Co-design of a tablet app for communicating inpatient brain injury rehabilitation goals

Abstract

The design of a tablet app for people with recent severe brain injuries is described, providing short videos outlining their current rehabilitation goals during inpatient rehabilitation. This research explored questions of desirability, functionality and usability. A co-design process was undertaken with clinicians and three current clients of such a brain injury service along with their family/whānau, iterating on a series of prototypes. Clinician, client and family participants responded positively to the concept and guided the design. Many design considerations reflected fairly universal principles—providing graphical/visual cues to complement text-based controls, and striving for a simple user interface and experience. The final design struck a balance between user control and a curated linear flow through app content. A sharp focus on the main objective was key—guiding rehabilitation goal setting best practice. The end result was an iPad app ready for clinical trial. Such tools may be able to contribute to rehabilitation processes through supporting client engagement, raising awareness of the purpose of rehabilitation, and thus potentially contributing to rehabilitation outcomes.

GRAPHICAL ABSTRACT

Keywords:

• Co-design
• brain injury
• rehabilitation
• goals
• video
• tablet

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Wairua—spirituality, soul, essence (Te Reo Māori).

2 Whānau—family, extended family (Te Reo Māori).

Additional information

Funding

This research had funding support from the Medical Technologies Centre of Research Excellence Seed Project under grant number 3705718; the Auckland University of Technology Strategic Research Investment Fund; and the AUT Centre for eHealth. We thank our clinical partner ABI Rehabilitation, the MedTech CoRE, and AUT for their support of this work.

Notes on contributors

Duncan R. Babbage

Duncan R. Babbage, PhD, is a former clinical psychologist turned academic, researcher and entrepreneur. At the time of conducting this research, Duncan was Director of the Centre for eHealth at Auckland University of Technology and an Associate Professor in Rehabilitation at their Centre for Person Centred Research. Duncan’s research examined health innovation, the use of technology in healthcare, and neuropsychological rehabilitation after brain injury. Duncan today focusses on the practical implementation of that background as founder and indie developer of Intro (https://intro.app), an app focussed on helping everyone to connect more effectively with people. Intro includes a tool for learning names and recognizing faces based on errorless learning and spaced retrieval, and search tools for when you can only recall fragments to enable searching notes, contact details and identifying people by their physical characteristics. Intro is not the focus of this paper and Intro Ltd does not have a financial stake in the Rehab Portal project described here.

Juliet Drown

Juliet Drown is a Research Officer in the Centre for Person Centred Research at Auckland University of Technology. She brings experience of primary care as a pharmacist and work in public health, to research projects focussing on traumatic brain injury, rehabilitation and disability. She was the Research Programme Manager for the Centre for eHealth when this research was conducted and played a key role in every stage of the design, implementation, evaluation of the research and preparation of this manuscript.

Jonathan Armstrong

Jonathan Armstrong obtained his Bachelor’s degree in occupational therapy from The University of Derby in the UK and his MHSc in rehabilitation from AUT University in Auckland. Jonathan is an active member of the International Networking Group of the American Congress of Rehabilitation Medicine. He was Director of Rehabilitation at ABI Rehabilitation NZ Ltd at the time this research was conducted. Jonathan is currently Clinical Director for Allied Health at Counties Manakau Health in Auckland, New Zealand. Jonathan facilitates national workshops for rehabilitation professionals, chairs the regional occupational therapy neurological special interest group, and works as an auditor for the New Zealand Board of Occupational Therapy. He also works as a surveyor for CARF International. His clinical and research interests include community re-integration following brain injury, goal setting in rehabilitation, motor control post-stroke, and cognitive interventions after brain injury. Jonathan is currently undertaking his DHSc at AUT University examining how people with brain injury reintegrate into their communities on return home from inpatient rehabilitation.

Maegan Van Solkema

Maegan Van Solkema is a Speech Language Therapist and Clinical Lead of Speech Language Therapy at ABI Rehabilitation NZ Ltd. Her doctoral research at the Department of Speech Science, School of Psychology, University of Auckland is examining the role and remediation of attentional processes involving communication and its impact into quality-of-life following moderate/severe TBI. Maegan’s research spans Pragmatics, Discourse Analysis and Cognitive Psychology.

William Levack

William Levack, PhD, is Dean of the University of Otago, Wellington, and a Professor in the Rehabilitation Teaching & Research Unit in the Department of Medicine. He is the current President of the New Zealand Rehabilitation Association, and an Executive member of Cochrane Rehabilitation—an organization he helped establish in 2016. He is a New Zealand registered physiotherapist. William’s work focuses on patient experiences of rehabilitation, goal setting processes, and interventions to increase patient engagement in rehabilitation activities—particularly in the areas of neurological and respiratory rehabilitation. He has ongoing research projects with colleagues in multiple countries, including Japan, Italy, Germany, Pakistan, Malaysia, and the UK.

Nicola Kayes

Nicola Kayes, PhD, is Professor of Rehabilitation, and Director of the Centre for Person Centred Research (PCR) at Auckland University of Technology (AUT) in New Zealand. With a background in health psychology, Nicola’s research draws insights from the intersection between health psychology and rehabilitation—critically exploring how people think, feel, behave, and respond in the context of injury and illness to inform ways of working that optimize rehabilitation outcomes. This broadly includes an interest in health service delivery and the rehabilitation structures, cultures, policies, and technologies that can make possible or constrain ways of working and impact on our ability to deliver outcomes that matter to people.