Designing and Developing an eHealth Program for Patients With Persistent Physical Symptoms: Usability Study

Oliver Rønn Christensen; Leonora Hedegaard; Mette Trøllund Rask; Jane Clemensen; Lisbeth Frostholm; Marianne Rosendal

doi:10.2196/42572

Designing and Developing an eHealth Program for Patients With Persistent Physical Symptoms: Usability Study

JMIR Hum Factors. 2023 Feb 8:10:e42572. doi: 10.2196/42572.

Authors

Affiliations

¹ Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark.
² Department of Culture and Learning, Aalborg University, Aalborg, Denmark.
³ Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
⁴ Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
⁵ Research Unit for General Practice, Aarhus University, Aarhus, Denmark.

^# Contributed equally.

PMID: 36753312
PMCID: PMC9947758
DOI: 10.2196/42572

Abstract

Background: Patients with persistent physical symptoms presenting in primary care are often affected by multiple symptoms and reduced functioning. The medical and societal costs of these patients are high, and there is a need for new interventions tailored to both the patients and health care system.

Objective: This study aimed to examine the usability of an unguided, self-help treatment program, "My Symptoms," developed to assist patients and general practitioners in symptom management.

Methods: In all, 11 users (4 patients with persistent physical symptoms and 7 laypeople) participated in web-based thinking-aloud interviews involving the performance of predefined tasks in the program. Thematic analysis was used to categorize the severity of usability issues. General usability heuristics were cross-referenced with the usability issues.

Results: The analysis identified important usability issues related to functionality, navigation, and content. The study shows how therapeutic knowledge in some cases was lost in the translation of face-to-face therapy to a digital format. The user testing helped uncover how the functionality of the digital elements and general navigation of the program played a huge part in locating and accessing the needed treatment. Examples of redesign to mediate the therapeutic value in the digital format involving health care professionals, web developers, and users are provided. The study also highlights the differences of involving patients and laypeople in the interviews.

Conclusions: Taking the experience of common symptoms as a point of departure, patients and laypeople contributed to finding usability issues on program functionality, navigation, and content to improve the program and make the treatment more accessible to users.

Keywords: digital health; eHealth; medically unexplained symptom; persistent physical symptom; persistent symptom; physical symptom; self-management; symptom management; think aloud; thinking aloud; unexplained symptom; unguided; usability.

©Oliver Rønn Christensen, Leonora Hedegaard, Mette Trøllund Rask, Jane Clemensen, Lisbeth Frostholm, Marianne Rosendal. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 08.02.2023.