User-centered design method for the design of assistive switch devices to improve user experience, accessibility, and independence

Despite an increasing awareness of user-centered design (UCD), there is limited discussion of how such approaches can be translated into the resource and time constrained environments of medical engineering departments; yet, much of the work in such environments involves the prescription and tailoring of equipment for an individual. This article explores the suitability of adopting a user-centered design approach to understanding the needs of 10 electromyography standalone switch users who have complex disabilities. This feasibility study was conducted in a busy Rehabilitation Engineering Unit of a National Health Service hospital. A UCD approach was developed and tested using a range of qualitative techniques that included user interviews in the home environment, content analysis, and affinity mapping. This approach enabled clinical engineers to work alongside design researchers to elicit key parameters for future switch designs. A number of themes emerged relating to the day-today use of environmental controls by individuals with a limited range of physical lower limb movements. A key finding concerning switch use was the importance that users placed on the ability of a switching device to increase their independence and have control of their activities; conversely, there was also the revelation that in some cases the effort invested in using an assistive technology was not worth the gain to the user. In such cases having a caregiver perform the task instead was preferential. This paper documents a university-affiliated research team's efforts to guide user-led practice and product insight acquisition with the implementation of a UCD approach.