JMIR Publications

ABSTRACT

Background:

Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and social burdens. One promising avenue to address caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented Reality (AR) applications, specifically, offer new affordances to aid caregivers with vital care tasks in the context of virtual care delivery.

Objective:

This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to: (1) shed light on caregivers’ current challenges performing physical care tasks at home; (2) investigate opportunities for AR to support caregivers; and (3) understand the risks of AR exacerbating caregiver burdens.

Methods:

We conducted a qualitative video elicitation study with caregivers and clinicians. We created three video elicitations that offer ways AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing—tasks in post-surgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity and Hololens2. Using elicitations enabled us to avoid re-discovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled non-intrusive exploration of the inherently sensitive in-home cancer care context.

Results:

We recruited 22 participants for our study: 15 clinicians (oncologists, nurses) and 7 caregivers. Our findings shed light on caregivers’ current information and communication challenges as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the particular needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers’ already significant burdens.

Conclusions:

These findings can inform both the design of future AR devices, software, and applications; and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies, and the affordances they provide (e.g., tailored support, enhanced monitoring and task accuracy, improved communications), should be considered as one dimension of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that naturally blend in-person and virtual synchronous and asynchronous care, illness, and recovery.