Academic journal article International Journal of Design

Thinking beyond the Cure: A Case for Human-Centered Design in Cancer Care

Academic journal article International Journal of Design

Thinking beyond the Cure: A Case for Human-Centered Design in Cancer Care

Article excerpt

Introduction

Medical technologies are designed with the intention of improving patient health, with each new development aimed at increased detection and better treatment offerings. Nevertheless, sometimes the very devices intended to improve health result in negative, even traumatic, emotional experiences for the patient. In this article, we make a case for human-centered design (HCD) research within healthcare, to study the emotional aspects of treatment and the impact that the built care environment can have upon patient wellbeing.

Drawing from a wealth of nursing research investigating cancer patients' experiences of care, we first present nursing research showing that anxiety is a well-documented and commonly expressed emotional component of having cancer, along with findings which suggest that patient perceptions of the treatment environment and the care staff can play an important role in shaping their care experience. Within this paper, patient experience is defined as the sum of all interactions that influence patient perceptions across a continuum of care. The scope of our research is restricted to aspects of patient experience that occur solely within a radiotherapy clinic, i.e., the situational aspects of radiotherapy treatment. Analysis of nursing interventions aimed at managing patient anxiety shows that the current solution space of person-centered care (PCC) is focused on helping patients cope with their anxiety. This paper suggests that implementing a HCD approach to investigate the triggers of patient anxiety within cancer treatment can lead to a broader understanding of this problem area and its solution space.

We then present our case-study of a radiotherapy clinic at a large university hospital, where we employ 'quick' ethnographic methods to investigate cancer patients' experiences of radiotherapy treatment. Using a design lens we look closely at patients' interactions with care providers, the technology and the environment in order to identify situational sources of patient anxiety. Initial observational findings highlight the fixation device as a key technology within the radiation treatment process and patient experience. Further investigation of this technology, used to immobilize patients during radiation therapy, led to our critical analysis of it as a designed entity and its impact upon patient emotional wellbeing within this clinical setting.

Stories told by patients and the care staff, as well as images and detailed field-notes taken during our ethnographic investigation are used to highlight the negative emotional impact this technology has on patients during treatment. Using Science and Technology Studies (STS) theories about the social construction of technology, we analyze our observational findings to suggest why this particular technology elicits anxiety in patients. Going a step further, we assess how the impact of the fixation device can extend beyond creating negative emotions in the patient, to actually affecting the efficacy of the radiotherapy treatment. Based on our analysis of the fixation device, we present a brief summary of the many different ways in which design research can expand the solution space for dealing with patient anxiety within healthcare. The focus of this paper is not placed upon design solutions that have been implemented within the clinic, instead, it takes a detailed look at the process of problem identification, i.e., patient anxiety, and how HCD research can broaden the understanding of this problem and its potential solution spaces. The article ends with some reflections on the benefits of introducing a human-centered design approach to current cancer care practices.

Patient Centered Care

Evidence-based medicine is currently one of the predominant approaches within healthcare in the western world. It has been defined as an approach to healthcare that "integrates individual clinical expertise with the best available external clinical evidence from systematic research in order to ensure the best prediction of outcomes in medical treatment" (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996, p. …

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