Table 4 Results of Usability Testing for the SAMI-Self-Care CDS Program: Patient Perspectives
Usability Testing Themes | CDS Tool Content* | CDS Tool Component** | Examples |
|---|---|---|---|
Visual appeal | Comments about introductory pages that had a lot of content | Visual appeal and design | “Some pages seem overwhelming.” |
Understanding of terminology | Pain severity question | Written content and terminology | “What does ‘bearable pain’ mean?” |
Medication questions for all symptoms | Written content and terminology | “What does ‘able and willing’ [to take a medication] mean?” | |
Nausea and vomiting question | Written content and terminology | “Position change- does that mean when I lift my head up?” | |
Medication questions | Written content and terminology | “Unclear about the word ‘dose’ in the questions.” | |
Medication question | Written content and terminology | “Did you take the dose you were due for? Does that mean the dose time already passed or the next dose I am due for?” | |
Pain quality question | Written content and terminology | “Define what type of pain you are referring too”, is it “pokey pain, electrical current, shock pains burning pains, etc.” | |
Pain quality question | Written content and terminology | “I wouldn’t have categorized numbness as pain...I’m glad it’s there.” | |
Pain severity question | Written content and terminology | “I like ‘faces’ as part of the pain scale. They make the pain measure more clear.” | |
Constipation definition | Written content and terminology | “Definitions were too wordy, for example, constipation definition had too much information.” | |
Pain medication list | Written content and terminology | “I have trouble understanding meaning or relevance to words such as Morphine or Opioids.” | |
Constipation medication list | Written content and terminology | “Is Senna tea the same as Senna medication?” | |
Nausea and vomiting red flag safety questions | Written content and terminology | “What are two glasses of water per day?” | |
All symptom medication questions | Written content and terminology | “Need to add a time frame to the question: ‘Did you take your medication?’” | |
General content related to introduction of program and definition of all symptoms | Written content and terminology | Simplicity of terminology required for some patients with little medical sophistication makes clinical concepts difficult to communicate and can be tedious for more medically sophisticated patients. | |
Nausea and vomiting questions | Written content and terminology | “Why are you asking me about acid reflux and then position change? Are they related?” | |
Nausea and vomiting red flag safety questions | Written content and terminology | “Why is bone marrow transplant question asked?” | |
Pain red flag safety questions | Written content and terminology | Reason for why some questions are asked is not understood, e.g., “Not everyone has back pain.” | |
Nausea and vomiting questions | Written content and terminology | “Some patients may be getting some agents that aren’t considered chemotherapy but the patient thinks they are getting chemo.” | |
Constipation questions and medication lists | Written content and terminology | “I didn’t know that morphine and opioids can cause constipation.” | |
Pain and nausea and vomiting medication questions | Written content and terminology | “Don’t you want to know exact time and date of [a medication] dose?” | |
Pain questions and medication list | Written content and terminology | Word “narcotic” brought up negative feelings it was “a scary word.” | |
Pain question and medication list | Written content and terminology | “I know narcotic is bad for you.” | |
General comment from bilingual participants | Written content and terminology | “Is this available in Spanish?” | |
Format and navigation | Pain and nausea and vomiting medication questions | Format and navigation | “Can we input all the medications we are taking into the system?” |
All symptom assessment questions | Format and navigation Suggestions to improve | “Add checkboxes to make this [the entry of symptoms] easier.” | |
All symptom questions | Written content and terminology | “Create an option of ‘I don’t know.” | |
General comment about iPad functionality | Format and navigation | “Are there instructions for those who are not computer users to know how to use this function?” (Referring to functionality of hovering over a definition for more information.) | |
General comment on iPad | Format and navigation | “Use ‘back’ instead of ‘previous.’” | |
Wording of self-management suggestions | General comment for instructions for call clinicians on report | Written content and terminology | “I don’t want to bother my care team.” |
General comment for instructions to call clinicians on report | Written content and terminology | “When should I contact my care team?” | |
General comment for instructions to call clinicians on report | Written content and terminology | “What should I tell my care team?” | |
Other | |||
Patient safety | Pain report suggestions | Written content for report | “Is it safe for me to take this medication?” |
Nausea and vomiting red flag safety questions | Written content for safety questions | “Are we allowed to drink 2 large glasses a liquid per day? Shouldn’t we ask the doctor first?” | |
Constipation report suggestions | Written content for suggestions | “Is it safe for me to initiate the proposed intervention?” | |
Resources | Constipation suggestions | Other concerns | “Do I have suggested medications in my home?” |
General comment about iPad | Format and navigation | “Some people will lack the technology to access the system.” |