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research-article

Care Frictions: A Critical Reframing of Patient Noncompliance in Health Technology Design

Authors:

Eleanor R. Burgess,

Elizabeth Kaziunas,

Maia JacobsAuthors Info & Claims

Proceedings of the ACM on Human-Computer Interaction, Volume 6, Issue CSCW2

Article No.: 281, Pages 1 - 31

https://doi.org/10.1145/3555172

Published: 11 November 2022 Publication History

Abstract

Patient work encompasses a challenging set of activities necessary for learning about and managing chronic conditions over time. Many patient-centered health technology interventions focus on supporting types of patient work, such as symptom tracking, medication adherence, and information sharing between patients and providers. However, people may not always follow, or may actively resist, the activities prescribed by their formal patient role. In this paper, we present three case studies about patients with different chronic conditions to critically reflect on the types of patient behavior commonly taken up in health technology design as acts of "noncompliance." Detailing conflicts that emerge when patients are caught between meeting their personal needs and following clinical best practices, we show how everyday life and health system goals are often misaligned in ways that can't be easily reconciled through current design approaches. As a way forward, we argue for alternative ways of understanding the tensions routinely shaping people's healthcare experiences. We introduce the term care frictions as a sensitizing concept useful for helping designers reframe "noncompliant" behaviors as legitimate forms of patient work. Our paper also offers design considerations-both on challenges and generative possibilities-for future CSCW research seeking to support a wider breadth of patient behavior. In this, we call attention to the value of designer and researcher reflexivity in making visible the problematic assumptions in health technology design that can lead to social and emotional patient harms.

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Index Terms

Care Frictions: A Critical Reframing of Patient Noncompliance in Health Technology Design
1. Human-centered computing
  1. Collaborative and social computing
    1. Collaborative and social computing theory, concepts and paradigms
  2. Human computer interaction (HCI)
    1. Empirical studies in HCI

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cover image Proceedings of the ACM on Human-Computer Interaction

Proceedings of the ACM on Human-Computer Interaction Volume 6, Issue CSCW2

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November 2022

8205 pages

EISSN:2573-0142

DOI:10.1145/3571154

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Published: 11 November 2022

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Kong EHuang KGautam AFarzan RLópez CCardoso Llach DQuercia DMustafa MNiu SWong-Villacrés M(2024)Envisioning Possibilities and Challenges of AI for Personalized Cancer CareCompanion Publication of the 2024 Conference on Computer-Supported Cooperative Work and Social Computing10.1145/3678884.3681885(415-421)Online publication date: 11-Nov-2024
https://dl.acm.org/doi/10.1145/3678884.3681885
Bellini R(2024)Abusive Partner Perspectives on Technology Abuse: Implications for Community-based Violence PreventionProceedings of the ACM on Human-Computer Interaction10.1145/36372928:CSCW1(1-25)Online publication date: 26-Apr-2024
https://dl.acm.org/doi/10.1145/3637292
Zghab SPagé GLussier MBédard SCheng J(2024)"It's Sink or Swim": Exploring Patients' Challenges and Tool Needs for Self-Management of Postoperative Acute PainProceedings of the 2024 CHI Conference on Human Factors in Computing Systems10.1145/3613904.3642916(1-11)Online publication date: 11-May-2024
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Ankrah EMarathe MBhattacharya ARitt-Olson AMilam JTorno LHayes G(2023)Plan For Tomorrow: The Experience of Adolescent and Young Adult Childhood Cancer Survivors as they Transition to Adult CareProceedings of the ACM on Human-Computer Interaction10.1145/36102017:CSCW2(1-27)Online publication date: 4-Oct-2023
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