Mullaney, Tara, 1980-, et al.
(författare)
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Why ‘design research practice’ is not design as we know it
- 2014
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Ingår i: Proceedings of DRS 2014. - Umeå : Umeå University. - 9789176010686 ; , s. 1039-1048
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Konferensbidrag (refereegranskat)abstract
- Is there a difference between design practice and design research practice? Building on recent discussions within design research about whether the design practice which occurs within design research is distinct and separate from the design practice which occurs within the design profession, this paper presents a case where constructive design practice was employed within a research project, using this example to study the nature of the design process in research. Through a thorough analysis of the designs generated, the motivations behind their development, their use as research tools, and the knowledge they generated, we identified three ways in which the design process was altered when it was imported into the research. First, the degree of development of the designs shifted from fully functional to functional enough. Second, the designs were developed in order to ask questions rather than trying to solve a problem. And finally, the failure of the design was equally able to contribute to generating knowledge as its success. We argue that these shifts in values clearly distinguish design research practice from professional design practice, but come with very real consequences that challenge the core measures we use to assess design.
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| 14. |
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| 15. |
- Ångström-Brännström, Charlotte, et al.
(författare)
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Children Undergoing Radiotherapy : Swedish Parents' Experiences and Suggestions for Improvement
- 2015
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Ingår i: PLOS ONE. - : Public library science. - 1932-6203. ; 10:10
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Tidskriftsartikel (refereegranskat)abstract
- Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80-90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child's and the parent's view of the procedure. As part of an ongoing multi-center study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents' experience when their child undergoes radiotherapy treatment, and to report parents' suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2-16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people's lives upside down, affecting the entire family. Further, the parents experience the child's suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process.
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| 16. |
- Ångström-Brännström, Charlotte, et al.
(författare)
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Parents’ experiences and responses to an intervention for psychological preparation of children and families during the child’s radiotherapy
- 2018
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Ingår i: Journal of Pediatric Oncology Nursing. - : Sage Publications. - 1043-4542 .- 1532-8457. ; 35:2, s. 132-148
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate parents’ experiences and responses to a systematic intervention for psychological preparation of children and families during the child’s radiotherapy (RT) treatment. In this case-control study at 3 pediatric RT centers, an intervention with a preparatory kit, including age-adjusted information on tablets, gift of a stuffed toy or a pair of headphones, a parent booklet, and toy models of the computed tomography and RT machines was implemented. For evaluation, a mixed methods data collection was conducted. A total of 113 parents of children undergoing RT were included—n = 59 in the baseline group and n = 54 in the intervention group. Health-related quality of life was rated low, but parents in the intervention group expressed less anxiety after the RT compared with the baseline group. They found information suitable for their young children, siblings, and friends were involved and the toy models were used for play. Parents expressed positive feelings due to close interaction with staff and each other within the family. The solutions developed within a human-centered design approach and shaped as a systematic family-centered strategy contributed to parents understanding and coping with the child’s RT.
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