100 Chapter 4 4 Also, it should be clear to children and caregivers where the children can engage with the app. Caregivers were sometimes unsure if children were ‘allowed’ to play in the consultation room or during the weighing and measuring. Theme 5: procedural comfort Though not part of the initial research question and not explicitly asked, most of the caregivers indicated that the children were more at ease as they were distracted from the waiting. The children were focused on the animal search and caregivers observed positive emotions such as enjoyment and pride upon finding another animal. Two caregivers reported that they enjoyed seeing their child searching with another child. One mother noted that seeing her child be at ease helped her to relax. However, the distraction was only temporary, as illustrated by the following quote: “The distraction was due to the QR codes. She was just seeking through the blood sample room. But we found the code the moment she was poked. The nurse said, ‘look how mom is scanning, look what will happen’. At this moment, the monkey came out. So it gets the pressure off of her. But the needle needs to stay in her arm for a while to take three vials of blood. So yes, within a second, she started screaming ‘take the needle out, the needle must come out, I feel it, it is hurting!” – Mother of 6 year old daughter. While almost all respondents experienced some distraction, one mother indicated that the app disrupted her standard routine used to help her child cope: ‘..if I am honest, we had a kind of a routine and this interrupted it a little bit. She is comfortable in her own expectation pattern. Besides that, she is also a bit shy with unfamiliar people, which I really noticed in the waiting room with all the people sitting there.’ – Mother of 6 year old daughter. Regarding the preparation part, it should be noted that due to COVID-related postal delays, most respondents had not downloaded the app at home but in the hospital. Hence, they had not engaged with the app at home nor used it as a preparation tool. Also, caregivers did not know about the animation video explaining the blood drawing procedure. When asked if caregivers would think it would help the children prepare, caregivers indicated that they thought it was helpful. Those who visited the hospital regularly added that they wished they could have had the app for the first hospital visit. Recommendations Children and caregivers were asked for suggestions how to improve the app during the interview and with an open question in the online survey. Suggestions were clustered into four domains: age differentiation, usability, tailored and immersive journey and others. All recommendations are depicted in Table 3.
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