Use of a Wearable Self-Tracking Instrument by Refugees With Complex Posttraumatic Stress Disorder: A Qualitative Study of Psychotherapeutic Mediation and Engagement
Notice bibliographique
Résumé
Background: Wearable self-tracking technologies are increasingly used in mental health care to enhance engagement and personalize treatment. However, most existing instruments focus on passive data collection or predefined symptom monitoring. Less attention has been given to tools that enable patients to actively track personally meaningful, self-defined mental health experiences as part of psychotherapy, particularly in vulnerable populations such as refugees with complex posttraumatic stress disorder (CPTSD). Objective: This study aimed to explore how the One Button Tracker (OBT), a novel single-purpose wearable self-tracking instrument that enables in-the-moment active registration of self-defined, personally relevant mental health phenomena, supports therapeutic engagement among refugees receiving psychotherapeutic treatment for CPTSD. Methods: This qualitative study was part of a larger participatory action research project conducted from 2022 to 2024 at a specialized clinic for trauma-affected refugees in Denmark. A total of 9 adult refugees diagnosed with CPTSD used the OBT during psychotherapy to actively track a personally relevant and collaboratively defined target phenomenon through a button press. The OBT provided vibrotactile feedback and stored timestamped data for therapeutic use. A total of 25 semistructured interviews were conducted across 3 time points: before, during, and after treatment. Reflexive thematic analysis guided by a postphenomenological framework was used to explore how the technologies mediate experience. Results: Participants (6 women and 3 men, median age 47 years, IQR 31-57 years) had lived in Denmark for an average of 21.4 years. The duration of OBT use ranged from 22 to 366 days. Participants tracked between 2 and 14 different phenomena and registered between 37 and 4733 events in total during their courses of treatment. Thematic analysis revealed five central themes that captured the multistable character of the OBT: (1) from external instrument to extension of the self, (2) mental switch, (3) faithful companion, (4) scarlet letter, and (5) emergency lifeline. Patients described the OBT as a meaningful anchor in distressing moments, enhancing emotional regulation, self-awareness, and continuity between sessions. The OBT's vibrotactile feedback was experienced as affirming and responsive, reinforcing a sense of being acknowledged and connected, even in the absence of direct therapist contact. However, the visibility of the OBT also introduced challenges, including stigma and altered social dynamics. Conclusions: The OBT functioned as an active mediator in therapy. It supported in-the-moment tracking of personal experiences, encouraged agency and emotional regulation, and helped patients feel connected to their therapist outside of sessions. The vibrotactile feedback played a key role in how the OBT was embodied and interpreted. These findings highlight the value of designing digital mental health technologies incorporating active self-tracking that emphasize relational use, experiential meaning, and personalization. A focus on simplistic design, adaptability, and patient-defined use may enhance therapeutic relevance, especially in settings where stigma or complexity limits engagement.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,009 | 0,013 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,002 | 0,009 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».