Academic journal article International Journal of Design

Using Phenomenological Hermeneutics to Gain Understanding of Stakeholders in Healthcare Contexts

Academic journal article International Journal of Design

Using Phenomenological Hermeneutics to Gain Understanding of Stakeholders in Healthcare Contexts

Article excerpt


Human-centered design represents an overall perspective wherein human needs and concerns are the foremost drivers for the development of technologies. As such, human-centered design research deals with people who use or who are potential users of products and services, and it aims to provide frameworks that can contribute to more successful solutions (Roth, 1999). Human-centered design applied to healthcare contexts is important for at least two reasons. First, medical products and services that fail to respond to the needs of the stakeholders can, at worst, have disastrous consequences. As such, the healthcare context imposes on designers a special responsibility to ensure that products and services are well adapted to a wide variety of stakeholders, such as patients and healthcare personnel. Second, medical products are typically used and purchased because people need them, rather than because they have a special desire to use them. Since users do not have a choice in using these products, it is important for designers to be sensitive to stakeholders and use context. In this paper we suggest that such sensitivity can be accomplished through seeking gained understanding of stakeholders and use contexts by using phenomenological hermeneutics.

In this article, the term 'stakeholder' is employed for individuals and groups who have a direct interest in the product or service, the situation and its development (Eason, 1998). There is a need for more knowledge on how designers can gain an understanding of stakeholders' experiences with products that they are compelled to use for medical reasons. Despite the desire to pay special attention to people, the application of human-centered design principles in healthcare contexts can be challenging for a number of reasons. Health-related issues are often vulnerable. For this reason, it can be difficult not only to actually come in contact with people and involve them in studies but also to relate to people's experiences, which can be demanding. As such, healthcare contexts often challenge designers because people and their situations can appear hard to reach and relate to.

Although phenomenological hermeneutics has at its core an acknowledgement of a human-centered view based on lived experience, it has received limited attention in design literature. This article is an attempt to understand how human-centered designers can benefit from taking a phenomenological hermeneutics perspective for meeting the needs of stakeholders in healthcare contexts. We are not drawing an explicit distinction between the notions of hermeneutic phenomenology and phenomenological hermeneutics. As Paul Ricoeur (1975) emphasized in 'Phenomenology and Hermeneutics':

The question is no longer to define hermeneutics as an inquiry into psychological intentions which are hidden in the text, but as the explication of the being-in the-world shown by the text. (p. 93)

An analytic distinction can be made in that phenomenological hermeneutics is sometimes used to describe a method aiming at a certain phenomenon (Lindseth & Norberg, 2004), while a characteristic of hermeneutic phenomenology is to present a rich and deep account of the phenomenon by simultaneously acknowledging one's own implicit assumptions about it as well as one's attempt to make them explicit (Cohen, 2001). One reason to choose phenomenological hermeneutics for this article is that to be hermeneutic means to be aware of one's own perceptions and experiences in a subjective, cultural, and historical context (this is referred to as the lifeworld) and include them in the interpretation process. Thus, in the ductus of phenomenological hermeneutics, the main question of this article is not "How should we analyze care?" Rather, it is one of the following: How do the stakeholders experience care in the hospital situation? What is the core of their experience? What can I, as a designer, learn from them, and how? The results of such research is then to elucidate what a particular caring experience means for parents and nurses in order to learn more about how to design sensible products for children's medical treatment. …

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