Show me where it hurts
Show me where it hurts was a research project looking at how those with severe speech and physical impairments could use technology to effectively communicate pain to a doctor.
During this study I worked with a GP, several users with cerebral palsy (with varying degrees of severity) and their carers to develop a concept that could make a trip to the doctor a little less painful.
Background
“GP staff often struggle to communicate with people with communication disabilities, particularly if they do not know them well, and tend to rely on carers.”
Experiences of pain are internal, unique and can be shaped by a number of psychological and physiological factors. As such, it can be difficult to express and assess pain on an objective, universal scale. Medical professionals commonly assess pain using the SOCRATES model, which collects information about the Site, Onset, Character, Radiation, Associations, Time, Exacerbating Factors and Severity of the pain.
For patients with severe speech and physical impairments, accurately describing pain can be more challenging due to impairments affecting the ability to communicate. In these situations, patients with SSPIs often communicate through a mediating support worker (diminishing the privacy between patient and medical professional), or an Augmentative and Alternative Communication (AAC) device that the medical professional may have no training or experience with.
The Prototype
Several iterations of prototypes covering different technologies and methods for identifying pain. Each prototype was put under the scrutiny of the resident cerebral palsy user testing group at the University of Dundee.
With a short period of time, at was more effective to create a low-fidelity video concept to show the result of the research.
The platform:
A tablet app was decided as the best platform for the application. The doctor's surgery would own the device. Alternative options, such as having an app the patient could track changes in their condition were also considered by the researchers and the user group. This was the best option for all.
Tap size and recovery:
No need to be accurate, the patient can tap/hit anywhere on the screen. The countdown gives them the opportunity to make changes, if they were to tap the screen at the wrong time. the countdown does seem very long. But for our participants, any less time caused anxiety.
Pain location:
Starting with blocking out areas of the body and asking the patient more specific location questions as they go means that a fairly accurate location of the pain can be obtained very quickly. However, one area for improvement would be to identify the source of the pain or the worst pain, if the pain were all over the body.
Type of pain:
Icons to describe types of pain went through several iterations to ensure that each icon described the same type of pain for patient, the carer and the doctor. The focus groups on this were great fun.
Pain intensity:
Using the traditional 1-5 scale. This is instantly recognisable. Future iterations would cover if 1-5 were enough.
The rest of the SOCRATES pain model:
Unfortunately, this is as far as the project went. However, a more full solution would cover all 8 factors of the pain model.
