Experience of device programming in neurostimulator users: Examining the relationship between patients' perceptions of medical technology & wellbeing

脑深部电刺激（DBS）是用于患有帕金森病的特定个体的有效疗法（Schuepbach等人，2013年）。植入后，调整刺激参数以优化症状缓解（Allert等人，2011年）。基于临床的调整成本高昂，且不能很好地反映家庭环境，可能导致次优程控，对生活质量产生负面影响（Harizand Hamberg，2014）。同时，一些患者在家中独立地修改设置，以最大化治疗效果;其他人对此表示困惑或不满（Hariz和Hamberg，2014）当前文献未充分探讨术后生活经验和程控仪使用（Hariz和Hamberg，2014年）。本研究将通过探索调节使用的心理因素，次优设置体验和专业设备使用便利。将进行一对一的半结构化录音访谈，通过经验方法-解释性现象学分析（Smith，2009）进行分析。将对10名DBS和10名脊髓刺激器（SCS）患者进行比较，每组5名男性和5名女性。SCS也是一种用于慢性疼痛管理的程控刺激器（Medtronic，2019）。将在术后2个月和12个月进行访谈，以评估初始器械熟悉情况和随时间的变化（Maier等人，2016）。每个护理团队的专业人员将分别接受采访，探索护理实践。访谈时间表将制定涉及患者，护理人员，专业人员和现有文献。为了建立一个解释性账户，将进行逐行分析，以确定个体内部和个体之间的紧急模式（Smith，2009年）。预计参与者的经历可能会激发对身份，代理，性别差异和与医疗技术的关系的分析。该分析将为患者干预目标、以患者为中心的结局定义和专业实践变化提供建议。研究结果将发表在期刊上，并提交给相关会议和慈善机构。该项目符合ESRC的承诺，即从心理学角度对行为和感知进行个人层面的洞察，以改善福祉。

Deep Brain Stimulation (DBS) is an effective therapy for specific individuals with Parkinson's Disease(Schuepbach et al., 2013). Following implantation, stimulation parameters are adjusted to optimise symptom relief (Allert et al., 2011). Clinic-based adjustment is costly and poorly reflects the home-environment, resulting potentially in sub-optimal programming, negatively affecting quality of life (Harizand Hamberg, 2014). Whilst some patients independently modify settings at home, maximising therapeutic effect; others report confusion or resentment towards this (Hariz and Hamberg, 2014).Current literature inadequately explores post-operative lived experiences and programmer utilisation (Hariz and Hamberg, 2014).This study will investigate patient device engagement, by exploring psychological-factors mediating utilisation, sub-optimal setting experiences and professional device-usage facilitation. One-to-one semi-structured, audio-recorded interviews will be performed, analysed by the experiential approach --Interpretative Phenomenological Analysis (Smith, 2009).Ten DBS and ten spinal cord stimulator (SCS) patients will be compared, with five males and five females in each group. SCS is also a programmable stimulator (Medtronic, 2019) used in chronic-pain management. Interviews will take place two- and twelve-months post-op to assess initial device familiarisation and changes over time (Maier et al., 2016). Separately professionals from each care team will be interviewed, exploring care practices. The interview schedule will be developed involving patients, carers, professionals and existing literature. To develop a hermeneutic account, a line-by-line analysis will be performed to identify emergent patterns within and across individuals (Smith, 2009).It is expected that participants' experiences may stimulate, inter-alia, an analysis of identity, agency, gendered differences and relationships with medical technology. The analysis will offer suggestions for patient-intervention targets; patient-centric outcome definitions and professional practice changes. The findings will be presented in journals and to relevant conferences and charities. The project is in line with ESRC commitment to develop individual-level insights to behaviours and perceptions, from a psychological perspective to improve wellbeing.