Insight from patients with breathing issue
This project start from a design workshop with NHS and STEAMhouse. We had a research session with patients and physiotherapists to have a better understanding of their frustration in different situation. The aim of this project is framing a potential design approach to improve users problems.
Context
Problem
The lack of understanding and practice of breathing exercises is worsening the condition of patients with respiratory issues. One key challenge is that patients are unable to detect timing errors in their breathing patterns. Additionally, physiotherapists can only assess these errors through video calls, which often lack the precision needed for accurate evaluation.
Opportunity
Professional machines are available to collect various breathing data from patients, but they are too expensive for most individuals. A more accessible solution that provides accurate guidance could help alleviate the high demand for physiotherapy appointments, ensuring that those in critical need receive timely care.
Who are we design for?
While patients are the primary stakeholders benefiting from a solution that empowers them to learn, monitor, and evaluate their breathing exercises independently, physiotherapists also play a crucial role. Their expertise provides essential support, ensuring patients receive guidance and feedback to improve their performance.
Research
Shadowing and Interview
Patients need to perform a breathing exercise called the Active Cycle of Breathing Technique (ACBT), which can improve airway clearance by up to 89%. We spent two hours shadowing patients with breathing difficulties to observe their daily routines and how they manage their condition. Following this, we conducted an interview with a respiratory specialist physiotherapist to gain further insight into how they provide instructions and manage patient care.
Case Studies
We mapped out the ACBT process in detail and compared it to the exercise instructions given to patients, identifying patterns that lead to misunderstandings. We then examined three patients at different stages of their ACBT progress, working closely with a physiotherapist to gain specific insights from each case.
#1. The Beginner
User Case
“I am new to ACBT. I am still learning it based on the instruction but I am confuse when there are some optional steps when I get into the second round, I am not sure if I need to do that or not.”
Participants
👩🏾🦱 Alida (Patient) 👩⚕️ Amy (Respiratory Specialist Physiotherapist)
Insights
The confusion arose from the instructions for ACBT. While patients can book a video session to learn ACBT, some may not be able to attend. Simply reading the instructions may not be sufficient for patients to understand the exercise, especially without a physiotherapist present to guide and monitor them.
understanding monitoring
#2. The Special Case
User Case
“I am a special case as I cannot do a deep breathing as long as normal patient. I adjusted my exercise with Physiotherapist but sometimes I just not sure if I am doing it with the right timing or I would just forget to stop the action sooner, my chest would be in pain because of that.”
Participants
🧑🦳 Anna (Patient) 👩⚕️ Amy (Respiratory Specialist Physiotherapist)
Insights
It is challenging for physiotherapists to track whether patients are performing ACBT on time and correctly when they are at home. This is especially concerning for those who require customized adjustments. These special cases need to be monitored closely, as incorrect execution of the exercise could potentially cause harm.
monitoring communication
#3. The Frequenter
User Case
“I know that it is important to do the ACBT, which I need to do it 4 times per day. However, sometimes I just don’t know if I do it right or not unless I book a section with my Physiotherapist and she would tell me if I am doing it right.”
Participants
👨🦳 Joseph (Patient) 👩⚕️ Amy (Respiratory Specialist Physiotherapist)
Insights
Patients can book a video session with a physiotherapist to assess and evaluate their ACBT performance. However, this requires a significant time investment from both parties. Patients need to perform ACBT at least four times a day, while physiotherapists must monitor multiple patients simultaneously, making it a challenging and time-consuming process.
monitoring
Ideation
Hypothesis
Our research identified key pain points for both patients and physiotherapists. Using these insights, we created an affordable solution to capture breathing data. We believe tracking breathing duration will improve ACBT performance understanding and help spot mistakes, leading to better communication and increased exercise accuracy.
1️⃣ Patients can evaluate their breathing actions their own
2️⃣ Physiotherapists can compare patients performance to the ACBT standard
Principal and Criteria
Many existing products offer guidance for patients to follow specific breathing patterns. However, we require more detailed data to allow both patients and physiotherapists to analyse and assess each individual breathing action. To achieve this, they need a tool that is:
Measurable
They need a tool that displays data in a way that enables them to compare their performance with a set standard.
Recordable
They need a tool that can record their breathing data in a manner that is both specific and adaptable.
Noticeable
They need a tool that captures breathing data in a way that is clear and precise, allowing them to notice and identify the exact timing of each breath.
Pattern and Timing
The goal of the function we designed is to capture the breathing pattern and timing during a patient’s ACBT. We simplify the breathing actions by breaking them down into distinct steps, allowing the patient to focus more effectively on each individual action. This approach also enables us to collect specific data for each step of the process.
Mapping
We focus on collecting data on the duration of each breathing action, with triggers to start and stop recording. By mapping these actions to the capabilities of a mobile device, we provide an efficient, sustainable, and cost-effective way for patients and physiotherapists to evaluate breathing exercises.
Contribution & Collaboration
We invited some engineer and created a quick prototype to test whether the function meets our goal. We tested the solution with patients and physiotherapists to validate our hypothesis. Based on their feedback, we evaluated the impact of the function and identified areas for improvement.
Breathe and Tap
We record patients’ breathing actions using the mobile device’s affordances. They tap and hold the screen to start an action, then release their thumb once it’s complete. Once they become familiar with the mechanism, this direct mapping allows them to easily collect and view their breathing data on the screen.
The Comparison
By comparing their breathing data to the standard, patients can identify errors and assess their performance. Meanwhile, physiotherapists can adjust the standard timing based on the patient’s performance and provide immediate feedback.
Results
Participants' impression of the function
Patients and physiotherapists can identify errors in the ACBT exercise by comparing their data to the standard.
Participants describe the purpose of the function
“I can see if there are any wrong timing or delay of the breathing action. So I can know how “good” I am.”
100% Success Rate
All 3 patients completed the task– they needed an extra 10 minutes to practice synchronising their breathing with the thumb action. Both patients and physiotherapists believe this approach could effectively help evaluate ACBT performance.
Increases of understanding
They gain a clear understanding of their performance and can track their improvement by noticing a reduction in errors.
What’s Next
Things to inform future design decisions
The mapping between breathing actions and affordance is working but it need some time for patients to practice their muscle memory to synchronise their breath and their thumb. This tell us that we will need to make sure we provide a clear on boarding instruction for users to “warm up” when we design the product.
Area for further research
How might we better present patients’ performance on their device?
How we can cooperate with their tools while they are doing ACBT?
How we can provide better management for physiotherapists to consult their patients?
More case studies