Experience of device programming in neurostimulator users: Examining the relationship between patients' perceptions of medical technology & wellbeing

Deep Brain Stimulation (DBS) is an effective therapy for specific individuals with Parkinson's Disease(Schuepbach et al., 2013). Following implantation, stimulation parameters are adjusted to optimise symptom relief (Allert et al., 2011). Clinic-based adjustment is costly and poorly reflects the home-environment, resulting potentially in sub-optimal programming, negatively affecting quality of life (Harizand Hamberg, 2014). Whilst some patients independently modify settings at home, maximising therapeutic effect; others report confusion or resentment towards this (Hariz and Hamberg, 2014).Current literature inadequately explores post-operative lived experiences and programmer utilisation (Hariz and Hamberg, 2014).This study will investigate patient device engagement, by exploring psychological-factors mediating utilisation, sub-optimal setting experiences and professional device-usage facilitation. One-to-one semi-structured, audio-recorded interviews will be performed, analysed by the experiential approach --Interpretative Phenomenological Analysis (Smith, 2009).Ten DBS and ten spinal cord stimulator (SCS) patients will be compared, with five males and five females in each group. SCS is also a programmable stimulator (Medtronic, 2019) used in chronic-pain management. Interviews will take place two- and twelve-months post-op to assess initial device familiarisation and changes over time (Maier et al., 2016). Separately professionals from each care team will be interviewed, exploring care practices. The interview schedule will be developed involving patients, carers, professionals and existing literature. To develop a hermeneutic account, a line-by-line analysis will be performed to identify emergent patterns within and across individuals (Smith, 2009).It is expected that participants' experiences may stimulate, inter-alia, an analysis of identity, agency, gendered differences and relationships with medical technology. The analysis will offer suggestions for patient-intervention targets; patient-centric outcome definitions and professional practice changes. The findings will be presented in journals and to relevant conferences and charities. The project is in line with ESRC commitment to develop individual-level insights to behaviours and perceptions, from a psychological perspective to improve wellbeing.