Co-designing a device to guide breathing instructions during deep inspiration breath-hold (DIBH) radiation therapy (RT) for service users with hearing impairments

Introduction: This study aims to investigate the key characteristics of a device to support patients with hearing impairments in utilising deep inspiration breath-hold (DIBH) radiation therapy (RT). Method: A qualitative approach was adopted. Semi-structured interviews were conducted both online and in person with 11 participants, including key stakeholders from a range of backgrounds: radiation oncologists, radiation therapists, medical physicists, RT service managers, industry vendors, and deaf service users. Data were analysed using thematic analysis, following the six-step approach outlined by Braun and Clarke. Results: Participants’ attitudes towards a device were explored across four key themes: • Device characteristics Shape and size Interference with treatment Associated challenges Thematic analysis identified several unifying themes, including the importance of co-designing a device incorporating both vibrational and visual elements. Overall, participants expressed a preference for a small and wireless device. Conclusion: This study identified potential characteristics for a device to support patients with hearing impairments in accessing DIBH during their radiation therapy treatment. A device incorporating both visual and vibrational elements may be optimal for addressing the diverse needs of patients in this cohort.