CARETUNES FOR FAMILIES: CONNECTING ICU PATIENTS AND THEIR FAMILIES THROUGH MUSIC
User research, UX and service design, Sound design 2020
Critical Alarms Lab, TU Delft
Graduation thesis Thesis link
CareTunes for Families is a service that connects ICU patients and their families through music that is generated from the patients’ physiological data. The service fulfills the families' emotional and social needs by presenting the patients to their families in a warm and assuring way, creating a positively memorable experience.
PROJECT CONTEXT
People are admitted to the Intensive Care Unit (ICU) when they are in a life-threatening situation, and special equipment is used to constantly monitor and support their bodily functions. At the same time, their families often experience distress and anxiety as they cannot make much contact with the patient, due to the medical restrictions or because the patient is unconscious. Families therefore have an unfulfilled need to connect with the patient, to feel assured, and to care for them, and CareTunes for Families presents an opportunity to fulfill these emotional and social needs by building the connection using music generated from the patient’s data.
PROCESS
User research and literature research were first conducted to explore the needs of the families and the possibilities of designing for connectedness with sound and music. Then, two cycles of design iteration and user evaluation were carried out to determine how music can best present the patient and connect them to their family, and how it can reduce the family's negative emotions.
EXPLORING THE TARGET USER: A CLOSER LOOK INTO THE FAMILIES
Families of ICU patients face many challenges, such as uncertainty, role alteration, and various negative emotions such as worry, guilt, fear of loss, etc. These challenges lead to many emotional and social needs, such as the need for assurance, the need for closeness, and the need to support. The project aims to improve the patient-family connection and the feeling of connectedness in order to meet these needs, and to reduce the families’ negative emotions by evoking positive emotions such as calmness, comfort, acceptance, and hope.
BUILDING CONNECTION WITH MUSIC
To build the sense of connectedness, an intimate experience that involves caring actions is created. Social cues are used to bring the presence of the patient to the family in the form of music messages and music streaming. At the same time, music is used to present the patient's mental and/or physical activities, while regulating the family’s emotion with calm and positive musical features. As music allows much freedom in interpreting, it can make the experience more intimate by bringing out the family's memories of their loved one.
DESIGN ITERATIONS
The design went through two cycles of iterations before the final design and evaluation. In design cycle 1, three design concepts were prototyped (see this playlist) for qualitative user testing. Main user test results showed that:
Positivity and liveliness in the music enhance the feeling of intimacy and connectedness.
Presenting directly the vital signs of the patient can increase anxiety and uncertainty. In contrast, people feel relaxed and find it more meaningful when the music presents the emotions or activities of their loved ones.
Personal messages evoke the feeling of intimacy, while music streaming evokes the sense of presence. The family’s preference can change depending on the patient’s condition.
People feel the need to be more active, such as sending back messages.
In design cycle 2, an ICU nurse and an end-of-life design expert were interviewed. The main insights include:
Talking to the patient can be comforting for the family and the patient.
If the patient passes away, the family would need to go through a transition/ritual before accepting it.
The final design therefore emphasizes music’s emotional effect on people, and focuses on creating a meaningful experience for the families.
MUSIC DESIGN
The final music design captures the patients’ physiological data, such as heart rate and brain waves, to symbolically represent the patient. The basis of the music is the theme melody of the patient, which is repeated throughout their stay in the ICU as the music is continuously generated. Multiple music tracks are layered upon the theme to create variations in the music. As the music flows, its variation follows the patient’s physical and mental activities, allowing the family to relate to their loved one. For example, heart rate can signify arousal and bodily activation, and brain waves can signify the state of consciousness. A rise of level in wakefulness will add a track of fast occurring notes to the previously calm melody, enhancing the liveliness of the music.
A demonstration of the music can be found here, and the variation samples can be found in this playlist.
UX DESIGN - FIRST USE AND DAILY USE
The CareTunes for Families app is introduced to the family upon the patient’s admission to the ICU. From then on, the family can listen to the music of their loved one at home and feel their presence throughout their stay in the ICU, by playing the live-streaming music or by receiving music messages at regular intervals.
UX DESIGN - SENDING BACK VOICE MESSAGES
Families can send back voice messages, which would be comforting for both themselves and their loved ones in the ICU, and look to the app for suggestions of positive topics if needed.
UX DESIGN - END OF USE
At the end of the patient’s stay in the ICU, the theme melody of the patient will continue to play, while the variations stop. The family can decide when to end the music, for example when they are ready to accept the change. The app will also create a mashup of the music to be stored.
SERVICE DESIGN
The stakeholders of the service include the family, the patient, and the nurse. The data from the monitoring devices are processed backstage, and the service mainly runs automatically to avoid adding the nurses’ workload.
USER EVALUATION AND FUTURE VISION
In the user evaluation of the final design, both user experience design and music design have been proven to be able to increase connectedness between the family and the patient, to meet the families’ emotional and social needs, and to reduce their negative emotions. The patient data that is normally used for diagnostic purposes can now create an emotional bond between families and their loved ones. This human-centered approach to data-driven design points to a new realm of possibilities in using data other than their analytic purposes; data can take on new forms and express new levels of meanings to meet human needs and values.
