Prospective user-oriented design of medical products - methods to foster compliance of selfapplied medical aids

Status:

completed 12/2011

Aims:

The acceptance of technical aids in medical rehabilitation as well as the methodological quality in the measurement of compliance should be improved. Most studies assessed the implementation of therapy recommendations only in a retrospective questioning.

Activities/Methods:

The usage of orthoses after surgeries of knee- or ankle-injuries was examined with an online survey to determine influences in the therapy behavior. Within six months 105 patients have been enrolled. The duration on use was monitored by a thermal sensor, which measured the temperature at the aid and stored date. During the course of therapy the measurements in treatments of 90 minutes have shown the time period of using medical aids.
Different approaches to improve the acceptance in technical aids were researched. At first characteristics of patients were considered, their satisfaction with the device or how they cope with problems. The usability of orthoses was similar important, especially in connection with developing new guidelines for a user-oriented design.

Results:

Patients who have been prescribed an ankle-foot-orthosis used their device for 50 % of therapeutical requirements on average. Patients with a knee-orthosis wear the device on average only for 30 % of the recommendations given after the surgery. The monitored wearing time was calculated in relation to the daily treatment regimen, e.g. during daytime only.
The intention and motivation for a continuous use were important conditions for a high acceptance but they required a detailed consultation when the device was handed over. In practice, health care providers had less time available and patients had to find their own strategies in coping with problems, e.g. interruption of the treatment if problems like pressure marks occurred.
For both types of devices similar usability problems have been pointed out by the participants. First difficulties in use were linked to a lack of adaption. The devices could not be adjusted on atrophy of muscles, increased swelling or pain. Second issue concerned problems with microclimatic conditions at the points of contact with the skin.
A multi-dimensional approach to improve the acceptance of technical aids in rehabilitation should integrate more systematic information for patients, contained in product instructions (e.g. in the form of FAQ). In addition the shape, the volume and the materials of these devices should be designed user-oriented adaptive to therapy demands.

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