In‐hospital usability and feasibility evaluation of Panda, an app for the management of pain in children at home

Abstract

Summary Background Postoperative pain in children is often poorly managed at home, leading to slower functional recovery, poor oral intake, sleep disturbances, and behavioral changes. Panda is a smartphone application (app) designed to support parents in assessing their child's pain and managing medications. Aims The aim of this study was to evaluate the Panda app's usability and feasibility in hospital prior to testing the app at home. Methods The study comprised two phases. Phase I evaluated Panda's usability with nurses, parents, and adolescents using simulated scenarios. Usability was measured by task completion rate, user error rates, and the Computer Systems Usability Questionnaire. Phase II evaluated Panda's feasibility by observing parents/guardians of pediatric patients using the app on the postsurgical ward. Feasibility was measured using response frequency and delay following app notifications from an audit trail of app function, and parental satisfaction from an interview. Feedback was used to guide iterative app improvements. Results In Phase I, 13 nurses, 12 parents, and 5 adolescents evaluated the app. A total of 103 usability issues were identified, analyzed, and addressed. In Phase II, 29 parents responded to a total of 151 app notifications, with 84% responding within 1 hour in the final round of testing; 93% of participants reported the app was easy to use, and rated the app with a median [interquartile range] Computer Systems Usability Questionnaire score of 2 [1‐4]. Significant barriers to use included lack of flexibility in the medication scheduling, low volume of alert sounds, and the extra time spent on medication safety checks. Conclusion Panda's usability was improved and its feasibility demonstrated in the controlled hospital environment. The next step is to evaluate its feasibility for use at home.

Methodological Quality of Manuscripts Reporting on the Usability of Mobile Applications for Pain Assessment and Management: A Systematic Review

“…Besides, most manuscripts did not report on the measurement of effectiveness, efficiency, and satisfaction, because they fail to use a combination of methods that allows assessing these three domains [27]. Only eight out of the 31 manuscripts included [19,29,32,37,38,[54][55][56] assessed all the three domains of usability, despite existing recommendations to include measures of efficiency, effectiveness, and user satisfaction since a narrower selection of usability measures may lead to unreliable conclusions about the overall usability of the app [64]. Furthermore, there was an inconsistency between what was reported in the methodology section and the results presented.…”

“…A more detailed analysis shows that all manuscripts, except one (out of 31) [51] assessed usability using appropriate procedures for the app development phase, but only two (out of 31) reported to have used an investigator adequately trained [35,40], and only one (out of 31) refers that the investigator responsible for usability assessment was external to the product development process [29]. Of the 31 manuscripts included, 11 used valid instruments to assess usability [19,29,31,[41][42][43]45,48,[55][56][57], but only nine triangulated methods of usability assessment [19,39,40,43,47,49,50,55,57]. The detailed results on the methodological quality assessment are presented in Table 2.…”

“…Of these 23 studies, five also targeted specific age groups: four used children or adolescents [32,33,49,51] and one used older individuals [29]. From the remaining manuscripts (n = 8), two used children and adolescents [54,55] for usability assessment, four used individuals from the general population [35,39,56,57] and another two used health professionals [58,59]. The overview of the manuscripts analyzed is presented in the Table S1 from the Supplementary file.…”

Pain relief in the palm of your hand: Harnessing mobile health to manage pediatric pain

“…Panda sends periodic notifications to alert the patients to conduct a pain check and take medication. In a recent study, usability was improved and feasibility was demonstrated in the hospital setting …”

“…Panda sends periodic notifications to alert the patients to conduct a pain check and take medication. In a recent study, usability was improved and feasibility was demonstrated in the hospital setting 30. Children with illness, including cancer, also experience acute pain, which can occur repeatedly throughout the course of treatment.Accordingly, two promising mHealth interventions targeting pain during cancer treatment have been developed.…”