46 Chapter 2 2 the interview. The gloomy screens would motivate them to “get Brad back on track” and use their maintenance inhaler again. The other two participants did not require Brad as a motivator and stated that the challenge in itself was sufficient. The end report was helpful, but they predicted that it without the narrative the reports would only become monotonous over time, and they would lose interest in the game. Usefulness All participants indicated that the game helped them to be more aware of their asthma and their inhaler use. Importantly, they also mentioned that due to playful and non-medical appearance it did not make them feel like a patient. Effect on adherence behaviour Three of the four participants indicated that Ademgenoot had a positive effect on their inhaler use during the test period. One participant, who had practically never used her maintenance inhaler before the challenge, reported improvement but still encountered difficulties in using her inhaler in the morning. Nonetheless, the gloomy screens served as motivating factor to exert her best effort: “The confrontation with the screen worked for me. I am very sensitive to color. I like that, the grey sky with the character. I start with sunshine and a beautiful sky. I’m doing a bad job and really have to do something” Furthermore, participants expressed curiosity to continue using Ademgenoot for the following six weeks and stated that this first week was a good first motivator. Various reasons to continue after the first week were mentioned. For instance, one participant was curious to see if taking their medication would have a positive effect on their symptoms: I now have more symptoms, and I want to try to see if it [using maintenance inhaler daily] helps. I have not used it for such a long period now and I am learning to live with that. I am however short of breath. If I use it for a longer period, do I notice it? I am very curious about that. Another participant mentioned that especially getting insight into her trigger moments would be a reason to continue with Ademgenoot. Effect on sense of control over the asthma Three participants expressed their expectation that, if Ademgenoot helped them to adhere to their maintenance inhaler and experience fewer symptoms, they would gain a greater sense of control over their asthma. They mentioned that continuing to track symptom triggers over time would help them get better insight into their triggers, recognize trigger events, and respond better to the triggers. In addition, the weekly overviews provided them with a sense of control. Participants trusted that the Ademgenoot could also help in controlling their asthma symptoms. However,
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