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Prosthetic Realities, Prosthetic Futures: Challenging the Status Quo of External Breast Prosthesis Design

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Prosthetic Realities, Prosthetic Futures: Challenging the Status Quo of External Breast Prosthesis Design University of Plymouth PEARL https://pearl.plymouth.ac.uk 04 University of Plymouth Research Theses 01 Research Theses Main Collection 2021 Prosthetic Realities, Prosthetic Futures: Challenging the status quo of external breast prosthesis design Brave, Rosie http://hdl.handle.net/10026.1/17279 University of Plymouth All content in PEARL is protected by copyright law. Author manuscripts are made available in accordance with publisher policies. Please cite only the published version using the details provided on the item record or document. In the absence of an open licence (e.g. Creative Commons), permissions for further reuse of content should be sought from the publisher or author. PROSTHETIC REALITIES, PROSTHETIC FUTURES: Challenging the status quo of external breast prosthesis design by ROSIE BRAVE A thesis submitted to the University of Plymouth in partial fulfilment for the degree of RESEARCH MASTERS School of Art, Design & Architecture June 2021 COPYRIGHT STATEMENT This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and that no quotation from the thesis and no information derived from it may be published without the author's prior consent. ii “Nobody can control cultural processes. But designers can and should become cognizant of the conversations that enable them to create their designs, continue well after they have done their part, and ultimately impact a culture.” - Krippendorff (2007) iii ACKNOWLEDGEMENTS I owe a debt of thanks to all the participants in this research project, to Sam and Sue Jackman, my very patient husband, my supervisors, the technicians who helped me begin my journey with casting and mould making, 3D design software and 3D printing, and to all the many other people who have given time, information or feedback to help me develop this project. Thank you all. I acknowledge the inspiration I have taken from the visionary work of Sophie de Oliveira Barata of The Alternative Limb Project, Becalelis Brodskis for the instructional conversation about the concept of “re-imagining” and Agi Haines for the formative introduction to speculative design. The research would not have been possible without a studentship funded by the 3D3 Centre for Doctoral Training (itself funded by the Arts & Humanities Research Council). Finally, I am grateful to my parents for encouraging my involvement in and exposure to a wide range of visual, performing and liberal arts throughout my life which has served to feed my imagination and fuel my desire to keep learning and keep questioning – without this it is hard to conceive how I would have embarked on such an interdisciplinary research project. iv AUTHOR’S DECLARATION At no time during the registration for the degree of Research Masters has the author been registered for any other University award without prior agreement of the Doctoral College Quality Sub-Committee. Work submitted for this research degree at the University of Plymouth has not formed part of any other degree either at the University of Plymouth or at another establishment. This research was financed by the 3D3 Centre for Doctoral Training. Word Count: 22,063 Signed: Dated: 17 June 2021 v PROSTHETIC REALITIES, PROSTHETIC FUTURES: Challenging the status quo of external breast prosthesis design Rosie Brave ABSTRACT This practice-based research identifies the need and opportunity to update the design approach used in the production of external breast prostheses (EBP) for women post mastectomy. Spurred by accounts of some women’s negative experiences with their EBP, this research took influence from colour psychology, emotional design and consumer psychology to explore the potential to create a satisfying and transformative product and user-experience. Drawing on grounded theory, design ethnography and human-centred design practices, an iterative, empathic and participant-centred design process and methodology emerged. Insights from interviews, cultural probes, co-design activities and solo practice were combined to inform the making of speculative prosthesis prototypes that could advance the discourse of EBP. The aesthetics of prosthetics is a nascent research field, with some literature focussed on prosthetic limbs and a lack of attention on the prosthetic breast. Current external breast prostheses are semi-realistic or highly realistic and, as such, can keep wearers focussed on the absence of their breast(s) rather vi than new opportunities for expressing identity - opportunities already available to wearers of limb prostheses. This research concludes that through empathising and designing with wearers, designers can improve the EBP so that it better meets the diverse needs and desires of women and provides the potential for positive associations for those women who are currently dissatisfied with their prosthesis. vii TABLE OF CONTENTS Cover page…………………………………………………………………………………... Copyright statement………………………………………………………………………...ii Epigraph……………………………………………………………………………………..iii Acknowledgements…………………………………………………………………………iv Author’s declaration………………………………………………………………………...v Abstract………………………………………………………………………………………vi Table of contents……………………………………………………………………… ….viii List of illustrations………………………………………………………………………….xiv List of tables………………………………………………………………………………..xv Chapter 1: INTRODUCTION 1.1 Thesis introduction, research aims and objectives………………………………...1 1.2 EBP: the product……………………………………………………………………….4 1.3 The wearer and her experiences……………………………………………………..7 1.4 EBP context…………………………………………………………………………….12 1.5 Research enquiry……………………………………………………………………...17 1.6 Methodology……………………………………………………………………………19 1.7 Thesis overview………………………………………………………………………..25 viii Chapter 2: METHODS & AN INTRODUCTION TO PRACTICE 2.1 Chapter introduction…………………………………………………………………..27 2.2 Notes on ethical practice……………………………………………………………..28 2.3 Notes on designer-researcher bias………………………………………………….29 2.4 Notes on collaboration………………………………………………………………...31 2.5 Methods………………………………………………………………………………...32 2.6 Towards Antidotal Design…………………………………………………………….37 2.7 Evolution of practice…………………………………………………………………..39 2.8 Chapter conclusion……………………………………………………………………44 Chapter 3: PRACTICE & LEARNINGS 3.1 Chapter introduction…………………………………………………………………..45 3.2 Making 3.2.1 Making discursive objects and images for elicitation……………………46 3.2.2 Making as product development…………………………………………..48 3.2.3 Making discursive/critical objects for exhibition………………………….52 3.2.4 Collaborative making as dissemination (co-producing/designing with students)…………………………………………………………………………….53 3.3 Interviews……………………………………………………………………………….54 ix 3.4 Workshops 3.4.1 Speculative design workshop………………………………………………56 3.4.2 Co-design workshops……………………………………………………….59 3.4.3 Co-design student workshop……………………………………………….63 3.5 Remote………………………………………………………………………………….67 3.6 Probes…………………………………………………………………………………..69 3.7 Analysis 3.7.1 Analysis of cultural artefacts, practices and media representation to inform discursive designs ...………………………………………………………72 3.7.2 Analysis of participant narrative themes, visual preferences and emotional journeys, to inform the design of critical exhibition objects………..75 3.7.3 Thematic analysis overview………………………………………………..78 3.8 Exhibition (Becoming)………………………………………………………………...80 3.9 Chapter conclusion……………………………………………………………………83 Chapter 4: SYNTHESIS: PROSTHETIC REALITIES, PROSTHETIC FUTURES 4.1 Chapter introduction…………………………………………………………………..84 4.2 PROSTHETIC REALITIES: women’s experiences of deciding whether to use an EBP x 4.2.1 Processes and priorities…………………………………………………86 4.2.2 Mindsets after mastectomy………..……………….……………………89 4.3 PROSTHETIC FUTURES: aesthetics and design process/practice 4.3.1 A grounded theory of the aesthetics of EBP……………………………..95 4.3.2 A model for antidotal design……………………………………………….97 4.3.3 Summarised Design Guidelines for External Breast Prostheses………99 4.3.4 Designer’s Guide to Re-imagining the EBP…………………………….104 4.4 Chapter conclusion…………………………………………………………………..106 Chapter 5: DISCUSSION & CONCLUSION 5.1 Chapter introduction…………………………………………………………………108 5.2 Summary of learning and a note on limitations…………………………………...109 5.2.1 Women’s experiences……………………………………………………..110 5.2.2 EBP aesthetics…………………………….…………….…………………111 5.2.3 Impact of EBP design………………………………….………………….112 5.2.4 Design processes…………………………..…………….………………..113 5.3 Research value and contributions to knowledge and practice…………………….…………….…………….…………….…………….………114 5.4 Future research and practice…….…………….…………….……………………..118 5.4.1 Recommendations for scholars…………………….…………….………119 5.4.2 Recommendations for practitioners………………….…………………..121 5.4.3 Personal intentions for future research and practice…………………..122 xi 5.5 Concluding statement and call to action……………………………….………….123 References………………………………….…………….…………….…………..…….124 Bibliography………………….…………….…………….…………….…………….……128 Appendices Appendix A Recruitment criteria……………………………………….…………….………………..139 Appendix B Choices I made evidencing a feminist/ inclusive philosophy.………………………..142 Appendix C Sample consent form……………………………………….…………….……………...145 Appendix D Becoming: 10 new possibilities for EBP…………………………….………………….148 Appendix E Sample interview protocol……………………………………….…………….………...174 Appendix F Sample interview notes……………………………………….…………….……………176 Appendix G Social and Personal Meanings: Discourses of completeness………….……………180 xii Appendix H Four Themes: the wearer’s experience and how to improve it………………………186 Appendix
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