"I think I could have designed it better, but I didn't think that it was my place": a critical review of home modification practices from the perspectives of health and of design.

Purpose: The research presented demonstrates the disharmony between end user goals and their consideration in service outcomes within ageing-in-place and asks "what can design offer health" within this domain.Methods: Data was collected using semi-structured interviews with various stakeholders within the context of ageing in place. All data are thematically analysed through a theoretical lens of control theory.Results: The results demonstrate a contrast between purported patient-centred care models, and a human-centred design model. This contrast in cultures causes a disconnect between the health practitioners and the end users, with a lack of clarity about the end user's intended engagement within the modification of their environment. Consequently, the goals of older adults are inadequately represented as typical home modification design processes often fail to support the reflection of goals in practice, in turn, restricting client engagement and control. Reviewing occupational therapy practices through the critical lens of control has highlighted opportunities for service improvements.Conclusion: The consideration of co-design methodologies within home modification design is a way to reinforce client engagement and provide better pathways for older adults to remain in control and raise acceptability of modification through a better-informed decision-making process.Implications for RehabilitationThe following points detail the implications of this research upon the rehabilitation practice and theory: Compliance with recommendations is deeply connected to a person's intrinsic sense of control within the clinical decision-making process.Co-design practices between practitioners and clients provide and novel pathway to achieve truly person-centred care and create better service experiences and clinical outcomes.The human-centred design methodology is highly applicable within clinical practice and provides an opportunity for clinicians to see and learn about their patients through a holistic lens centred around goals and motivations rather than physical impairments.The scoping of health literacy should be inclusive of all service artefacts and touchpoints that a client may encounter throughout the entire duration of experience, this includes design artefacts such as architectural drawings and other home modification designs.

The design briefing process matters: a case study on telehealthcare device providers in the UK.

PURPOSE: The telehealthcare sector has been expanding steadily in the UK. However, confusing, complex and unwieldy designs of telehealthcare devices are at best, less effective than they could be, at worst, they are potentially dangerous to the users. METHOD: This study investigated the factors within the new product development process that hindered satisfactory product design outcomes, through working collaboratively with a leading provider based in the UK. RESULTS: This study identified that there are too many costly late-stage design changes; a critical and persistent problem area ripe for improvement. The findings from analyzing 30 recent devices, interviewing key stakeholders and observing on-going projects further revealed that one major cause of the issue was poor practice in defining and communicating the product design criteria and requirements. CONCLUSIONS: Addressing the characteristics of the telehealthcare industry, such as multiple design commissioners and frequent deployment of design subcontracts, this paper argues that undertaking a robust process of creating the product design brief is the key to improving the outcomes of telehealthcare device design, particularly for the small and medium-sized enterprises dominating the sector. Implications for rehabilitation Product design criteria and requirements are frequently ill-defined and ineffectively communicated to the designers within the processes of developing new telehealthcare devices. The absence of a (robust) process of creating the design brief is the root cause of the identified issues in defining and communicating the design task. Deploying a formal process of creating the product design brief is particularly important for the telehealthcare sector.

The cutlery effect: do designed products for people with disabilities stigmatise them?

The purpose of this study was to investigate of how assistive cutlery design effects perception of the user. Studies regarding the usage and development of assistive cutlery have primarily focused on the ergonomics, whereas research into the aesthetics of assistive cutlery has been minimal. A method based on Canter's "Room Inference Protocol" from the field of environmental psychology was used to evaluate the aesthetics of the assistive cutlery. A series of images were digitally composited and a survey was deployed online, with an outcome of 562 usable responses. The results demonstrated that the female model with assistive cutlery was perceived to be less attractive, less stylish and less sporty in comparison with the male model that was utilising identical pieces of assistive cutlery. The research contributes to the existing literature in the field, complimenting the study by Torrens and Smith and validating the need for greater aesthetic consideration in addition to an ergonomically acceptable response for assistive cutlery. This in turn highlights the importance of industrial design for the context and adaptations of use, rather than just a design response given to the physical manifestation of a product. Implications for Rehabilitation Reduced grip can be not only physically debilitating but also socially isolating through stigmatisation. Current assistive cutlery may be ergonomically sound, but aesthetically lacking. Large, multinational study demonstrates significant gender effect relating to the perception of women using these devices.