Design Requirements for a Digital Aid to Support Adults With Mild Learning Disabilities During Clinical Consultations: Qualitative Study With Experts

Abstract

BackgroundAdults with mild learning disabilities (MLDs) face a plethora of obstacles when accessing effective health care. Central to many of these barriers is communication, with medical practitioners often remaining untrained on how to interact with patients who have learning disabilities (LDs). To date, research on how to promote this communication has largely centered on the development of low-tech aids.ObjectiveThe objective of this study was to assess the feasibility of utilizing tablet technologies to promote communication between general practitioners and patients with MLDs. We achieved this by identifying a set of design requirements from experts in LDs.MethodsA set of design guidelines was formed during a 2-phase process. Phase 1 involved conducting a series of requirements-gathering interviews with 10 experts in LDs—the protocol of which emerged from the results of a separate scoping review. The interviews were subjected to a framework analysis to discern the key requirements discussed by the experts, and these were embedded within a technology probe. In phase 2, this probe was presented to a subset (n=4) of the experts during a round of usability studies, and the feedback received was used to update the requirements identified in phase 1.ResultsAn initial set of design requirements has been produced that may assist in the development of clinical Alternative and Augmentative Communication technologies for adults with MLDs. Factors that must be considered range from the health, physical and cognitive needs of stakeholders, to the more individual needs of users.ConclusionsThe experts involved in the study were optimistic about the proposed app. They believe that such technologies can help to alleviate time constraints and promote communication by presenting information in a form understood by both practitioners and patients.

A structured medication review tool to promote psychotropic medication optimisation for adults with intellectual disability: feasibility study

“…Electronic records are already used extensively in healthcare settings but use of technology as a more dynamic application may represent a more profound culture change and requires the development of new skills and ways of working. It is possible that digital interventions, if properly designed, can enhance communication between doctor and patient, for example, by incorporating augmentative and alternative communication methods 22 23. Given that patient involvement and the opportunity for shared decision-making are fundamental to medication optimisation, the HT-SMR would benefit from incorporating a greater role for people with ID and their carers to amplify the patient voice.…”

Ontology-Driven, Adaptive, Medical Questionnaires for Patients with Mild Learning Disabilities

“…This results in a reduced ability to cope independently and begins before adulthood with a lasting effect on development." LDs can also have a significant impact on an individual's capacity to interact with digital technologies as is discussed in depth in [6,7].…”

“…A more empirical evaluation was not appropriate at this stage due to the lack of available clinical alternative and augmentative communication applications for people with LDs. Previous research such as [6,7] has focused on extracting design requirements from experts, as opposed to target stakeholders; thus, embedding the questionnaire within such technologies could negatively influence the results obtained, if the user interface is inappropriate for the participants needs. Currently, the Medical Questionnaire Ontology is populated with 110 Questions across 9 distinct Questionnaires capturing conditions of the mouth, feet, chest, ears and eyes, as well as the patient's mental wellbeing, toiletry habits, weight trends, and general health.…”

“…In contrast, these symptoms may be embedded in ICS (such as [3][4][5]) that dynamically adjust to a patient's individual medical context, therefore identifying such conditions on a more consistent basis. Furthermore, systems such as [6,7] can present information to people with LDs in the format most suited to their own needs, thus increasing their ability to communicate about their health. As such, adaptive ICS are particularly useful for patients with LDs since the medical conditions and specific needs of this population are heterogeneous and wide-ranging − meaning a 'one-size-fits-all' model is simply unfeasible.…”

“…As such, adaptive ICS are particularly useful for patients with LDs since the medical conditions and specific needs of this population are heterogeneous and wide-ranging − meaning a 'one-size-fits-all' model is simply unfeasible. Consequently, developing a multitude of questionnaires to cater for every possible scenario would be unmanageable and would not scale [6,7].…”