Self-care Technologies in HCI: Trends, Tensions, and Opportunities

A patient who is self managing a chronic condition is actively involved in the prevention, understanding and regulation of his symptoms by means of his behavior and choices. The most diffused self management theories and strategies are presented, with an accent on those that can be relevant for supporting solutions in Healthcare HCI. The user centered design process is explained by making the example of a project for the development of tools supporting the self management of stroke, congestive hearth failure and chronic pain. Paper prototypes are illustrated throughout the work

International Conference on Pervasive Technologies Related to Assistive Environments, 2009

This paper describes an interdisciplinary, user-centered approach to the design of healthcare technologies, involving clinicians, therapists, developers, Human-Computer Interaction (HCI) and Health and Social Care researchers. Our starting point has been to understand patients' experiences of becoming ill through a series of focus groups with health professionals, patients and their carers. We used the metaphor of illness as a journey to capture those experiences. We have also reviewed data in the public domain (http://www.healthtalkonline.org). We have employed a theoretical framework which combines concepts from Activity Theory and other social sciences approaches to model illnesses. We outlined a set of design concepts for the design of the SMART 2 system which are emerging from our analysis of the patient experience.

futurecomm.tssg.org

With the actual aging population and the increase in chronic diseases, the health care sector has to deal with an increasing shortage of professional personnel and constantly increasing costs caused by the development of new treatments in combination with a rising demand for them. A corresponding movement of technologies and information will unavoidably accompany the displacement of treatments from hospitals, clinics and expert users to domestic environments and lay people. Consequently, patients will be more and more invested with opportunities to take care of their health on their own, in their home environments. In this scenario, self-care and patient empowerment become phenomena of increasing importance and have an ever increasing impact on the health care sector and, more in generally, on our society. Self-diagnosis and measuring devices will allow better monitoring and support prevention; new technologically mediated treatments will allow patients to self-medicate in their domestic environments, thus fostering their autonomy in the management of their disease. However, this might raise issues about the lay appropriation of medical technology and information that originally belonged to expert professionals and that has now spread massively into domestic environments where users are neither trained or necessarily able or willing to deal with them. On the other hand, the notion of appropriation can also suggest a form of situated adaptation to personal practicalities that, in the context of patient experience, could actually contribute to rather than threaten the premises of patients' autonomy, centrality and empowerment although it might challenge the traditional dependencies on institutionalized health care professionals. When thinking in these terms, we are confronted with a trade off between autonomy and control on the one hand, and safe and unsafe behaviour on the other and this makes the notion of appropriation difficult to address in this changing and controversial scenario. In this work, I aim to focus on some aspects of self-care practices and their implications for the patient by investigating the appropriation of self-measurement devices (in particular, blood pressure monitors and glucose meters) that represent -at least in their premises and given their recent mass diffusion -an interesting step toward the establishment of technologically mediated self-care practices and patient empowerment. Through a variety of cases from field investigations, I want to show that, as these devices migrated into lay patients' lives and their domestic environment, we are confronted with a series of different instances of appropriation where self-measurement and patient empowerment and autonomy take different forms. Embedded in the everyday practices of patients, self-measurement devices sometimes become the means for the development of autonomous self-care practices even if this might redefine their interdependency with some health care professionals; at other times, they instead lead to the development of unsafe and frantic practices that complicate rather than ease the collective management of the disease and its cost. This poses worrying questions about the role of design and assessment in self-measurement devices in particular, and in self-care technology in general. In line with these concerns, and by showing how the appropriation of self-care technology is carried out differently by different patients in their domestic environments, the aim of this work is to argue that the association between a self-monitoring device (and more generally self-care technology) and a patient's empowerment and autonomy cannot be taken for granted and that the actual extension of care beyond hospitals, expert professionals and expert knowledge brings new risks and opportunities for the design and evaluation of future self-care technologies. The paper is organized as follows. Initially, I review the notion of appropriation and the various domains where it is discussed. Then, I show that when it comes to the health care sector, which is a safety critical domain, the notion of appropriation loses the attractiveness that it has recently gained in other domains. By referring to the work by and , I try to extend some of the concerns and points regarding the customization of medical devices by nurses in hospitals to the practice of self-testing by lay people in their homes. Instead of describing devices' customizations, I will show the role

CHI Conference on Human Factors in Computing Systems

We report on a Diary Study investigating daily practices of Selfcare by seven UK adults living with Human Immunodeficiency Virus (HIV), to understand their routines, experiences, needs and concerns, informing Self-care technology design to support living well. We advance a developing HCI literature evidencing how digital tools for self-managing health do not meet the complex needs of those living with long-term conditions, especially those from marginalised communities. Our evaluation of using a Self-care Diary as Design Probe responds to calls to study Self-care practices so that future digital health tools are better grounded in lived experiences of managing multi-morbidity. We contribute to HCI discourses including Personal Health Informatics, Lived Informatics and Reflection by illuminating psychosocial challenges for practicing and self-reporting on Self-care. We offer design implications from a Critical Digital Health perspective, addressing barriers to technology use related to trust, privacy, and representation, gaining new significance during the COVID-19 pandemic.

This paper aims to raise issues concerning the design of self-care technology, which supports an increasing number of individuals' chronic disease in everyday life. It discusses the results of an ethnographic study that exposes the intricacies and practicalities of managing diabetes in everyday life, and informs the patient-centric design of a diabetes journaling tool. It also sheds light on some everyday chronic self-care practices and suggests how to rethink some of the assumptions and connotations of the current medical model and the traditional role of the patient, which is not always fully appreciated in the design of ubiquitous and personal technologies for the patient. In particular, the analysis covers: the open-ended and uncertain nature of chronic care, the wide inter-and intra-variability of patients' conditions and attitudes towards the disease, and the need for more symmetrical interactions and consultations with medical experts. These findings informed the design of a proof of concept called Tag-it-Yourself (TiY), a mobile journaling tool that enables the personalisation of self-monitoring practices. A final discussion on the actual use of the TiY tool is also offered along with general implications for the design of self-care technologies and an outline of future directions for research in this area.

This article discusses implications for the design of evaluation studies of self-care technologies and practices with respect to a current shift toward technologically mediated self-care in health care. Through the notion of appropriation of technology , this article shows that as self-care devices migrated into lay patients' lives and their domestic environment, we are confronted with a series of different instances of appropriation where patient empowerment and autonomy take different forms. With a particular focus on self-monitoring devices such as blood-pressure monitors and glucose meters, the article examines a series of illustrative vignettes from an ethnographic study and discusses multiple forms of appropriation of self-care technology and the need to understand its implications on the design of studies for their evaluation. Three conclusive reflections to rethink the role of evaluation study in the current shift toward self-care are addressed: the need to move beyond technological determinism, the need to reflect on whose interests the evaluation serve, and the need to carefully rethink the very goal of evaluation studies in self-care themselves.

2013 46th Hawaii International Conference on System Sciences, 2013

support the self-care and management for healthy individuals as well as patients with chronic conditions. Despite these advances, the adoption and diffusion of these solutions into practice is limited. The objective of this paper is to enhance adoption and diffusion by providing actionable recommendations for the design of IT systems for self-care. The recommendations are grounded in socio-technical design theory and in an extensive review of self-care literature. The findings indicate that despite the diversity of disease conditions, users, technologies, and implementation environments, ITsolutions for self-care often fail to encompass a holistic socio-technical view. The design of such systems will need to account for the intrinsic and interrelated characteristics of the underlying tasks, actors, technologies, and environment. Baxter and Sommerville [6] (p. 4) refer to sociotechnical systems design (STSD) methods as "an approach to design that consider human, social and organizational factors, as well as technical factors in the design of organizational systems".

Journal of Medical Internet Research, 2008

Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care.

BMJ Open

IntroductionChronic diseases in older adults are one of the major epidemiological challenges of current times and leading cause of disability, poor quality of life, high healthcare costs and death. Self-management of chronic diseases is essential to improve health behaviours and health outcomes. Technology-assisted interventions have shown to improve self-management of chronic diseases. Virtual avatars can be a key factor for the acceptance of these technologies. Addison Care is a home-based telecare solution equipped with a virtual avatar named Addison, connecting older persons with their caregivers via an easy-to-use technology. A central advantage is that Addison Care provides access to self-management support for an up-to-now highly under-represented population—older persons with chronic disease(s), which enables them to profit from e-health in everyday life.Methods and analysisA pragmatic, non-randomised, one-arm pilot study applying an embedded mixed-methods approach will be c...

2010

The National Health Service (NHS) in the UK, like many other public health services worldwide, is facing a number of key challenges. Among them are an ageing population and a rising incidence of chronic health conditions. This situation requires a radical re-examination of how people manage their health and their healthcare in ways that challenge the relationship between people and healthcare services. Combining this observation with the opportunities afforded by pervasive information and communication technologies, we argue that design research should reach beyond simply locating devices and services to offer healthcare `in the home' and should examine this broader agenda. Rather than focussing design discourse on the specifics of one location, we should adopt a holistic view, beginning from people's lived experience. In this position paper we describe the User-Centred Healthcare Design (UCHD) project, 5-year collaboration between universities and NHS Trusts in South Yorkshire, UK. We suggest that new models of healthcare that re-define the institutional and social context of care are required if we are to meet the challenge of chronic illness. We describe our progress to date on the UCHD project, our commitment to placing patient experience at the centre of design, and our initial experiences of using an experience-based co-design method to improve outpatient services in a Sheffield hospital.