{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:49:35Z","timestamp":1791355775148,"version":"4.3.1"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Family engagement has been associated with improved outcomes following critical illness, but communication barriers challenge family engagement. Traditional video or phone call strategies to navigate communication barriers are time-, resource-, and labor-intensive for hospital staff, often limiting their use. VoiceLove is a Health Insurance Portability and Accountability Act (HIPAA)-compliant mobile phone app that enables family members to send real-time voice messages to intensive care unit (ICU) patients without relying on the clinical team to coordinate calls. We conducted iterative usability testing of VoiceLove to optimize use for patients, families, and their clinical teams in the adult ICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We completed 2 rounds of usability testing of the VoiceLove app in a simulated environment. Usability was assessed through System Usability Scale (SUS) scores and task success rates. Semi-structured interviews were used to identify themes, concerns, and design priorities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean SUS scores for rounds 1 and 2 of testing were 77.5 (SD 11.1) and 75.9 (SD 26.8), respectively. The app concept was overall viewed favorably as a tool with the potential to provide comfort and streamline communication. Key usability issues included navigation, clarity of labels, and accessibility, which were addressed through iterative app improvements. Implementation concerns included nursing workload, family cognitive burden, and interplay with complex family dynamics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A diverse group of ICU stakeholders found the VoiceLove app demonstratedpotential to improve communication with critically ill patients inherently disadvantaged in their ability to communicate. Further testing in a real-world setting is needed to assess the impact of VoiceLove implementation on clinical team work load and family dynamics<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1838229","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:56Z","timestamp":1791352256000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["VoiceLove for patient-family communication in the ICU: a usability study of a novel voice messaging app"],"prefix":"10.3389","volume":"13","author":[{"given":"Soibhan","family":"Kelley","sequence":"first","affiliation":[{"name":"Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center (VUMC), Nashville, TN, United States"},{"name":"Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, VUMC, Nashville, TN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne M.","family":"Boehm","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, VUMC, Nashville, TN, United States"},{"name":"Vanderbilt University School of Nursing, Nashville, TN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariu","family":"Duggan","sequence":"additional","affiliation":[{"name":"Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, VUMC, Nashville, TN, United States"},{"name":"Division of Geriatric Medicine, Department of Medicine, VUMC, Nashville, TN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Slagle","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Anesthesiology, VUMC","place":["Nashville, TN, United States"]},{"name":"Center for Research and Innovation in Systems Safety, VUMC, Nashville, TN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Reale","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Systems Safety, VUMC, Nashville, TN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russ","family":"Beebe","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Systems Safety, VUMC, Nashville, TN, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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