van der Molen P, Maas AH, Chen W, et al. Identifying User Preferences for a Digital Educational Solution for Young Seniors With Diabetes

Transcription

1 van der Mlen P, Maas AH, Chen W, et al. Identifying User Preferences fr a Digital Educatinal Slutin fr Yung Senirs With Diabetes Online Appendix A: Cmplete Persnas and Custmer Jurney Maps Cntents: Persna Lisa 2 Persna Gerard 3 Custmer Jurney Map Lisa 4 Custmer Jurney Map Gerard 8

2 Surce phts: artist: stckimages Lisa A. Persnas Receptinist 57 years, cmes frm Eindhven (NL) Lives alne, divrced 12 years ag Living with diabetes is quite dable, but yu need t keep paying attentin. Lw Incme (, mnd/jr) 2400/33000 Educatin Cmputer use Playing games Scial active Try smething new Learn abut diabetes Glucse check self High Behavir and daily life Lisa likes t g shpping, the extensive walking helps t exercise enugh hurs she says. She lves t play bard and family games, always has, she is very gd at Operatin (Dr. Bibber). She has a laptp which she uses t lk fr infrmatin and fr ding administratin. Lisa uses her smartphne t call and send Whatsapp messages. Als she likes t play games casually thrughut the day, like Wrdfeud with her children r Candy Crush. Her brther als has diabetes and difficulty walking, therefre, Lisa buys grceries fr him. Since her divrce, she wrks as a receptinist, just like she did befre her children were brn. Partly due t her full time jb, her day is quite rutined. Attitude twards diabetes Lisa has diabetes fr nearly tw years, she fund ut because a wund didn t heal. Therapy: she cannt endure Metfrmine. She injects 1x lng and 3x shrt term insulin per day. Since the beginning f her diabetes, Lisa lks fr infrmatin abut diabetes and lifestyle. She tries t manage her illness as well as pssible: she makes sure she has a rutine fr meal times and walks a lt fr exercising. She lves tasty fd, like everyne, but has the tendency t eat t much Lisa and her brther share their experiences abut their diabetes and lifestyles Once in every three mnths, she ges t the diabetes nurse and asks questins abut what she read. That is hw she discvered BlusCal, a tl t help understand mre abut her diabetes. Gals and needs Lisa wuld like t eat healthier, especially mre vegetables and less carbs. Smetimes she is quite frustrated abut having diabetes, she tries t d her best, but at times her bdy seems nt t want t crprate with her. 2

3 Surce phts: Artist: imagerymajestic Gerard Frester 65 yeas, just retired, frm Aalst (NL) Lives tgether with his wife I just want t g my way and nt be ruled by diabetes. Lw Incme (, mnd/jr) 2000/27500 Educatin Cmputer use Playing games Scial active Try smething new Learn abut diabetes Glucse check self High Behavir and daily life Even thugh he is retired, Gerard ften ges t wander arund in his frest. Besides that, he babysits his grandsn (8 years ld) tw days a week. Smetimes they play games tgether n the tablet f his grandsn; Gerard keeps being amazed by the skillset f his grandsn with such new devices. Every week, Gerard plays cards with his wife and their neighbrs, mstly Belte (Klaverjassen) His wife usually uses the cmputer they have; he is nt very interested in it. Since he retired, his day is much less rganized. Especially when he is in the frest it happens that he lses track f time and frgets t eat. Attitude twards diabetes Gerard diabetes fr 6 years nw, he discvered it when he was very thirsty and sweaty. Therapy: uses Metfrmine befre meals and injects lng term insulin nce every day. He still desn t quite understand what diabetes is. He tries t d what the dctr says, but he just frgets t take his medicine smetimes, especially when he is ut. Gerards wife is wrried abut his irregular lifestyle, als because f his high bld pressure Gerard is the nly ne in his family with diabetes, smetimes he gets tired f the interference f thers arund him. What d they knw? Sugar free cake is just hrrible t eat. Once every three mnths he visits the practice nurse. She discusses gals with him, t wrk twards t, he finds that hard t wrk with. Gals and needs Gerard wants t try t have mre rutine in his day, fllwing the dctrs advice. He wuld like fr ther peple t understand that diabetes is nt abut eating sugar free junk, althugh they mean well. 3

4 C) Custmer Jurney Map - Lisa Stry Part 1/4 Emtins & thughts Y-axis: frm psitive (up) t negative (dwn) Phase/timeline Discvering 1 st time PN (wk2) Sharing 1 st time medicine Reactin medicine Tw days later Lisa fell just De GP tells her One week later Lisa tries t At hme, she calls Diner time! Lisa In the days after she visits the befre Christmas that she has a she is at the GP s understand her brther wh takes her she desn t feel practice nurses and her wund high glucse level. practice t discuss everything. She als has diabetes Metfrmin and well, her belly (PN). She asks Lisa just desn t heal. Lisa needs t visit the test results. thinks it is a lt t en tells him she eats a salad meal. aches and she abut her eat and She feels ill t, the hspital fr She indeed has take in, s she just can t believe she experiences exercise habits s she ges t the mre detailed diabetes and lets the has it t. diarrhea. She and explains GP fr advice. bld tests. needs t use infrmatin flw. decides t call the abut diabetes. Metfrmin. GP. I hpe the GP knw what is ging n Eew, I dn t like needles! That desn t sund gd Well, my lifestyle, I never really thught abut it Eh that is a lt f infrmatin I can t believe this happens t me Cntact pints (infrmatin surces) - General practitiner/nurse in practice - Diabetes specialist in the hspital - Flyers frm the hspital - Manuals frm the devices/tls - Grup curse - Diabetes specialist via the telephne - Magazines (hme, waiting rms) - Family/friends Just start healthy straight away Legend and abbreviatins: = direct infrmatin x = indirect infrmatin (memry) GP = General practitiner PN = Practice nurse DN = Diabetes nurse This really isn t funny anymre 4

5 Phase/timeline 3 rd time GP (wk3) Realizatin 1 st time reading infrmatin At hme, she sits dwn at the cuch and starts reading the brchures the PN gave her. Stry Part 2/4 The GP thinks that Lisa might nt be able t endure Metfrmin. They decide t wait fr a few weeks, because the alternative is using insulin. Lisa starts t realize that she is stuck t diabetes. She gets frustrated; she isn t living that unhealthy, right? Sn she realizes that she just has t deal with it and s she decides t learn as much as pssible abut diabetes and a healthy lifestyle. Reading the brchures raises a lt f questins: What can t she eat? What happens if she frgets her medicatin? 2 nd time PN (wk3) 1st time dietician (wk4) Lisa asks her She agrees with questins fr the the dietician that PN via the phne. she will fill in a She answers them fd diary. Als, and advices Lisa she will try t t meet a walk every day fr dietician. half an hur. 1st time diary Diner time again. Lisa takes her Metfrmin and eats a ready-made meal, because it says exactly hw many carbs it cntains. After dinner, she writes dwn what she ate that day, as far as she can remember and calculate it. Emtins Insulin? I prefer t cntinue withut needles Why me?! I m just ging t d it Hmm, that s interesting Actually, it desn t explain much I hpe she can help me If shpping cunts, that shuld be dable Nicely dne, if I may say s myself It s nt s easy t write it dwn crrectly Cntact pints - GP/PN in practice - At the hspital - Flyers hspital - Manuals - Grup curse - Via the telephne - Magazines - Family/friends Legend and abbreviatins: = direct infrmatin x = indirect infrmatin (memry) GP = General practitiner PN = Practice nurse DN = Diabetes nurse 5

6 Phase/timeline 2 nd time dietician Sharing 4 th time GP (wk7) Sharing 3 rd time PN 1 st time Stry Part 3/4 One week later, she visits the dietician with her fd diary; they decide Lisa will eat less carbs. Lisa tries her best t d everything right, but it isn t easy. Luckily she can find supprt by her brther. Lisa visits the GP because she is really bthered by the Metfrmin. They decide she will start t use insulin. At hme she calls her brther and explains that she needs t start insulin as well: nce lng term and trice shrt term insulin. The next day, Lisa visits the PN wh explains t her hw the glucse meter and insulin pen shuld be used. Time fr lunch, s first time fr measuring and injecting all by herself. Lisa wished the PN was with her t check if she s ding it right. Glucse level measured, insulin injected, time t eat. Tgether with the PN she decided t keep her diet the same fr nw. T 2 nd line - hspital (1yr) 10 mnths later she still desn t get her glucse right, althugh she really tires. Her GP sends her t the internist at the hspital. 1 st time carrusel meeting During a carrusel meeting, everything is checked and a new plan is made with the internist, diabetes nurse (DN) and dietician. Emtins That s a pity because I lve pasta My whle live seems t be abut diabetes Things really need t change It s time Pretty scary, t inject myself As lng as I dn t d it wrng Pff, that s that Hpefully things get better nw It s like hitting a reset buttn Cntact pints - GP/PN in practice x x - At the hspital - Flyers hspital - Manuals - Grup curse - Via the telephne - Magazines - Family/friends Legend and abbreviatins: = direct infrmatin x = indirect infrmatin (memry) GP = General practitiner PN = Practice nurse DN = Diabetes nurse 6

7 Phase/timeline Hyp (mth 13) 2 nd time DN Searching inf 3rd DN (mth 15) Searching inf 4th DN (mth 18) Curse (mth 20) Reflectin The DN asks Lisa if During a walk She sits dwn and The next day, Lisa She asks the DN In ne f the Lisa takes the She ges t the she engaged in a thrugh the gets a cartn f decides t lk abut it during magazines she magazine t the BlusCal training, physical activity r neighbrhd, range juice. Half nline fr mre their next receives at hme diabetes nurse, where she als husehld chres Lisa starts t an hur later, she infrmatin abut meeting. Luckily she reads abut a wh explains that meets ther like cleaning the sweat and feels feels slightly hyps. Sme f the DN can clarify bluscalculatr, they arrange diabetes patients windws. If yes, light headed. She better and calls the infrmatin is things fr her. a tl which can curses arund and wh als she shuld inject suspects a hyp, the diabetes cntradictry. calculate the the BlusCal in share their less insulin which she read nurse. amunt f insulin the hspital. Lisa experiences. arund thse abut. yu need t use. decides t jin. activities. Stry Part 4/4 Emtins I feel terrible, is it a hyp? Hpefully the sugar kicks in sn Indeed a hyp, gd t knw What t believe? Ah, that explains Bluscalculatr, that might be smething fr me I m very curius Gd t knw that I m nt the nly ne Cntact pints - GP/PN in practice - At the hspital - Flyers hspital x - Manuals - Grup curse - Via the telephne - Magazines - Family/friends Legend and abbreviatins: = direct infrmatin x = indirect infrmatin (memry) GP = General practitiner PN = Practice nurse DN = Diabetes nurse Pain pints in Lisas Jurney T much infrmatin at nce Cnflicting infrmatin Nervusness Afraid f needles Once hme, Lisa thinks abut the past tw years. It was difficult, but she still stands and she desn t have t d it all by herself. Living with diabetes is quite dable but yu need t keep paying attentin 7

8 D) Custmer Jurney Map - Gerard Stry Part 1/4 Emtins & thughts Y-axis: frm psitive (up) t negative (dwn) Phase/timeline Discvery 1 st time dietician (wk1) Gerard desn t feel well, he keeps drinking and sweating while it s freezing utside. His wife takes him t his GP. yes, I m ging already At the GP he discvers he has high glucse levels. Gerard needs t g t the hspital fr tests immediately. Let s wait and see One week later he visits the GP again t discuss the test results. He is diagnsed with diabetes and needs t start using Metfrmin. Hm, I didn t expect that The GP refers him t a dietician. She explains t him what diabetes entails. Besides that, she asks him t keep a fd diary. And what des this all mean? Gerard tries t understand her stry. He thinks it is a lt f infrmatin and desn t quite understand all f it. yeah right Sharing 1 st time medicine 1 st time diary At hme he explains his wife abut the diabetes and that he needs t take even mre pills nw, ne extra at mealtimes. h well, f curse we can add ne mre Dinnertime, Gerard takes his metfrmin and eats with relish his htchpt with an extra sausage and gravy. tasty, they aren t ging t take this away frm me, are they? Nw he needs t fill in his diary and cunt carbs. He thinks it s a hassle but the dietician tld him t d it s its prbably imprtant. she will nw it Cntact pints (infrmatin surces) - General practitiner/nurse in practice x - Diabetes specialist in the hspital - Flyers frm the hspital - Manuals frm the devices/tls - Grup curse - Diabetes specialist via the telephne - Magazines (hme, waiting rms) - Family/friends Legend and abbreviatins: = direct infrmatin x = indirect infrmatin (memry) GP = General practitiner PN = Practice nurse DN = Diabetes nurse 8

9 Stry Part 2/3 Phase/timeline 2 nd time dietician (wk2) Gerard ges t the dietician tgether with his wife. They discuss his fd diary and make a fd plan. She gives him sme brchures as well. Sharing 1 st time reading Realizatin 1 st time PN (mth3) He is happy that his wife jined him, because she is the ne wh usually prepares their fd. Reluctantly, Gerard decides t read the brchures the dietician gave him. His wife sits next t him and lks int them as well. Slwly, he starts t realize that things indeed need t change, he desn t want t d that. Tw mnths later, he visits the hspital fr a check. Next he visits his practice nurse (PN) t get ntified abut the test results. The PN explains that he needs a higher dse f Metfrmin. She als suggests he walks an hur everyday. Difficulty It s hard fr Gerard t fllw the fdplan. He likes t take a candy drp nw and then, r 2, 4, 10, maybe half a bag? 2 nd time PN (mth6) Three mnts later his HbA1C is t high. After cnsulting the GP, the PN suggest that Gerard starts t inject insulin, nce a day. She explains him the glucse meter and insuline needle. He practices with it while the PN checks ut if he s ding alright. Emtins What if I can t eat tasty fd anymre? Tgether we ll find a way Ww, that s a lt f text Why shuld I? I m quite fine nw Let s see what she says I dn t mind walking, I can g t my frest That s hw I ve always dne things and I feel fine with it What, why? This shuld wrk Cntact pints - GP/PN in practice - At the hspital - Flyers hspital - Manuals - Grup curse - Via the telephne - Magazines - Family/friends Legend and abbreviatins: = direct infrmatin x = indirect infrmatin (memry) GP = General practitiner PN = Practice nurse DN = Diabetes nurse 9

10 Phase/timeline Difficulty 1 st time using insulin at hme Stry Part 3/3 Emtins Dinner is htchpt again, but this time withut extra bacn and gravy. Gerard gets angry. I dn t want t be lived by diabetes Time t sleep and measuring and injecting alne fr the first time. Gerard is in dubt, his wife checks ut the manuals fr him. Hw was it again? Hyp (mth 8) Tw mnths later, Gerard wakes up at night sweating and shaking. He suspects a hyp, the PN tld him abut it. Ops, I frgt t eat smething in the evening He desn t have range juice at hme, what shuld he d? His wife finds Dextr in his frester bag, she hands him six tablets. Phew, that was scary Yearly full check up (yr1) During his yearly chek up the GP explains that Gerards HbA1c is quite high, als his kidneys are starting t fail. Uhuh.. that desn t sund gd De GP checks Gerards insulin pen and glcuse meter as well. His injectin marks are fine. The GP warns him t eat less salty fd. yes, yes, I knw this already Reflect When Gerard cmes hme he thinks abut the past year. He is nt happy with is new diet, but besides that he can pretty much d what he wants. I can g my wn way, diabetes des nt dictate my life Yearly full check up (yr8) Jump in time: Gerard visits the yearly check up fr the 8 th time. The GP tells him that his bldwrk is nt satisfactry. I heard this befre Having mre hyp s at night, failing kidneys and a high bld pressure, the GP decides t refer him t the secnd healthcare line: hspitals with internists &DNs. Apparently it s time fr smething new Cntact pints - GP/PN in practice x x - At the hspital - Flyers hspital - Manuals - Grup curse - Via the telephne - Magazines - Family/friends Legend and abbreviatins: = direct infrmatin x = indirect infrmatin (memry) GP = General practitiner PN = Practice nurse DN = Diabetes nurse Painpints in Gerards Jurney T much infrmatin at nce Desn t want t eat differently T much text in brchures 10