e-Ouch: usability testing of an electronic chronic pain diary for adolescents with arthritis.

OBJECTIVES The aim of this study was to evaluate the usability of the e-Ouch electronic chronic pain diary in adolescents with juvenile idiopathic arthritis. METHODS A qualitative usability testing approach with semistructured, audiotaped interviews with two iterative cycles was used. A purposive sample of 10 adolescents per cycle was drawn from a rheumatology clinic in a university-affiliated pediatric tertiary care center. Participants were provided with a brief demonstration of the diary and then asked to use the diary "thinking aloud" to record the pain they experienced: (1) when they woke up that morning, (2) during that afternoon, and (3) from the previous evening. Adolescents were then asked a series of open-ended questions addressing ease of use of the diary. Qualitative thematic analysis was used to generate categories and emerging themes from interview data. RESULTS All of the adolescents stated the e-Ouch diary was very easy to learn, use, and understand and was satisfying to complete. Participants took less than 9 minutes to complete all three of the diary entries with minimal errors. The usability evaluation revealed aspects of the interface that were suboptimal (eg, VAS slider) and impeded the performance of certain tasks. Adolescents generated ideas on how the diary interface could be improved. CONCLUSIONS A multifaceted usability approach provided important insight regarding the use of technology by adolescents with arthritis and, more specifically, for understanding how adolescents can more effectively use an electronic chronic pain diary.