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RHEUMATOID ARTHRITIS AND CHRONIC FATIGUE LAUREN NICHOLSON PRODUCT DESIGN BSC PRODUCT RESEARCH 2, DP261 DR EDDY ELTON
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Contents
Introduction 1 Literature Review
2
Methodology 4 Research Findings
6
Persona 8 Image Board
9
URS 10 References 11
Introduction
‘To what extent does fatigue influence everyday life of rheumatoid arthritis suffers’ over the age of 65 in the UK?’
Rheumatoid arthritis (RA) is a chronic and progressive disease where the immune system attacks the synovial lining to the joints and other organs. If left untreated, the joint can lose its alignment, cause bone erosion and ultimately lead to permanent disability. It is a systemic disease, which means it can also affect internal organs of the body such as the heart, eyes and lungs
Infographics: Arthritis Research UK
60%
NRAS, 2014
There are nearly 690,000 people across the UK suffering with RA, and approximately 62 people in every 100,000 over 65s are diagnosed every year (Arthritis Research UK, 200-e). The disease is most commonly diagnosed between the ages of 40-50 (NRAS, 2014);
The risk of a heart attack 1 year after diagnosis, compared to someone without RA
as a consequence of it being a long-term condition with no known cure, and with 20,000 new diagnoses every year (BRS, 2014), there is a rapidly growing proportion of sufferer’s over the age of 65. It is a fast progressing disease, leaving 5% of sufferers with extensive disability (Arthritis Research UK, 200-f) and others experiencing symptoms ranging in severity including (but not restricted to) chronic disabling pain, inflammation, stiffness, chronic fatigue and reduced function and impaired mobility (NRAS, 2014). Preliminary research revealed that chronic fatigue, in particular, is an invisible
10%
AFFECTS
1%
OF UK POPULATION
symptom of the disease that can severely impact upon a person’s quality of life
Proportion of sufferers who will have severe lung complications as a result of their disease
and requires better understanding and management. It was for this reason that chronic fatigue was made the research focus of the report.
ANNUAL COST
AFFECTS
1%
OF WORLD’S POPULATION
OF RA TO THE NHS
The ratio of male to female sufferer’s of RA in the UK
£560 million
AFFECTS
5.6%
OF FEMALES OVER 65
AFFECTS
3.3% OF MALES OVER 65
Literature Review This literature review will investigate; the causes of chronic fatigue for rheumatoid arthritis (RA) sufferers, the symptoms caused by fatigue, the existing treatments, the significance of fatigue and the impact on the sufferer’s quality of life. The intention is to discover which element could be the most effectively tackled to improve their quality of life.
Neither the arthritis or pain can be eradicated,
1.3.1 Medical Fatigue can be caused by the arthritis itself, driven by the underlying mechanisms of the disease (Gossec, 2015). The chemical cytokines,
78%
produced when tissue is inflamed, is similar to that found in viral illnesses, such as colds and flu, which can cause extreme fatigue (Arthritis Research UK, 200-d).
said the public was not at all aware of chronic fatigue was a symptom of RA
fatigue in RA within medical literature (Hewlett, Chronic fatigue has however been
defined by the National Rheumatoid Arthritis Society (NRAS, 2014) as an ‘unpleasant, unusual, abnormal or excessive whole-body tiredness, disproportionate to or unrelated to activity or
onset of insomnia symptoms was twice as strong in participants with widespread pain (i.e. RA patients) compared with those with some pain (Tang, 2015).
In a study published by Selvan
(2012) 89% of patients reported interrupted
Chronic fatigue is constant or recurrent, it is not
find a comfortable sleeping position (Arthritis
dispelled easily by sleep or rest.’
Foundation,
200-a)
and
oversleeping
fatigue have compared it to
‘constantly wading through mud, or walking with bricks in your shoes. Sometimes lifting a cup, having a bath, or brushing your hair can involve more effort than you can imagine.’ NRAS, 2013a
sleeping pattern, which also results in fatigue
said that the public were not aware of the impact chronic fatigue could have CHRONIC FATIGUE 4.01
Details published by the Arthritis Foundation (200-
STIFFNESS 2.74
a) also suggests anaemia affects up to two thirds
PAIN 2.32
moves and muscles get tired faster, resulting in fatigue. Furthermore RA also increases the risk of a patient having Cachexia, muscle weakness,
SWELLING 1.93 Public understanding of RA symptoms Ranked 1 (most understood ) to 5 (least )
which causes muscle mass to decrease. Loss of muscle tissue means the remaining muscles have
1.3.2 Self-Treated RA can cause a loss of appetite, as stated by the NRAS (2013b), and the resulting weight loss can
if they are too tired to prepare proper meals they will end up eating unhealthy alternatives, or skipping meals all together, which only worsens the problem.
preparing the body for crisis, and constant stress leads to permanent mental and physical exhaustion (Arthritis Research UK, 200-d).
In
a study by Goodchild (2012) health focused
(Arthritis Research UK, 2013).
so that the body has to work harder every time it
will often be disregarded in the greater picture of
reaction to stress is to release adrenaline,
FLU SYMPTOMS 4
of RA patients, altering levels of iron in the blood
this is seen as a secondary symptom to pain and
A further issue is stress and anxiety. The bodies
and
napping during the day creates an unusual Those who experience chronic
83%
population. Swollen and sore joints can make it difficult to
however often have fatigue as a side effect, but
nutrition is the responsibility of the patient, but
sleep, compared with 41% in the general
exertion and present for more than one month.
use of drug treatments. These treatments will
impact on tiredness levels. Eating a diet rich in
down (Arthritis Research UK, 200-d), and the
There are no universally agreed definitions of
but efforts are made to manage them with the
the patient’s health (Arthritis UK, 200-d).
Constant feelings of pain can wear a person
1.2 Definition
to bear the burden of the moving body (Arthritis Foundation, 200-a).
1.3 Causes
1.1 Aim
2007).
DATA ACCOMPANYING SECTION 1.5
anxiety,
catastrophic
thinking,
rumination
(repetitive worrying) and a sense of mental defeat were linked to physical disability and acted as predictor for sleep interference. Some sufferers are guilty of ‘overdoing it.’ Coined ‘boom or bust’ behaviour it often results in lots of activity succeeded by several days of rest (Arthritis Research UK, 200-d). On the opposite end of the spectrum a study by Tang (2015) concluded that reduced social participation explained 66% of the effect of widespread pain
NRAS (2014)
on insomnia onset. ‘Targeting social participation
in older people with pain may buffer co-morbid
reported finding it difficult to plan ahead and
insomnia, reducing the overall disease burden.’
stick to arrangements. This caused strained
Depression also generates the feeling of fatigue (NRAS, 2014) and sufferers of RA are twice as likely as other individuals to experience it (BSR, 2013). This was emphasised by Goodchild’s findings (2012) where mental defeat emerged as a significant predictor for impaired functioning. Depression is brought on because the chronic
relationships with friends and family, and led to an avoidance of activity. As explored by Oslon (2007) this only escalates the problem because ‘avoidance of activity as a result of the fatigue is deconditioning, encouraging less exposure to positive mood-inducing events and a loss of social contact.’
pain causes unstable levels of hormones and
1.5 Significance of Problem
neurotransmitters such as serotonin in the brain
1.5.1 Role as a Primary Symptom
(Arthritis Foundation, 200-a)
Behind pain, fatigue is not considered one of the most important symptoms of RA, however it
1.4 Quality of Life As stated by Campbell (2012) ‘fatigue impacts on quality of life more than any other common symptom.’ It can have a severe impact on a person’s functional status, levels of depression, psychological distress and anxiety (Gossec, 2015) and can deter sufferers from simply getting out of bed in the morning because they are too
is argued that it has greater impact on daily life than pain (Feldthusen, 2013). Moderate to high levels of fatigue persist even when the pain of the arthritis and the other symptoms are mild and being effectively managed (Lee, 2014). The level of awareness fatigue receives is not proportionate to its severity and impact.
exhausted to get dressed, or eat properly (NRAS,
1.5.2 Lack of Awareness
2013a).
In a survey conducted by the NRAS (2013b) just
Fatigue is a major concern for RA patients (Hewlett, 2011) and a survey conducted by the NRAS (2014) found that for 90% of people RA related fatigue caused them to feel depressed
The Im
f Fatigue on Sh ct o pa
Quite Noticeable
a bit
of an
impact
impact 70% Very
much
more
21% difficult
11%
7D
symptom of RA, compared to the 95% who were able to identify joint swelling. Worryingly, only 41% of respondents who identified as having
% of over 65s who suffer from fatigue, and the % of those formally diagnosed
RA themselves, or having friends and family
Quite a bit of an impact
S AY
ABILITY TO S HO
E IN TH LAS
g erin ow
ER W
correctly able to identify chronic fatigue as a
Noticeable impact 70%
21% 11%
Very much more difficult NRAS (2014)
affected by it, were able to identify fatigue as a
1.5.3 An Ignored Symptom
symptom. The lack of knowledge about extreme
But how can the public be expected to be aware
fatigue among this group was much higher than
when health care professionals are similarly
expected and indicates that even those with the
guilty of ignoring the symptom? Fatigue occurs
personal connection to people with the disease
alongside other symptoms such chronic pain,
are not fully aware of how it affects them.
inflammation and reduced joint function, and
NRAS (2014)
within the last 7 days. In the study respondents
43% of respondents over the age of 65 were
consequently, and as stated in the NRAS’ 2014
The two most common management strategies
Survey, it is repetitively not given enough weight
for respondents in the NRAS 2014 were to reduce
when assessing a patient’s health, despite the
activity levels (72%) and increase sleep (57%). As
detrimental effect it can have on a person’s
explored under ‘causes’ however this can actually
quality of life.
make fatigue worse.
The sufferers themselves are guilty of not talking
Regular exercise is the most supported technique
to their healthcare professional about fatigue
for self-help. Being more physically active on high-
because they simply accept it a symptom
fatigue days has the ability to buffer the negative
of the disease (Repping-Wuts, 2009).
As
effect of fatigue on positive mood, by a variance
further investigated by Campbell (2012), poor
of 24.8% (Rosisin, 2015). Older participants of the
communication with clinical staff can be driven
study had a strong positive relationship between
by a perceived lack of sympathy and the limited
physical activity and positive mood.
availability of effective treatment.
In research
conducted by NRAS (2014), 16% of patients admitted to doing nothing to attempt to combat their fatigue and many admitted to having never attempted to talk to their GP or specialist nurse about it.
by
Katz
(1995)
hypothesised that physical activity may be particularly beneficial to RA sufferers because it provides them with a sense of achievement and engagement with valued or meaningful activities,
Secondry research is required because the Literature Review provided little research specific to the over 65s and the qualitative ‘human’ side of living with the disease every day. The research commenced with the recruitment of the participants at a RASCALS’ (a local Rheumatoid Arthritis society) tea and cake event at 2.45pm on Tuesday 3rd November 2015, at Wyevale Garden Centre in Kingston-near-Lewes. Six participants between the ages of 66 and 85 were successfully recruited from the 20+ attendees of the meeting. All the volunteers were female with the exception of one, which was reflective of the demographic of the meeting. The cultural probes were sent via post on the 13th November, completed between 14th and 19th and returned on 19th November at a second RASCALS’ organised event at St. Wilfred’s Church Hall, Pevensey Bay. The cultural probes were completed at the participants home’s situated across East Sussex. The probe consisted of a ten page booklet compromised of activities and a diary page to be completed once a day.
disengagement with valued activities, which is a
1.6.1 Clinical Intervention
risk factor for depressive symptoms.
Pharmaceutically there are no specific drug treatments that are currently available to treat arthritis related fatigue (NRAS, 2013a). As quoted by Tang (2015) pharmacological agents with hypnotic qualities are commonly used as the first line of treatment, although evidence to support their efficacy and safety beyond 6-12 months is limited.
1.7 Conclusion the mitigating effects that social interaction and physical activity can have on levels of chronic fatigue in RA sufferers over the age of 65. Investigation should be focused towards the their current methods of treatment to identify if a
There are a number of non-pharmacological used
to
help
manage
the
manifestation of chronic fatigue in RA, but insufficient evidence about their effectiveness (Cramp, 2013). These include, but are not restricted to, regular exercise, acupuncture, cogitative behaviour therapy, and occupational
Research Question and Objectives
‘To what extent does fatigue influence everyday life of rheumatoid arthritis suffers’ over the age of 65 in the UK?’
The project brief will be to research further into
sufferers emotional reaction’s to their disease and
1.6.2 Non-Pharmacological Intervention
therapy.
research
Research Outline
while being less physically active may represent
1.6 Treatment
interventions
Additionally,
Methodology
more human-inspired perspective of treatment would be more effective.
QUANTITATIVE A1: Record participants fatigue levels
QUALITIATIVE B1: Record how often the participants talk
throughout the day to establish when it is
about their fatigue, and who they talk with.
best and worst
B2: Record the participants emotional
A2: Record how often fatigue stops
reactions to activities and past times
participant from doing something
B3: Record the participants emotional
A3: Record how many meals the
reactions to rooms of the house and the
participant eats and their dietary habits
tasks associated with them
A4: Record the number of hours sleep
B4: Find out what the participants consider
and sleeping habits
to be the causes of their RA B5: Find out what participants feel is the most frustrating part of their disease
The advantages of a cultural probe
and daily routine.
The advantages of a cultural probe are well
Furthermore, as explored by Murphy (2006)
explored in Wherton’s ‘Designing assisted living technologies ‘in the wild’: preliminary experiences with cultural probe methodology’ (2012). In the methodology Wherton outlines the main advantage as the probe’s ability to ‘offer a relatively unobtrusive way of providing insight into how technology could fit into a particular home environment.’
The other advantages
outlined in the methodology are below. 1. Cultural probes can support conversation between the researcher and participant, thereby helping to overcome power imbalanced between them. The method allows the participant to have a certain level of control in what information they share, and how they express themselves. 2. Cultural probes are incredibly diverse. They can offer ‘the lived experience, physical limitations and emotional significance of the domestic space; what the key social relationships are and how these play out.’ 3. The participant is an active contributor to the research. As an ‘expert’ in his or her own life their participation is encouraged, rather than them being a passive subject. This again can strengthen the relationship with the researcher and welcome a more forthcoming response. 4. Probes can add personal meaning and significance to data by enriching it with desires, emotions and intentions. 5. Probes are capable of capturing mundane and everyday actions, places, objects and people. The data is in an autobiographical (narrative) format, providing insights into their life stories
cultural
probes
give
the
opportunity
to
document their lives in their own context with minimal interference from the designer and on a large scale it can be cost saving and less time consuming. The data collection is left to the user
A cultural probe is a qualitative research method, and using the definitions set out in Robson’s Real World Research (2012) it can also be categorised as a flexible design research strategy. The cultural probe was first used on the Presence Project in 1999 by designers Gaver, Dunne and Pancenti (Gaver, Jan/Feb 1999) Gaver described it as ‘packages of maps, postcards and other materials… designed to provoke inspirational responses,’(Gaver, Jan/ Feb 1999)
leaving the researcher to solely focus on the analysis of the data.
EXTRACTS FROM DIARY STUDY
2.1.5 Why was this method preferable to others?
The limitations of a cultural probe Although a limitation of the data analysis method as opposed to the probe itself, Gaver (Sept/Oct
SIMPLE SNAPSHOTS
Has fatigue ever stopped you from every day tasks? Is there a place in the home where you feel in better control of your fatigue? Draw or write how you feel about what you get up to in each room.
1999) criticises the tendency to rationalize the
The cultural probe was the most appropriate
DAILY DIARY 6AM
12PM
DAY 1
lack of routine or structure in the participant’s life,
6PM
12AM
probes. ‘People seem unsatisfied by the playful, subjective approach… so design theirs to ask specific questions and produce comprehensible
BEDROOM
KITCHEN
Don’t like today’s prompt? Use this space to write down anything else you have been feeling or to make notes on the activity.
disadvantaged because it must strike a balance between keeping the user focused and interested without being too prescription. Too restrictive and there is a risk that inspiration and design ideas will be lost. On the other hand a lack of focus can lead to ‘noisy’ data that is difficult to analyse and does not provide any useful design insights. Furthermore, cultural probes require elapsed time, which is not always available in a
DAILY DIARY
DAY 2
Rate on the scale from low (no affect on energy levels) to high (you will avoid this activity because of how it will make you feel.)
FATIGUE GETS IN THE WAY BY... 6AM
12PM
6PM
12AM
FATIGUE SCALE LOW
HIGH
FATIGUE GETS IN THE WAY BY...
PROMPT: WHEN DO YOU NOTICE YOUR FATIGUE THE MOST? Don’t like today’s prompt? Use this space to write down anything else you have been feeling or to make notes on the activity.
FATIGUE SCALE LOW
HIGH
FATIGUE SCALE
GETTING TO THE ROOT LOW
HIGH
DAILY DIARY
DAY 3
the data lacks substance making their translation to design insights trickier.
considerably day to day. Fatigue is a constant feeling and not a single event to be observed and discussed. In addition, this type of research would have to be conducted in the participant’s ethical issues, as well as unreliability in the data as they are conscious of being watched. Some areas of interest would be unobservable, such as
In the pocket below are 10 cards with causes of fatigue printed on them, and a brief explanation of how they cause fatigue on the back. Order the cards from the most to least relevant to you and (keeping them in order) put them back in the pocket, discarding any that don’t apply to you.
is less helpful in the study of fatigue because
primary environment, their home. This could raise
FATIGUE GETS IN THE WAY BY...
6AM
12PM
6PM
12AM
night’s sleep, and only accessible with the use of a cultural probe or diary study.
PROMPT: ANSWER THE QUESTIONS BELOW
way of collecting quantitative data, and some of
in the collection of the data. This looks at what the
fatigue can impact everything they do and varies
What do you love doing? Write the activity in the heart and look at how fatigue gets in the way.
tight schedule. Lastly, cultural probes are not the most efficient
involve the researcher being an active participant user does in comparison to how they feel, which
BATHROOM WHAT DO YOU LOVE?
In addition, Murphy notes that the probe is
as observation would not’ (Murphy, 2006). Design ethnographies and contextual enquiries
PROMPT: WHAT ARE YOUR TOP TIPS FOR DEALING WITH FATIGUE?
results. They summarize the result, analyse them…’
method because it was able to ‘work around a
1. When was the last time fatigue stopped you from doing something? 2. Did you eat three meals today? Is this typical of most days? 3. How many hours sleep did you get last night? 4. How restful was your nights sleep?
Empathetic modelling was not appropriate because fatigue is not a condition that can be easily simulated in non-sufferers.
5. Did you nap today nap/ rest today?
FULL VERSION OF METHODOLOGY AVAILABLE IN THE APPENDIX (Inc. Methodologies’ References.)
Research Findings
80%
Selection of Words from Diary
16.4
said that they require a nap in the afternoon almost everyday
range 7-23
Rest required as mornings medicine tends to start wearing off.
4 the number of naps needed by some participants
Average number of years diagnosed with RA
aged 66-85
76.6
‘I just have to rest. If I don’t I am out of action for at least 3 days.’
Who do you talk to? The RA group Partner
Wake up feeling stiff and unrested, until morning’s medicine begins to take effect
AVERAGE OF 5 DAYS FROM 5 PARTICPANTS
KEY COMMENTS They feel as if they are losing a
6AM
part of their identity to fatigue. hobbies they love.
WEAKNESS PAIN Most common causes of participant’s fatigue in descending order.
12PM
Bedroom is seen as a prison they place where they can no longer feel enjoyment
DRUG TREATMENTS SLEEP DISTURBANCE
6PM 12PM
No longer able to partake in the
cannot leave, and the kitchen is a
OVERDOING IT
‘Everyday is different, but tiredness and pain are guaranteed.’
2 are carers for their partners, putting additional pressure on their fatigue. General feeling of wasted time. They aren’t able to achieve anything with their lives.
4:00
Lunch times pick up. Usually spent with friends or family Takes a long time to get member. ready for bed. Evenings can be incredibly tricky.
Average number of hours of sleep acheived per night. Lowest was 1 hour, and the hghest was just 6 hours.
RESTLESS: WAKING HOURLY
Shops
Fatigue and Daily Life
Frustration
Positivity
Anxiety
Sadness
ESS EVER Y TR
S
Bedroom DRE SS
RESTLESS
Bathroom
Appointments
D
UNWANTE
THE BA
ABLE TO UN
G IN
EEP SL
ED EB
RNING z MO
KING T H MA
WORN
DOCTOR
ST OF TH RE E
S NAP
FOR TH UT E O
Y DA
A PROBL E TR
RY ABO OR U W
N’T STAND CA
PAYING G
GI MIN S EX M
ENJOY N’T I O
R
S BEFORE TA
SY AND R BU
HED US
NG OVI M
OUT ING + BE
USTING HA
SHOPS
A
FA
Activity R LONG FO
N’T WALK CA
R DNE R AR
CIEVING RE
ORS SIT VI
BEFORE
OTHERS
SOME IRE
ITTING IS T KN
Shopping TO
READING
URITE RO VO
LOST PA S
IME ST
P
N
N SIO
LOST PA S
M O
LIANCE RE O
IS DISTR TV
LL ASLE FA E
TING AC
NG LE RITI T W
B RS / ILLS TE
STORED IS
N’T OPEN CA
CKAGING PA
DICATIO N ME
Garden
D
Living Room
SW I
Kitchen
S
GYM
SHOP
Persona
Once the keen cook, Judy is now struggling to stand for long enough periods of time to prepare food, and finds it increasingly difficult to grasp hold of the knife. If this was not frustrating enough,
Introducing Judy
she is having to pass on this role to her husband,
Judy King, 76. is a retired teaching assistant, living
despite his own problems.
in Seaford, East Sussex with her husband Frank, 83, for whom she has recently started to care for.
Drivers
They have two children and three grandchildren
Judy is incredibly family orientated, and being
together.
able to keep up with Frank ‘s is her main drier. Additionally Judy wants to be able to look after
“With my RA I have gotten used to not being able to live at quite the same pace as before, but in the last few months I’ve hit a real stumbling block with my fatigue, and I can’t even begin to tell you how awful it is making me feel. For Frank’s sake, and for the sake of my social life, I need to get this under control!”
disease for over 10 years. Over these years Judy
1. Judy’s life goal would be to get her disease under control enough that would allow for her and Frank to go on a cruise together, and to be able to enjoy the experience worry free. 2. An experience goal for Judy would be to find
Ph on e
ets l b
Ta
m
art
Although not keen on technology, Judy is competent
D
ways of reworking physical activity, and the social
S
her early 60s, and has been managing with the
Goals
SKILLS
Judy was diagnosed with rheumatoid arthritis in
her grandchilden
te x e
r it y
and can use a tablet device to Skype her children and place
has tried to ignore the disease progressing, but it
online shopping orders
is in the last few months that she has noticed a real degradation in her health- with more frequent and more chronic flare-ups in her hands and wrists,
As she has said for many years, Judy is reluctant
and going for walks in the local Sussex Downs.
side of physical activity back into her life. She
to try alternative treatments such as cognitive
Judy loves to be around people, and was a
finds friends and excersise can ellivate her mood.
days on end.
behaviours therapy and acupuncture and is
regular attendee of yoga and swimming classes
Judy has never been someone to make a fuss
looking for a different type of product or service
at the local sports centre.
to assist her.
but in particular sudden spells of chronic fatigue which are seeing her confined to the house for
or pull focus towards herself, but Judy’s doctor believes the newly added stress of caring for her husband is impacting her well-being and believes it is time she started trying to mitigate some of her symptoms.
Frustrations
Motivations
Not being able to get out of the house is making
Judy is naturally a very active person, and for
Judy feel very restricted, and having to watch her
many years she was a keen cook and baker. She
garden become incredibly over grown and not
enjoys her time outdoors, tending to her garden
being able to sort it is making her very agitated.
3. An end goal of Judy’s is to be able to enjoy her home once again. Her house has become a place of illness, where she feels trapped and confined. Finding a way s for her to enjoy her passions, such as cooking and gardening would improve her environment and overall well-being.
Image Board
PERIE X E R E N S CE U
User Requirement Specification A1: The product must encourage the user to increase their activity level.
the sufferer to try and combat the effects with
of social participation can also reduce RA
movement.
symptoms. Having a support network reduces
The research report shows that one of the key
B3: The product should have the durability of at least 2 years
ways to combat fatigue is to increase activity levels. Increased activity can provide a sense of well being and suppress other symptoms.
A2: The product must be operable with hand Research showed that RA sufferers have varying levels of dexterity in their hands. The ability to work with one hand demands it to be relatively simple design, which the user could operate in whatever manner feasible to them at the time and dependent of their flare-ups. This also forces the product to be ‘hand’ size and therefore portable.
B1: The product should both visually and audibly alert the user of their activity level Research showed that RA affects the sufferer’s whole body, including eyes. This means a higher proportion ofRA sufferers have deteriorating eye sight than the rest of the population. Additionally, RA sufferers are just as likely to have age related decline, e.g. worse hearing, as any other over 65.
B2: The product should be able to function correctly indoors and outdoors The product is being designed to increase activity, which could be indoors or outdoors depending on the user. It is important the the device is able to support the user wherever they choose to excursus, even if that is in wet or damp conditions. Research showed that RA get worse during cold and wet spells, this may encourage
The product must be durable because the user is relying on it on a daily basis to assess their
isolation and it is easier to stay on track.
B8: The product must not require charging more than once a week (even when being used frequently)
level of activity. After 2 years the user may have
The product should be available to use all times.
adapted their lifestyle and will no longer rely on
If it is constantly on charge the user may forget
the alerts of the device to up their activity levels.
or it might not be ready when they need it to.
B4: The product should be no more than 7cm x 7cm in size
B9: The product must be able to withstand being dropped
The product must be roughly smaller than this size
In order to account for the poor dexterity of RA
to allow it to fit in the hand, making it portable for
sufferers, especially those who suffer flare ups
a range of physical activities. RA
in their hands and wrists.
struggle with
walking and general moment, and if the product was any bigger thy may not take it with them because it would impede them further.
B10: The product must use technology efficiently, maximising the users experience whilst not being too complex to use.
B5: The product cost must be kept as low as possible
Many over 65s have had limited access to
This is so that the product could be considered
by the idea. It is important that the product is
as affordable to those living on pensions, and is
accessible to all and it is not just those with
accessible to all sufferers.
prior experience of electronic devices who are
B6: The product weight must be kept as low as possible This will account for muscle weakness in RA sufferers, especially in the hands and wrists.
B7: The product must incorporate a way of connecting the user to other people. In addition to increased activity, greater levels
modern technology and may be intimated
able to use the product.
References
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