Chapter 5 150 Abstract Many mHealth applications aim to ‘coach’ users in achieving a healthier, happier life. However, many of these e-coaches lack proper research on its effectiveness or sound background knowledge of its target users. When such e-coaching apps are then picked up and relied upon by vulnerable user groups in need of effective support, such as those with mental health disorders, it could have negative effects. One such target group are patients with a borderline personality disorder (BPD). Patients suffering BPD experience strong difficulties in regulating their emotions. As a consequence, these patients frequently engage in self-harming behavior. An important contributor to the difficulties in regulating emotions in BPD is a deficit in the ability to timely recognize emotions – often addressed in clinical literature as ‘low emotional awareness’ or ‘alexithymia’. By using a modified UXD-framework, we investigated the need amongst BPD-patients in clinical treatment and their therapists for a scientifically and theoretically informed ambulatory biofeedback ecoaching app with the purpose of coaching patients to better learn recognize changes in the arousal level of their emotions. The study added to the current literature: (1) a ‘design science’ approach to developing mHealth-applications. (2) The insight that although the user needs of both groups regarding the proposed ecoach did converge to a considerable degree, the use of personas in the Strategy and Scope plane made clear some fundamental differences between the therapists and patients as users. (3) A detailed set of requirements for a physiologically based realtime biofeedback tool for psychiatric patients. (4) Detailed personas for both our patients and therapists that can form the basis of other research and design for this particular group. Keywords: mHealth, borderline personality disorder, emotional awareness, participatory design, e-coaching, design science
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