Investigating Challenges and Design Requirements of Medical Examination Clothing: A Comprehensive Survey

Hong Y. J¹,Choi, H. E.¹,²^†

1 Department of Fashion and Textiles, Seoul National University, Republic of Korea

2 Research Institute of Human Ecology, Seoul National University, Republic of Korea

SUMMATIVE STATEMENT: This study addressed the challenge of redesigning medical examination clothing, considering the perspectives of both medical professionals and examinees. Medical professionals preferred efficient access to the examinees’ body with abbreviated sleeve lengths, deep necklines, expansive openings in colonoscopy examination pants, and easily operable covers, while examinees prioritized comfort and dignity, favoring three-quarter sleeve lengths, shallower necklines, more modest openings in colonoscopy examination pants, and secure covers. Balancing these diverse design requirements is a challenge for product development, requiring systematic methodologies to achieve optimal designs that accommodate both perspectives.

KEYWORDS: Medical examination clothing, design requirements, user-centered design

PROBLEM STATEMENT: Medical exams play a vital role in disease prevention and early detection. With the global aging population, there's a growing concern about various illnesses, emphasizing the importance of medical examinations. However, factors like embarrassing procedures, complications, preparation challenges, and past negative healthcare experiences hinder participation (Teo et al., 2016). These issues are closely linked to the design of examination clothing. In Korea, medical examination clothing usually includes a robe-style top and open-crotch bottoms. The design of these garments can lead to embarrassment and discomfort for examinees compared to regular clothing (Lucas & Dellasega, 2020; Syed et al., 2022). Therefore, redesigning hospital gowns to prioritize the self-esteem and dignity of examinees is crucial.

OBJECTIVE/QUESTION: Redesigning hospital patient gowns presents a unique challenge, considering both the wearer's comfort and practicality within healthcare institutions. These garments interact not only with patients but also with medical professionals, hospital staff, and laundry services (Gordon & Pokorny, 2019). Our objective is to establish a foundation for medical examination clothing design by studying the challenges and design requirements through surveys and focus group interviews involving both examinees and examiners.

METHODOLOGY: A survey encompassing 1,800 medical examination participants at eight Korea Medical Institute (KMI) examination centers nationwide was conducted between August 18 and August 27, 2023. The survey collected feedback on their dissatisfaction with existing exam clothing and their requirements for new designs using mobile platforms. In addition, we conducted focus group interviews involving 13 medical professionals from the examination centers simulating the 44 examination items to observe interactions and identify discomfort with existing clothing and brainstorm potential improvements.

Group 1 (5 participants)	Group 2 (4 participants)	Group 3 (4 participants)

Figure. Focus group interviews with medical professionals

Figure. Medical examination demonstration

RESULTS & DISCUSSION:

Design Requirements of Medical Professionals: The KMI offers a comprehensive array of 44 examination items, with 16 directly influencing examination clothing design. The deep V-neckline was chosen for its ability to expose the neck and clavicle, essential for examinations like thyroid and carotid ultrasounds. Sleeve length adjustments were made to facilitate equipment access during electrocardiograms, arterial sclerosis tests and blood drawing with a recommended sleeve elevation of up to 15 cm above the elbow. Front-opening gowns were favored for diagnostic procedures, with a focus on uncomplicated closures to ensure easy access. The use of fabric based closures was emphasized to avoid interference of metallic or plastic constituents with medical imaging such as upper gastrointestinal contrast studies, X-rays, CT scans, and MRI scans.

Gown length varied based on the type of examination. Shorter gowns were preferred for general medical exams, enabling easier access to the abdomen during procedures like waist measurements and abdominal ultrasounds. Conversely, longer gowns extending to the knee were essential for colonoscopy exams to effectively cover the pants' opening. For colonoscopy pants, a rear opening was essential to facilitate endoscope insertion without requiring complete pants removal. Ensuring that the opening was adequately expansive to fit diverse anatomical configurations of the examinees and incorporating a removable cover was crucial.

Design Requirements of Examinees: The survey involved 1,800 respondents (940 females and 860 males) with an average age of 41.7 (SD: 11.4). Regarding the neckline, 1,106 respondents (61.4%) found it appropriate, while 615 respondents (34.2%) expressed concerns about excessive exposure due to deeply cut necklines. Particularly, female participants voiced worries about breast exposure associated with a deep neckline. Regarding sleeve length, a substantial majority (62.2%, n=1,119) favored three-quarter sleeves, citing the convenience of rolling up sleeves during examinations and a perceived sense of stability. Concerning gown closures, a significant portion of respondents (54.7%, n=985) expressed a preference for alternatives to current tie closures. Furthermore, 722 respondents (40.1%) conveyed discomfort with tie fastenings, citing insecurity issues. Open-ended responses underscored a clear inclination towards alternative closure mechanisms such as buttons or zippers, perceived as simpler and more secure.

In terms of examination gowns, a thigh-length design was the preferred length for both general examinations (54.0%, 964 responses) and colonoscopy examinations (39.6%, 707 responses). Responses concerning colonoscopy examination pants highlighted concerns regarding the secure fixation of covers (310 responses), adequate coverage of the opening by the cover (184 responses), and the opening being excessively large (142 responses)

Figure. Requirements of examinees and medical professionals reflected in the developed examination gown

Figure. Requirements of examinees and medical professionals reflected in the developed examination t-shirt

Figure. Requirements of examinees and medical professionals reflected in the developed colonoscopy pants

CONCLUSIONS: This study revealed varying examination gown design preferences between two key user groups through the analysis of focus group interviews with medical professionals and surveys of examinees. Medical professionals prioritized efficient access to the examinee's body, favoring shorter sleeves, deeper necklines, expansive openings in colonoscopy pants, and easily operable covers for enhanced examination efficiency. Conversely, examinees emphasized the importance of mitigating concerns about bodily exposure and upholding their dignity, preferring three-quarter sleeves, shallower necklines, smaller openings in colonoscopy pants, and secure covers for comfort and stability. Products, such as examination clothing, serving diverse user groups often present conflicting design requirements. Thus, it is essential to include input from all user groups when developing such products, and future research should explore systematic methodologies to prioritize and optimize these varying design demands effectively.

REFERENCES:

Gordon, L. A., & Pokorny, C. G. (2019, December). Mapping the System-of-Use for the Patient Hospital Gown. In International Textile and Apparel Association Annual Conference Proceedings (Vol. 76, No. 1). Iowa State University Digital Press.

Lucas, C. M., & Dellasega, C. (2020). Finding common threads: how patients, physicians and nurses perceive the patient gown. Patient Experience Journal, 7(1), 51-64.

Syed, S., Stilwell, P., Chevrier, J., Adair, C., Markle, G., & Rockwood, K. (2022). Comprehensive design considerations for a new hospital gown: a patient-oriented qualitative study. Canadian Medical Association Open Access Journal, 10(4), E1079-E1087.

Teo, C. H., Ng, C. J., Booth, A., & White, A. (2016). Barriers and facilitators to health screening in men: a systematic review. Social Science & Medicine, 165, 168-176.

This work was supported by Korea Medical Institute (KMI) (No. 350-20230072).

This work was supported by Korea Institute for Advancement of Technology (KIAT) grant funded by the Korea Government (MOTIE) (P0012770, Professional Human Resources Training Project).