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Table 4 Results of Usability Testing for the SAMI-Self-Care CDS Program: Patient Perspectives

From: Algorithm-based decision support for symptom self-management among adults with Cancer: results of usability testing

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.”
  1. * CDS tool content refers to what aspect of the CDS tool that the comment sought to improve (i.e. medication vs. pain severity question)
  2. ** CDS tool component refers to what aspect of the CDS tool that the component that the comment sought to improve (i.e. written content vs. visual appeal)