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Designing tablet applications to help adults with

mild learning disabilities talk to their doctor

Easy Read Report

Ryan Colin Gibson

Dr. Mark D. Dunlop

Dr. Matt-Mouley Bouamrane

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Contents

Chapter 1: What is this report about? 3

Chapter 2: How did we do this? 4

Chapter 3: Challenges booking an appointment with a doctor

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Chapter 4: Challenges during an appointment with a doctor

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Chapter 5: Support during an appointment with a doctor

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Chapter 6: How can an app help the patient to attend appointments?

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Chapter 7: How can an app help improve communication?

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Chapter 8: How should the application work? 12

Chapter 9: How should the application look? 14

Chapter 10: Medical Images 16

Chapter 11: Contact Information 18

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Chapter 1: Introduction

Sometimes adults with mild learning disabilities find it hard to talk to their doctor.

Patients can find it hard to describe how they feel. The doctor may not understand what has been said. The doctor can speak too fast or use words that are hard to understand.

Unclear communication can lead to the patient staying ill or in pain.

Tablet applications can help people with learning disabilities to communicate with their doctor clearly. This report is about designing an application with 10 people who have mild learning disabilities.

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Chapter 2: How did we do this?

3 charities helped us to identify 10 people with mild learning disabilities. There were 5 males and 5 females. The youngest was in their 20s and the oldest in their 50s. The group was split into 3 design workshops based on where the participants lived.

The participants had to complete 4 tasks.

First, they had to talk about the challenges they face when going to the doctors. They also discussed how to get around these challenges including any technologies used.

In task 2, the participants had to draw what they think the application should look like. This allowed us to work out their views on how the application should run.

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In task 3, the participants had to select medical symptoms from a similar application. They then described what they liked about this application and what they found hard to use. This allowed us to identify the participants needs that were missed in task 2.

In Task 4, the participants had to discuss the clarity of medical images. These images were separated into two sets: clear and unclear. This allowed us to work out the factors that make an image clear to people with mild learning disabilities.

The results will help us to build an app that increases communication between doctors and patients with mild learning disabilities. This will help people to overcome the challenges discussed in task 1.

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Chapter 3: Challenges booking an appointment

The 10 participants in task 1 said that they face a lot of challenges when going to the doctors. One of the biggest challenges was booking an appointment.

It can take too long to book an appointment with a doctor. Your health can get worse when waiting for the appointment. You may worry about your health when waiting for the appointment.

Sometimes you may not know that you are ill. You might rely on others to book an appointment for you.

They might not notice you need help right away.

Finally, you might find it difficult to receive information over the phone. Practices might not change their methods to meet your needs.

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Chapter 4: Challenges during the appointment

Most of the participants said they want to see the same doctor each time. This doctor knows how to speak in a way that the patient understands. The doctor also knows the patient’s history so it is easier for them to work out what is wrong.

Sometimes it is not possible to see your favourite doctor. The other doctors may not know your needs and are harder to understand. The doctor may not understand what you are saying.

All of the participants said that their appointments are not long enough. They are not able to discuss everything they want to with the doctor. Some of the medical conditions are left untreated.

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People with learning disabilities are able to book double appointments. Longer appointments can help the doctor to figure out what is wrong with you. A lot of patients don’t know that they are allowed to book double appointments.

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Chapter 5: Support during the appointment

The participants often see the doctor with a support worker. Support workers help the patient and doctor to understand what is being said. Not all people with learning disabilities have the funding for support workers.

Sometimes support workers become too involved. They provide their own answers that might be wrong. The patient’s views may be ignored meaning symptoms could be missed by the doctor.

Only 1 of the 10 participants used a communication aid. This was a patient passport. Patient passports capture personal information that can help the doctor to provide better care. All 10 participants said that digital communication aids could help them talk to their doctor more clearly.

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Chapter 6: How can an app help the patient to

attend appointments?

In tasks 2 and 3, the participants discussed how the app could help them.

The first way was to help them remember the appointments they had booked. The app should display the time, date and location of these appointments. Reminders should be sent as a text or notification one day before the appointment.

The app can also help people book appointments. It should list the contact information of local healthcare services. Public transport routes to get to these services should also be provided. This can help you book and get to an appointment without a support worker.

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Chapter 7: How can an app help improve

communication?

Providing medical information to the doctor at the start of the appointment could help improve communication. Patients can show how they feel by pointing to the symptoms selected. Doctors can ask questions about the symptoms selected. More time can be spent talking about the serious symptoms.

The patient should fill in a medical questionnaire before going into the appointment. This questionnaire should be made up of conditions common to people with learning disabilities. It should be as short as possible so it can be completed by people who lose focus easily.

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Chapter 8: How should the application work?

The application should first look to identify the main body part or condition bothering the patient. For example, the patient may have a problem with their eyes or vision.

More symptoms that effect this body part or condition should then be identified. The first image shows this since the patient has to answer more questions about their eyes. These questions would be skipped if the patient did not have a problem with their eyes. The next body part or condition would be presented instead. This is shown in the second image. This helps to reduce the number of questions since many are skipped based on the answers given.

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The application should display all answers selected by the patient. This will allow the patient and doctor to talk about the choices made. The doctor will be able to figure out what is wrong with the patient.

These results could be sent to the doctor when booking an appointment. This means that if it’s serious you could get an earlier appointment.

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Chapter 9: How should the application look?

The questions and options should be displayed using images and simple language. Audio playback of text should also be offered for people who can’t read. This allows a range of people with different needs to use the app.

Buttons should also make use of images to show what they do. For example, the man with the speech bubble shows that this button will read text out loud.

A maximum of 6 options should be presented on the screen. This should make it easier for the patient to understand what is being asked. The patient can select more than one option at a time.

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People with learning disabilities have a wide range of needs. This means that the same application will not be usable to everyone with a learning disability. Changing the images displayed could help more people understand what is being said. Changing the background colour could help more people to read the text.

People with learning disabilities might not know how to use the app right away. A video showing them how to use it can help them to complete the questionnaire without their support worker.

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Chapter 10: Medical Images

In the final task the participants decided on the clarity of medical images. Images allow people with learning disabilities to understand difficult subjects. The participants found 6 features that made the images clear.

The images should show the most extreme sides of an emotion. For example, the man in the left should have tears to show that he is sad.

The characters should show the natural body position of someone experiencing a condition. For example, the man in the left should not be standing up when trying to sleep. It would have been better to show him in bed.

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Real life pictures were more clear than the cartoon drawings. This was because they could provide more detail.

Colour can be used to show the area and strength of pain. Red shows pain that you cannot live with. Orange is for pain that you can live with. Green or blue shows numbness.

The characters should look similar to you. For example, the man in the left should be replace with a woman if you are female.

Cartoons should be used to show more graphic conditions. This is because they can hide the graphic details with things like colour.

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Chapter 11: Contact Information

This study was carried out by Ryan Gibson, a PhD student at the University of Strathclyde. His supervisors are Dr Mark Dunlop and Dr Matt-Mouley Bouamrane.

Please contact Ryan Gibson if you have any questions. Email Address: ryan.gibson@strath.ac.uk