Supporting the Self-Management of Chronic Pain Conditions with Tailored Momentary Self-Assessments

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Vincent Moore
5 years ago
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1 Supporting the Self-Management of Chronic Pain Conditions with Tailored Momentary Self-Assessments Phil Adams, Elizabeth Murnane, Michael Elfenbein, Elaine Wethington, Geri Gay

2 3

3 Chronic Pain 4

4 Chronic Pain 20% 5

5 Chronic Pain 20% 30% 6

6 Chronic Pain 20% 30% 50-80% 7

7 Traditional Instruments 8

8 Traditional Instruments - Recall bias - Low test-retest reliability - Insensitive to temporal & situational changes in pain 9

9 Traditional Instruments - Recall bias - Low test-retest reliability - Insensitive to temporal & situational changes in pain - Adherence - Misreporting - Insensitive to participant preferences and idiosyncrasies 10

10 DESIGN PROCESS Ideation & Sketching & In-Lab Field Trial Review Prototyping Studies 11

11 Design Constraints: High usability Smartphone medium In-situ use Repeated use Cognitive translation processes Eliciting potentially distressing content 12

12 Design Constraints: High usability Smartphone medium In-situ use Repeated use Cognitive translation processes Eliciting potentially distressing content 13

13 Design Constraints: High usability Smartphone medium In-situ use Repeated use Cognitive translation processes Eliciting potentially distressing content 14

14 Design Constraints: High usability Smartphone medium In-situ use Repeated use Cognitive translation processes Eliciting potentially distressing content 15

15 Design Constraints: High usability Smartphone medium In-situ use Repeated use Cognitive translation processes Eliciting potentially distressing content 16

16 Design Constraints: High usability Smartphone medium In-situ use Repeated use Cognitive translation processes Eliciting potentially distressing content 17

17 Design Constraints: High usability Smartphone medium In-situ use Repeated use Cognitive translation processes Eliciting potentially distressing content 18

18 19

29 In-Lab Studies N=10, half 55+ years old Interviews User-testing Open-ended feedback & compare-and-contrast 30

30 In-Lab Studies N=10, half 55+ years old Interviews User-testing Open-ended feedback & compare-and-contrast 31

31 In-Lab Studies N=10, half 55+ years old Interviews User-testing Open-ended feedback & compare-and-contrast 32

32 In-Lab Studies N=10, half 55+ years old Interviews User-testing Open-ended feedback & compare-and-contrast 33

33 In-Lab Studies N=10, half 55+ years old Interviews User-testing Open-ended feedback & compare-and-contrast 34

38 SAFESlider SuperVASNumbered Source: Demo for Android: 39

39 Field Trial N=12, one-third 50+ years old Experience Sampling (ESM) 3 weeks Off-boarding interviews 40

40 Field Trial N=12, one-third 50+ years old Experience Sampling (ESM) 3 weeks Off-boarding interviews 41

41 Field Trial N=12, one-third 50+ years old Experience Sampling (ESM) 3 weeks Off-boarding interviews 42

42 Field Trial N=12, one-third 50+ years old Experience Sampling (ESM) 3 weeks Off-boarding interviews 43

43 Usage Statistics Response Validity Usability 96% r=.93 76% 84% r=.98 91% 44

44 Usage Statistics Response Validity Usability 96% r=.93 76% 84% r=.98 91% 45

45 Usage Statistics Response Validity Usability 96% r=.93 76% 84% r=.98 91% 46

46 Usage Statistics Response Validity Usability 96% r=.93 76% 84% r=.98 91% 47

47 THEMATIC ANALYSIS 48

48 Reporting Pain with Faces

49 Reporting Pain with Faces I can definitely imagine feeling the way this person looks. 50

50 Reporting Pain with Faces Doubts about accuracy - Difficulty interpreting - Uncomfortable reactions I can definitely imagine feeling the way this person looks. 51

51 Reporting Pain with Faces Doubts about accuracy - Difficulty interpreting - Uncomfortable reactions I can definitely imagine feeling the way this person looks. These are real people who are different from me that s a disconnect and it s harder to pick that one, even if it s the right degree in the scale. 52

52 Numbers People

53 Numbers People Everywhere you re taught to think in: one to ten, what s your pain level

54 Numbers People It s hard to put a numerical value on something like discomfort. Everywhere you re taught to think in: one to ten, what s your pain level

Pliable Interactions 7 8 9 You ve got the ability to move up

55 Pliable Interactions You ve got the ability to move up and down while you think about it, until it kind of feels right. 56

56 Report Resolution This [on the left] is more finegrained than I need. Jeez, I don t know, I don t know! [NRS-11 on the right] with 11 options is a relief, versus having to finagle with an unlimited number. 57

57 Report Resolution This [on the left] is more finegrained than I need. Jeez, I don t know, I don t know! [NRS-11 on the right] with 11 options is a relief, versus having to finagle with an unlimited number. I want it to go happier too! If I had no pain, I d be grinning ear to ear! 58

58 No Evidence of Negative Reactivity 59

59 No Evidence of Negative Reactivity It almost felt like the scales were an outlet for me Maybe like the way I might vent if I m upset. Somehow reporting it externalizing it actually eased it. When I m at 7 or 8, it s not like the system is going to remind me I m in pain I m not going to forget that! 60

60 No Evidence of Negative Reactivity It almost felt like the scales were an outlet for me Maybe like the way I might vent if I m upset. Somehow reporting it externalizing it actually eased it. When I m at 7 or 8, it s not like the system is going to remind me I m in pain I m not going to forget that! I ve been doing PT [physical therapy] at home... This reminder and filling out the measure didn t make my perception of the pain different, but it kept it on my mind so I would do things about it [like my PT]. 61

61 FUTURE DIRECTIONS 62

62 Future Directions Integration with clinical care Novel assessment modalities Complementing self-report with passive sensing 63

63 Future Directions Integration with clinical care Novel assessment modalities Complementing self-report with passive sensing 64

64 Future Directions Integration with clinical care Novel assessment modalities Complementing self-report with passive sensing 65

65 Summary & Contributions Improving pain measurement and management Design constraints Novel, validated self-report tools A characterization of idiosyncratic preferences to design around 66

66 Summary & Contributions Improving pain measurement and management Design constraints Novel, validated self-report tools A characterization of idiosyncratic preferences to design around 67

67 Summary & Contributions Improving pain measurement and management Design constraints High Novel, validated self-report tools A characterization of idiosyncratic preferences to design around 68

68 Summary & Contributions Improving pain measurement and management Design constraints Novel, validated self-report tools A characterization of idiosyncratic preferences to design around 69

69 Summary & Contributions Improving pain measurement and management Design constraints Novel, validated self-report tools A characterization of idiosyncratic preferences to design around 70

70 Summary & Contributions Improving pain measurement and management Design constraints Novel, validated self-report tools A characterization of idiosyncratic preferences to design around 71

71 Thank You! Questions? Improving pain measurement and management Design constraints Novel, validated self-report tools 1 A characterization of idiosyncratic preferences to design around Supporting the Self-Management of Chronic Pain Conditions with Tailored Momentary Self-Assessments Elizabeth Murnane elm236@cornell.edu

IMPROVING WELLNESS WITH MINDFULNESS

IMPROVING WELLNESS WITH MINDFULNESS Be happy in the moment, that's enough...each moment is all we need, not more. ~Mother Teresa Do You Ever Feel This Way? Mindfulness Based Cognitive Therapy (MBCT): What