Experience of device programming in neurostimulator users: Examining the relationship between patients' perceptions of medical technology & wellbeing

神经刺激器用户的设备编程经验：检查患者对医疗技术的看法之间的关系

• 批准号: 2466165
• 金额: --
• 依托单位: Birkbeck, University of London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2466165
• 关键词: Experience; device; programming; neurostimulator; users

Deep Brain Stimulation (DBS) is an effective therapy for specific individuals with Parkinson's Disease(Schuepbach et al., 2013). Following implantation, stimulation parameters are adjusted to optimise symptom relief (Allert et al., 2011). Clinic-based adjustment is costly and poorly reflects the home-environment, resulting potentially in sub-optimal programming, negatively affecting quality of life (Harizand Hamberg, 2014). Whilst some patients independently modify settings at home, maximising therapeutic effect; others report confusion or resentment towards this (Hariz and Hamberg, 2014).Current literature inadequately explores post-operative lived experiences and programmer utilisation (Hariz and Hamberg, 2014).This study will investigate patient device engagement, by exploring psychological-factors mediating utilisation, sub-optimal setting experiences and professional device-usage facilitation. One-to-one semi-structured, audio-recorded interviews will be performed, analysed by the experiential approach --Interpretative Phenomenological Analysis (Smith, 2009).Ten DBS and ten spinal cord stimulator (SCS) patients will be compared, with five males and five females in each group. SCS is also a programmable stimulator (Medtronic, 2019) used in chronic-pain management. Interviews will take place two- and twelve-months post-op to assess initial device familiarisation and changes over time (Maier et al., 2016). Separately professionals from each care team will be interviewed, exploring care practices. The interview schedule will be developed involving patients, carers, professionals and existing literature. To develop a hermeneutic account, a line-by-line analysis will be performed to identify emergent patterns within and across individuals (Smith, 2009).It is expected that participants' experiences may stimulate, inter-alia, an analysis of identity, agency, gendered differences and relationships with medical technology. The analysis will offer suggestions for patient-intervention targets; patient-centric outcome definitions and professional practice changes. The findings will be presented in journals and to relevant conferences and charities. The project is in line with ESRC commitment to develop individual-level insights to behaviours and perceptions, from a psychological perspective to improve wellbeing.

深部脑刺激（DBS）是针对特定帕金森病患者的有效疗法（Schuepbach et al., 2013）。植入后，调整刺激参数以优化症状缓解（Allert 等，2011）。基于诊所的调整成本高昂，并且不能很好地反映家庭环境，可能导致规划次优，从而对生活质量产生负面影响（Harizand Hamberg，2014）。有些患者会自行调整家里的环境，以最大限度地提高治疗效果；其他人对此表示困惑或不满（Hariz 和 Hamberg，2014）。当前文献没有充分探讨术后生活经历和程序员的利用（Hariz 和 Hamberg，2014）。本研究将通过探索介导利用的心理因素来调查患者设备的参与度、次优设置体验和专业设备使用便利。将进行一对一的半结构化录音访谈，并通过经验方法进行分析——解释现象学分析（Smith，2009）。将比较 10 名 DBS 和 10 名脊髓刺激器（SCS）患者，其中 5 名每组一男五女。 SCS 也是一种用于慢性疼痛管理的可编程刺激器（Medtronic，2019）。访谈将在术后两个月和十二个月进行，以评估最初的设备熟悉程度和随时间的变化（Maier 等，2016）。来自每个护理团队的专业人员将分别接受采访，探索护理实践。访谈时间表的制定将涉及患者、护理人员、专业人员和现有文献。为了开发解释学帐户，将进行逐行分析，以识别个体内部和个体之间的新兴模式（Smith，2009）。预计参与者的经历除其他外可能会刺激对身份、代理的分析、性别差异以及与医疗技术的关系。分析将为患者干预目标提供建议；以患者为中心的结果定义和专业实践的变化。研究结果将在期刊以及相关会议和慈善机构上发表。该项目符合 ESRC 的承诺，即从心理学角度发展个人层面的行为和感知洞察，以改善福祉。