Fulfilling psychological needs of critically ill patients through soundscape augmentation

Abstract

Although the current Intensive Care environment focuses on providing the best care, the current sounds in that environment do not contribute to an optimal patient experience, leading to high stress levels. Literature study showed that soundscape augmentation can reduce patients’ stress in healthcare settings if implemented correctly. This project focuses on designing and validating such a system for critically ill patients in the Adult Intensive Care. Throughout the project, key stakeholders are considered; patients, healthcare professionals and loved ones.

A soundscape is defined as the acoustic environment as perceived or experienced and/or understood by a person or people, in context (ISO 12913, 2014). The current acoustic environment has been outlined through a context study, along with its impact on key stakeholders. Together, this provided a clear understanding of the existing ICU soundscape. It can be stated that the current ICU soundscape hinders healing because it affects patients’ psychological well-being.

Existing interviews from the Critical Alarms Lab, which aims at shaping the future of soundscapes in these environments, are used to explore patient experiences in ICUs. Four unfulfilled psychological human needs were identified as the barriers to a positive ICU experience: lack of autonomy, comfort, recognition and stimulation. Following literature, these unfulfilled psychological human needs can be fulfilled by providing the right sonic ambience at the right moment. Together with the context study outcomes, a comprehensive patient journey map was created to gain insights into when those psychological needs are either fulfilled or unfulfilled. Interventions in ICU soundscapes need a tailored approach because psychological needs are constantly changing over time and do not arise and disappear at the same time for everyone. A personalized approach was needed to improve the ICU experience.

Four key interaction moments were defined: Patients before admission, loved ones at the start of the admission, healthcare professionals during admission and patients during admission. Several prototypes were created to conduct usability tests with fellow students and healthcare professionals. Insights were gained on which prototype provided the highest engagement and which technique was most intuitive and useful for integrating the system into the healthcare workflow.

A new brand identity was created, resulting in the final design: Amadé - A Soundscape Augmentation System that provides personalized soundscapes, tailored to patients’ needs. By aligning soundscapes with patient preferences and clinical needs, Amadé reduces stress and improves patient comfort. User interfaces were created, focusing on the right tone of voice for each interaction moment. An evaluation test was conducted with ex-ICU patients in multiple online sessions. There was a positive response to the usability of the interfaces, but distrust of the system’s effectiveness emerged. The feedback and insights gathered from these tests resulted in recommendations for future research and a project reflection.