CAPD eBook: Evaluating Multimedia Application for Continuous Ambulatory Peritoneal Dialysis (CAPD) Users Presenter: Mohammad Hafiz Ismail Arifah Fasha Binti Rosmani Nurul Fatahiyah Shalahuddin Siti Zulaiha Binti Ahmad

Abstract The main intention of this research is to evaluate the usefulness of CAPD eBook, which is an interactive multimedia application. This application is developed by integrating various multimedia elements such as text, animation, graphics, and audio. CAPD eBook is designated for renal patients who undergo CAPD as their dialysis method. This application is used to assist the patients in their CAPD training process. CAPD is one of the treatments that renal patients can choose to remove waste in their body. A Usability Test is performed to assess the application. The assessment includes interactivity, navigation, design, color, and integration of multimedia elements. It is found that by the usage of multimedia elements, significant impact in CAPD training for renal patients is provided. Keywords: CAPD (Continuous Ambulatory Peritoneal Dialysis), usability testing, heuristic evaluation.

Introduction Kidney failure is a condition where the kidney malfunctions and it cannot properly remove or filter waste and fluid in the body [1]. Therefore, kidney failure patients need to perform either Haemodialysis or Continuous Ambulatory Peritoneal Dialysis (CAPD) so as to continue living. These dialysis procedures help to filter urine, urea, and toxic in their blood. CAPD is one of the dialysis methods that can replace the work of kidneys for renal patients [2]. It is used to remove extra water, wastes, and chemical from the body for the end-stage renal patients. This procedure can be performed at home, provides flexible schedule, and allows patients to work, travel and do their favourite activities [3]. Patients who have chosen CAPD as their dialysis method need to learn and practise CAPD process as a way to replace the functions of their malfunctioning kidneys. Currently, CAPD processes are taught to CAPD users manually. The processes are quite complicated and difficult for new users to learn the correct procedure. Furthermore, patients need to stay for 2 weeks at the hospital to learn and practice using this method along with a family member. The family member will help in performing the processes if the patients are sick or bedridden and cannot perform it on their own.

Introduction cont. Hence, in order to assist the patients and their family member to learn the processes in an easier and interesting way, an interactive multimedia application named as CAPD eBook is developed. CAPD eBook is a multimedia application to guide renal patients on how to perform CAPD in their daily life and assist them in their dialysis training [4]. This application intentionally includes the multimedia elements such as text, animation, audio, and graphic to help renal patient in the learning process. This is because interactivity of a multimedia application is an important element to attract users to use the application. Interactivity is the integration of digital media including combinations of text, images, sound, and animation [5]. This multimedia application is specifically designed to assist renal patients to learn and perform CAPD as a way to remove toxic waste and creatinine from their blood. It also allows the patients to see the details of the procedure and steps repeatedly.

Definitions This section briefly explains the modules that have been developed in the CAPD eBook. The application is divided into three modules: 1) Hand Sanitizing, 2) CAPD Procedure, and 3) CAPD Animation. Modules Main Menu Hand Sanitizing CAPD Procedure CAPD Animation

CAPD eBook, Module 1- Hand Sanitizing Hand Sanitizing - Hand sanitizing is a module to demonstrate the right aseptic technique required for CAPD users before they start the complete CAPD process. Hand sanitizing is an important step to eliminate bacteria and germs.

CAPD eBook, Module 2- CAPD Procedure CAPD Procedure - CAPD Procedure is a module to show the full procedure of CAPD processes. Renal patients should follow every step of the procedure in order to perform their dialysis. Each step is very crucial as to ensure the correct way to perform CAPD and to avoid from any mistakes. Errors may cause vulnerability of getting infections to renal patients.

CAPD eBook, Module 3 - CAPD Animation CAPD Animation - CAPD Animation module is to illustrate the whole general process that is experienced by CAPD users. They can see the whole picture of CAPD before they learn and perform it by themselves.

Testing The methods used in the testing phase are usability testing and interview. The usability testing and interview involve patients and nurses who use CAPD. Usability Test Usability Test is important to measure all the criteria of multimedia application [8] such as objective of application, content, interactivity, sound, navigation, and interface of the application. It is a technique for ensuring that the user of the multimedia application can carry out the intended task efficiently, effectively and satisfactorily. Basically, usability testing is done after development of the multimedia application so that any significant issues identified can be addressed. –First, the respondents are given an opportunity to explore the CAPD eBook. Then, they need to complete a few tasks that are provided. During the session, observation is done on the interaction of patients and nurses with the application. Besides that, a questionnaire is given to the respondents to get their response on the application. The usability testing is done at patients’ homes and also at the hospital.

Testing cont. Heuristic Testing –Heuristic Evaluation is a form of usability inspection where usability specialists judge whether each element of a user-interface follows a list of established usability heuristics [9]. Hence, Heuristic Evaluation is the best method of the usability inspection method. Heuristic Evaluation is performed with respondents who are lecturers of computer science and graphic designers. The goal of Heuristic Evaluation is to judge whether each element of application meets the objective. Interview –Interview is a process of conversation with particular purposes. The interview is conducted with renal patients and hospital staffs to get their ideas and feedback about the CAPD eBook. It is an effective way to gain brilliant ideas from users. In addition the application can be improved in future based on the user’s needs.

Results and Discussion Result of Usability Testing –Most of the respondents agree that this application achieves its objectives (mean=4.60), the contents and structures are well arranged and easy to understand (mean=4.20), the interactivity is good (mean=4.20), the navigation is simple and direct (mean=4.40), the interface design is interesting, engaging and attracting (mean=4.60), the sound is clear and pleasant (mean=4.40) and the respondents agree that this application is interesting and knowledgeable (mean=4.40).

Results and Discussion Heuristic Test Results –Most of the experts agree that this application accomplishes its objectives (mean=4.34) and they also agree that this application is interesting, interactive and knowledgeable (mean=4.33).

Results and Discussion Interview Results –Positive feedbacks are received from the hospital staffs during the interview session. Furthermore, the hospital staffs are asked to check the consistency and comprehensibility of the contents. Most of them generally agree that the application is easy to understand and can help renal patients and guide them during the CAPD process. –By using this application, renal patients can refer to the procedure that they should follow. Thus, the images that are used in the application are simple to understand and can help patients to visualize the step by step process that they need to follow. –During the interview, patients are really excited to use the application as it is integrated with combinations of graphic, sound, animation, and text. The application can facilitate them to perform the dialysis. The patients’ family members can also learn the CAPD process together with the patient at their own pace.

Conclusion and Recommendations Positive and negative feedbacks are obtained from the respondents. Results clearly indicate that the application is successful in increasing the knowledge and understanding of renal patients in practicing and training CAPD. The integration of multimedia elements such as graphics, sound, animation, and text help in increasing the user’s interest and keep them captivated. Assimilation of simple navigation, friendly interface design, and organized contents also increase the patient’s learnability and motivation. However, based on the respondents’ feedback, a few ideas are suggested to improve the application for future use, for example the application can be enhanced on the design and quality of sound in order to make the application more interactive. Additionally, this application can be improved by using 3D animation or video features to guide renal patients to do CAPD processes.