5 Design study I: How to create an ambulatory app for patients with BPP 163 Table 1. List of user needs organized according to their priority for the participants. User needs ▪ The patient needs to have direct access to his/her current level of ‘physiological correlate of emotional arousal’ (PCEA) as a proxy for emotional arousal. ▪ The patient needs to be coached in a discreet manner ▪ The patient has a need to be able to have an overview over his/her recent course and development of his/her PCEA. ▪ Both patient and therapist have a need to intuitively understand how the intervention works when they see it (i.e., easy to comprehend interface and visualizations) ▪ The patient has a need to be reminded to personal tips or skills at certain levels of emotional arousal, but only based on his/her preferences ▪ The therapist has a need that the use of the intervention is gradually phased out during the course of treatment to prevent dependency ▪ Both patients and therapists need to know how to correctly use the system. ▪ The patient has a need to be reminded of standard emotion regulation skills at (increases to) certain levels of emotional arousal, based on his/her preferences ▪ The patient needs to have a choice in how to be made aware of their current level of PCEA, e.g., through different types of signals ▪ The patient wants an option to keep its therapist(s) up-to-date about the past course of their PCEA, if he/she chooses to do so. ▪ The therapist has a need to have control over if and when the patient uses the system. ▪ The therapist wants to be able to be kept up to date about the learning progress of the patients regarding the recognition of their emotional arousal. ▪ The patient wants to be able to look into his/her PCEA data over (longer periods of) time ■ ≥ 6 labels ■ 3-4 labels ■ 2 labels ■ Neutral Patients stressed how important it was for them that symbols and especially words should be ‘neutral’: one patient expressed the concern that bystanders could read what was on their screen and would ‘raise their eyebrows’. For example, the use of the Dutch word for ‘arousal’ (“opwinding”) is mainly used in the context of sexual arousal and was regarded highly inappropriate for use by an e-coach. Patients mentioned how a bad choice of words or pictures could be a source of distress in itself. For example, the hypothetical scenario of being asked by the e-coach if they
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