Caregivers' experiences and coping strategies relating to patient's subjective treatment-related cognitive impairment following Haematopoietic Stem Cell Transplant (HSCT)

The treatments involved in cancers of the blood and bone marrow can be physically and psychologically challenging and be associated with adverse secondary effects, including cognitive impairment. The incidence and severity of treatment-related cognitive impairment varies widely, however it can significantly impact quality of life by interfering with patients’ activities of daily living, relationships and future plans. It can also pose challenges for the patients’ caregivers, an area which has received comparatively less research attention. The aim of this study was to investigate caregivers’ experiences of treatment-related cognitive impairment in patients who have undergone Haematopoietic Stem Cell Transplant (HSCT); how they coped, both practically and emotionally, and what supports they believe could help them. Participants were caregivers to individuals who had undergone HSCT within the past 20 years and who had reported cognitive changes at the HSCT Late Effects Clinic, Beatson West of Scotland Cancer Centre. Five participants completed a single semi-structured interview. The data was then analysed using Interpretative Phenomenological Analysis (IPA). Results of this analysis illustrated four super-ordinate themes: noticing change; managing expectations, managing personal feelings and commitment. Findings from the current study highlighted the importance of caregiver education regarding post HSCT cognitive and behavioural changes and providing caregiver emotional support. Future research should explore the mutual needs of both care recipient and caregiver.

Effects of modality, urgency and situation on responses to multimodal warnings for drivers

Signifying road-related events with warnings can be highly beneficial, especially when imminent attention is needed. This thesis describes how modality, urgency and situation can influence driver responses to multimodal displays used as warnings. These displays utilise all combinations of audio, visual and tactile modalities, reflecting different urgency levels. In this way, a new rich set of cues is designed, conveying information multimodally, to enhance reactions during driving, which is a highly visual task. The importance of the signified events to driving is reflected in the warnings, and safety-critical or non-critical situations are communicated through the cues. Novel warning designs are considered, using both abstract displays, with no semantic association to the signified event, and language-based ones, using speech. These two cue designs are compared, to discover their strengths and weaknesses as car alerts. The situations in which the new cues are delivered are varied, by simulating both critical and non-critical events and both manual and autonomous car scenarios. A novel set of guidelines for using multimodal driver displays is finally provided, considering the modalities utilised, the urgency signified, and the situation simulated.