Nicole Barrett

This project was created as a way for women to take ownership of their breast cancer treatment and “accessories”, namely the “PICC” line and how it is covered. The final project provides a system enabling wearers to work through the emotional journey, in an individual way, to connect with other patients and to begin the acceptance process. It is meant to make women feel they can express their identity through medical objects instead of being limited by them.

Introduction

The project was created through a partial collaboration between Emily Carr University MED+ class and GF Strong Rehabilitation centre, where students would have access to contacts at GF Strong but would design their own project and get in contact with a co-creator.

Inspiration

I was initially inspired to form my project around breast cancer because of my own personal experiences with the disease. My mother went through the journey of breast cancer and the subsequent treatment in recent years and the experience impacted me greatly.

My goal from the beginning of the project was to focus on creating a non-medical solution to assist women in some way in their journey through breast cancer. I had brainstormed many ideas about where I speculate the gaps in care might be but I needed to further disseminate my knowledge on the subject. In essence, I wanted to offer what the knowledge I had and create something positive and constructive out of my experiences without allowing personal biases to affect the development of the design. To achieve this goal, I needed to get more evidence to really understand the complexities of this journey and ultimately, where the opportunities for the project would lie.

Co-creation

Because of the transitory and sensitive nature of the disease, I decided that it was a more realistic endeavor to fashion my project as a empathy study, combining research through books, articles, websites, surveys, interviews with former patients and experts as well as my own experience to create an assistive device. It came to be clear that PICC lines, which are long term I.V.s used to administer chemotherapy (as well as other things) were a major source of discomfort and embarrassment for women going through treatment.

To understand the medical side and constraints of the process, I researched at the medical library at UBC and read books ranging from textbooks on breast cancer nursing and the chemotherapy process to books on the women’s personal experiences. As well, I emailed and interviewed medical experts to further understand the intricacies of the process of breast cancer treatment and what constraints that would bring to the possible design.

Furthermore, I conducted an interview with breast cancer survivor Sandra Crawford who clearly and honestly answered my questions and took me through her own journey from diagnosis to recovery and life beyond cancer. What I learned from this initial research was that each cancer journey is incredibly unique both medically and non medically. Just as each cancer was different, each women went through an individualized treatment and an incredibly personal journey; therefore the end product that I would create for the project could not be one size fits all.

Identity

“Every little thing helps.” was a quote from one of my surveys that embodied some of the main ideas and themes that continually came up in my research and eventually began to define the spirit of the project.

It seemed that many women struggled quite strongly with how breast cancer changed them physically and in turn, how this acted as a change or “loss” in their femininity.

As Deborah Hobler Ka- hane said in her book “No Less a Woman”, “Believe me, I did not feel like the essence of femininity at this time.”

This recalibration of women's identity cemented my leanings to create a non-medical assistive device. As well, I wanted to create something that would help women to focus on their own needs, as many feel full of shame for worrying about how they look and how this makes them feel.

The PICC line

Brainstorming determined that this would be a soft product. This narrowed focus was important because of the nature of the PICC line, as it is temporary. The PICC line is inserted into a large vein in the arm, and consists of one to three ports or lumens where the medication is dispensed into the device. The line is stabilized by three pieces: a butterfly shaped piece is sutured to the skin further up the line, an adhesive piece called Statlock holds the line in place with hinged doors and a clear adhesive dressing called Tegaderm that covers the apparatus up to the lumens which hang down at the bottom. The tegaderm dressing is vital to keeping the area clean and sterile.

Women are given stretchy pieces of gauze to keep the lumens from flopping around and to cover the area. I was able to get a hold of a central catheter (through GF Strong and Vancouver General Hospital. With their assistance, I learned how to properly adhere the dressing and flush the line out with saline.

I was not allowed to get the line wet and had to wear the gauze provided. It did not take the PICC line to get uncomfortable and cumbersome; the gauze would not hold in the lumens and the tegaderm was incredibly insulating and irritating to the skin. Furthermore, people’s reactions to the line began to affect how I felt about my situation and how I looked. The reactions ranged from sympathy and exclamations of how awful it looked from friends and colleagues to silent glances and stares from the public. Once the constraints of the PICC line were established, I wanted to focus on creating a way to cover it that would be comfortable as well as individual and personal.

Systems Design

At this point in the design process, looking back at my precedent research helped to determine that I wanted the PICC line cover to work to act as more than just an object but connect to a greater system of connection and therapy. I was inspired by the work of “Look Good, Feel Better” as well as “Hanky Pancreas” both of which aim to create a system of products that both allow a women to feel better by allowing her to look how she wants to feel. They also let the women work through their treatment by learning new ways and techniques to connect to the medical objects that affect them in real life. I wanted my PICC line cover to create a way to offer women a way to feel a sense of control over these medical objects that they did not ask to be connected to.

Figuring Out Specifics

At this point, I had determined that I would be working with covering a PICC line, and creating a non-medical, functional and fashionable form. As well, it needed to be comfortable and functional while allowing it to be customizable and stylish, and offering an opportunity for interaction with other women. The one problem remained: women are all different and at a time when identity means so much, how do you design a cover to satisfy every woman’s wants and needs? My design also had to work around the constraints of the PICC line which were that it needed to be lightweight and breathable, would not cause sweating or build up of heat and would allow for ease of use and use in many different situations.

Form and Function: Materiality

Research and the ethnographic research had ruled out many types of sports fabrics, as they seemed to cause irritation underneath the tegaderm dressing.

In the final stages of the design, the materials list remained simple, mostly coming back to organic cottons, linens, and rayons. I felt that these materials related well to the core values of the project. They evoked a sense of comfort and safety, as well as could be fashionable and feminine. They were common fashion and clothing fabrics and were soft and comfortable to wear against sensitive skin. It ended up being a bit more work to adjust the form to fit the fabrics but with some creative sewing and the help of magnets as closures, the form came together.

Final Project

The final project became a form that attached to a system that allowed for women to customize their PICC line cover if they so chose. First, the actual form consisted of a wrap with pockets that would allow for the lumens to be tucked in without touching the skin, or being visible on the outside. The initial meeting would happen before the woman would have her PICC line inserted where the process would be explained to her in a non-medical way and the volunteer would offer her the options of fabrics and types of covers.

The women would also have a choice of receiving customization options with her cuff in a kit that would be mailed to her house. When the woman receives the kit, there would information inside to direct her in its use, how she can create the items in the kit and finally how she can get in touch with other women who also have PICC lines. My hope for the project would that it would allow women to change or customize their cuff, providing them a distraction and something to work through. The possibilities of creating a community of women who are going through the same thing would be phenomenal.

Findings

The evocative nature of the product and the system that go along with it are what I feel bring the project together. Through the process of this project, I learned the value of quality research and exploration, to reach beyond my comfort zone, as well as effectively distilling the problem space of a project. I also learned that despite the fact that it may be tempting to try and fix all of the issues within a project, it is more important to focus in on a certain point and design a quality solution.