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This thesis adds to a stream of research suggesting that healthcare can be more patient centered and efficient by redefining the role of the patient from a passive receiver to a more active and collaborative participant. This may relate to healthcare provision (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) and innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Through research initiative containing four healthcare units and 68 patients, the present thesis combines healthcare research (e.g., Anderson and Funnell, 2005; Nelson et al., 2002) with service research (e.g., Grönroos, 2006; Vargo and Lusch, 2008, 2004) to explore three aspects of patient involvement and service innovation. Firstly, the concept of patient involvement itself is investigated through an extensive literature review of empirical research on patient involvement. A model describing the antecedents, forms and consequences of patient involvement is proposed. What value is, and how patients can co-create value is discussed from the perspectives of healthcare research and service management thought. Secondly, the thesis proposes a diary-based methodology for involving patients in service innovation. My colleagues and I developed the methodology in collaboration with the participating care providers and applied it in practice. We used the experiences we gained from the project and the contributions from the patients to examine the opportunities for user involvement in service innovation. The participants contributed with ideas and insights stemming from their experiences in their contact with healthcare and other resources. We suggest the following three ways of learning from the collected data: As ideas for improvements; through summary reports to illustrate other quantitative data; and as narratives to promote change. Thirdly, the thesis explores patients’ motivations to participate in service innovation, a hitherto unexplored field. Through an analysis of patients’ contributions and interviews with participants we found that there are a number of factors that motivate patients to participate and that participation is perceived as a social- and meaningladen event. Patients derive psychological well-being and support from participation, but disease was sometimes a barrier to participation. This thesis elaborates on how the most motivated users can be involved in service innovation, applying thinking from the lead-user methodology to a healthcare setting. Overall, the thesis explores patient involvement from new perspectives and, by doing so, adds to our collective efforts to improve healthcare. / Denna avhandling syftar till en mer patientcentrerad och effektiv sjukvård. Den bidrar till en strömning inom forskningen som menar att sjukvården kan förbättras genom en omdefiniering av patientrollen – från en roll som passiv mottagare till aktiv, samskapande aktör. Patienten kan ses som en resurs både i utförande av vården (Anderson and Funnell, 2005; Berry and Bendapudi, 2007; Bitner and Brown, 2008; McColl-Kennedy et al., 2012; Nordgren, 2008) och inom utveckling och innovation (Bate and Robert, 2006; Groene et al., 2009; Longtin et al., 2010). Avhandlingen kombinerar sjukvårdsforskning (Anderson and Funnell, 2005; Nelson et al., 2002) med tjänsteforskning (Grönroos, 2006; Vargo and Lusch, 2008, 2004) i en forskningsansats som innefattar fyra vårdenheter och 68 patienter. Den utforskar tre aspekter av patientinvolvering och tjänsteinnovation. För det första undersöks konceptet patientinvolvering genom en omfattande litteraturöversikt av den empiriska forskningen på området. Översikten leder till en konceptuell modell för att beskriva patientinvolvering: vad dess förutsättningar är, vilka former av patientinvolvering som finns och vad patientinvolvering leder till. Avhandlingen diskuterar även begreppet värde och hur patienter kan samskapa värde, utifrån perspektiv inom vårdforskning och tjänsteforskning. För det andra föreslår avhandlingen en dagboksbaserad metod för att involvera patienter i tjänsteinnovation. Deltagande patienter skriver i denna metod ner sina ner sina idéer och upplevelser varje dag under två veckors tid. Mina kollegor och jag utvecklade metoden i samarbete med personal från de deltagande vårdenheterna och applicerade den på praktiken. Erfarenheterna från projektet och de deltagande patienternas bidrag användes för att utforska möjligheterna med patientinvolvering i utvecklingen av vården. Vi föreslår tre sätt att lära sig från det insamlade materialet: som direkta idéer till förbättringar; summerat till rapporter för att ge kvalitativ förståelse av andra kvantitativa mätningar; och enskilda patienters berättelser kan användas för att förmedla patientperspektivet i organisationen och mana till förändring. För det tredje undersöker avhandlingen patienters motivation att bidra till tjänsteinnovation, ett hittills outforskat område. Genom en analys av patienters bidrag och genom intervjuer med deltagare finner vi att patienter motiveras att delta av en rad olika anledningar, från ett behov av upprättelse till en glädje av att utföra aktiviteten. Deltagandet uppfattas som en social och meningsfull händelse. Patienter upplever psykiskt välbefinnande och stöd genom att delta, även om sjukdom kan vara ett hinder i deltagandet. Avhandlingen undersöker även hur de allra mest motiverade patienterna kan identifieras och inkluderas i tjänsteinnovation, detta inspirerat av lead  user-metoden (von Hippel, 1986). Sammantaget utforskar avhandlingen patientinvolvering och tjänsteinnovation från nya perspektiv och bidrar därmed till våra gemensamma ansträngningar för att förbättra vården och patienters välbefinnande.

Submitted by Micheli Abreu (mabreu@fiocruz.br) on 2016-04-15T14:40:15Z No. of bitstreams: 1 Ariélly_Fidelis_EPSJV_Mestrado_2015.pdf: 4030638 bytes, checksum: 1cac5141946d0e14060659dcc3956e36 (MD5) / Approved for entry into archive by Mario Mesquita (mbarroso@fiocruz.br) on 2016-04-15T18:19:44Z (GMT) No. of bitstreams: 1 Ariélly_Fidelis_EPSJV_Mestrado_2015.pdf: 4030638 bytes, checksum: 1cac5141946d0e14060659dcc3956e36 (MD5) / Made available in DSpace on 2016-04-15T18:19:44Z (GMT). No. of bitstreams: 1 Ariélly_Fidelis_EPSJV_Mestrado_2015.pdf: 4030638 bytes, checksum: 1cac5141946d0e14060659dcc3956e36 (MD5) Previous issue date: 2016 / Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Programa de Pós Graduação em Educação Profissional em Saúde / Diferentes concepções de cuidado permeiam o setor da saúde e influenciam as práticas adotadas em todos os campos, inclusive o da saúde mental. Cada local de atendimento em saúde adota um perfil de cuidado, que nem sempre atende às reais necessidades da população. Este estudo buscou sentido para o cuidado em saúde mental na Rede de Atenção Psicossocial do Sistema Único de Saúde (SUS). O estudo configura-se metodologicamente como qualitativo de cunho fenomenológico, a partir do referencial hermenêutico de Heidegger. Para trilhar o caminho analítico tomou-se por inspiração, também, o referencial da Antropologia Visual e o seu fazer etnográfico. O esforço empreendido nesta pesquisa se deu a partir da seleção de 21 imagens fotográficas que retratam distintas vivências que apontam para o cuidado exercido no interior de diferentes dispositivos de saúde mental do Sistema Único de Saúde do Brasil. Cinco imagens retratam cenas de Centros de Atenção Psicossocial (CAPS), oito de Hospitais Psiquiátricos e oito de Residências Terapêuticas. A partir destas imagens, o sentido do cuidado exercido nos dispositivos da RAPS emergiu como ainda atrelado à noção de cuidado baseado nos procedimentos e ações efetivas, ao funcionamento considerado adequado exclusivamente desde o cumprimento de protocolos, critérios e atividades assistenciais preconizadas nos manuais. O cuidado considerado necessário para o âmbito da saúde mental é o que, certamente, contribui para a progressão da Reforma Psiquiátrica Brasileira, valoriza as pessoas, reconhece seus contextos de vida, se interessa por seus sentimentos e expectativas quanto ao que os profissionais podem vir a colaborar para a satisfação das necessidades, para a redução do seu sofrimento e para a reconfiguração dos dispositivos de saúde. / Different conceptions of care permeat the health sector, playing important role in the practices adopted in all fields, including mental health. Each health device adopts a care profile, which does not always achieve the real needs of the population. This study sought meaning for mental health care in Psychosocial Care Network of the Brazilian Unified Health System (Rede de Atenção Psicossocial - RAPS of the Sistema Único de Saúde - SUS). The study has methodological and qualitative phenomenological nature, with the referential of heideggerian hermeneutics. To tread this analytical path took as an inspiration, also, referential of the Visual Anthropology and its ethnographic approach. The efforts undertaken in this research come up from the selection of 21 photographic images that depict different experiences about to the care exercised inside of some devices of SUS. Five images show scenes of Psychosocial Care Centers (Centros de Atenção Psicossocial - CAPS), eight are to looking for experiencies in psychiatric hospitals and eight are set up inside therapeutic residences (Programa de Residências Terapêuticas). From these images, the meaning of care exercised in the RAPS devices emerged as still linked to the notion of care based on procedures and effective action, operation considered appropriate only from compliance protocols, welfare criteria and activities recommended by manuals. The care deemed necessary for the scope of mental health is what certainly contributes to the progression of the Brazilian Psychiatric Reform, values people, recognizing their life contexts, their feelings and expectations as to what professionals can come to collaborate to meet the needs, to reduce their suffering and to the reconfiguration of health devices.

Submitted by Izabel Franco (izabel-franco@ufscar.br) on 2016-10-10T14:50:02Z No. of bitstreams: 1 DissAAS.pdf: 1435150 bytes, checksum: 7abcf360d540c17a74c711194318bbda (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-20T19:59:08Z (GMT) No. of bitstreams: 1 DissAAS.pdf: 1435150 bytes, checksum: 7abcf360d540c17a74c711194318bbda (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-20T19:59:13Z (GMT) No. of bitstreams: 1 DissAAS.pdf: 1435150 bytes, checksum: 7abcf360d540c17a74c711194318bbda (MD5) / Made available in DSpace on 2016-10-20T19:59:19Z (GMT). No. of bitstreams: 1 DissAAS.pdf: 1435150 bytes, checksum: 7abcf360d540c17a74c711194318bbda (MD5) Previous issue date: 2016-03-31 / Não recebi financiamento / The biopsychosocial phenomenon of drug use becomes a challenge to the health promotion because of the multitude of factors involved; among them, the subject's autonomy. Aiming to identify and understand a set of aspects related to personal autonomy for the use and search for treatment because of disorders related to use of illicit drugs, we used the clinicalqualitative Method and interpretive interactionism to investigate the people's autonomy in the beginning of the treatment at CAPS- AD São Carlos, SP. The data obtained through nondirected interviews done with ten of these subjects were organized into thematic categories, which the content analysis showed that some people had a voluntary action, both for the drug use and for the search for treatment. However, others did not recognize their volitional intention for drug or had their self-care autonomy impaired. On the other hand, it was observed that the reflection about the use condition itself seems to move people to search for treatment. Therefore, it is important to consider that the subject's autonomy is crucial for both the determination by the use of drugs and for seeking treatment and self-care, although it may be impaired in some circumstances. This implies that the treatment project for the care of people who use illegal drugs need to consider the reflections and decisions of the subject itself about their living conditions and the maintenance of the use factors, as well as the possibility of choice and improved quality of life. / O fenômeno biopsicossocial do uso de drogas torna-se um desafio à promoção de saúde diante da multiplicidade de fatores envolvidos; entre eles, a autonomia do sujeito. Com o objetivo de identificar e compreender um conjunto de aspectos ligados à autonomia pessoal para o uso e para busca pelo tratamento por transtornos relacionados ao uso drogas ilícitas, utilizou-se o Método clínico-qualitativo e o interacionismo interpretativo para investigar a autonomia de pessoas em início do acompanhamento para cuidados no CAPS-AD de São Carlos, SP. Os dados obtidos por meio de entrevistas não-dirigidas feitas com dez desses sujeitos foram organizados em categorias temáticas, cuja análise do conteúdo mostrou que algumas pessoas apresentaram uma ação voluntária, tanto para o uso da droga, quanto para a busca por tratamento. Contudo, outras não reconheceram sua intenção volitiva para o uso da droga ou tinham sua autonomia para o autocuidado prejudicada. Por outro lado, observou-se que a reflexão sobre a própria condição de uso parece mobilizar as pessoas a buscar por tratamento. Portanto, é importante considerar que a autonomia do sujeito é decisiva tanto para a determinação pelo uso de drogas quanto para a busca do tratamento e para o autocuidado, ainda que possa estar prejudicada em algumas circunstâncias. Isso implica que o projeto terapêutico destinado ao cuidado às pessoas que fazem uso de drogas ilícitas precisa considerar as reflexões e decisões do próprio sujeito a respeito de sua condição de vida e dos fatores da manutenção do uso, bem como das possibilidades de escolha e melhoria da qualidade de vida.

Le discours sur l'Autre s'ancre dans le discours médical. Mais de quel Autre s'agit-il ? De quelle identité parlons nous dès lors qu'il s'agit d'altérité, de reconnaissances et de vulnérabilités du sujet de soin ? Qui reconnaît-on ? Nous explorons ici les équilibres relationnels au sein de la relation soignant-soigné en Orthopédie dento-faciale hospitalière. A travers une l'approche structurale des représentations sociales, via l'utilisation de cartes conceptuelles, est interrogé le rapport des partenaires thérapeutiques à l'objet prendre soin, notion symbolique et indicible de l'activité soignante. Introduire le prendre soin revient à souligner ce que la relation contient de dimension à la fois éthique, technique et politique. Avec la notion d'accueillance du sujet, élément matriciel central révélé par l'analyse de la représentation, lors des questionnaires réalisés, se dessinent les enjeux identitaires de la reconfiguration contemporaine de la relation de soin, modèle hybride entre une forme atténuée de paternalisme médical et une libéralisation relative. Cette perspective novatrice nous autorise à interroger ces différents registres de valeurs, qui sont autant de témoignages et d'illustrations de la notion de personne. Cette dialectique du même et de l'Autre, de l'identité et de la reconnaissance des acteurs, ouvre ainsi un débat de nature à la fois théorique, éthique et politique autour de l'espace relationnel du soin. / A discourse focused on the Other is firmly anchored in medical discourse. But what Other is being spoken about? What identity are we talking about when considering the otherness, recognition and vulnerability of the recipient of care? Whom are we recognising? Here, we will be exploring the relational balance within the patient-carer relationship in the field of dentofacial orthopedics. A structural approach to social representations, using concept maps, will be adopted in order to examine the relationship of the therapeutic partners to the concept of care provision - a symbolic component of the treatment process which is difficult to define explicitly. Introducing the notion of care provision means placing an emphasis on the ethical, technical and political content of the care relationship. The notion of the favourable reception of the patient, a central element of the relationship which is revealed by an analysis of representations based on questionnaires, highlights the role of identity in the contemporary reconfiguration of the care relationship - a hybrid model which combines a modulated form of medical paternalism and comparative emancipation. This original perspective enables us to examine these various value registers, which illustrate and testify to the notion of the individual. This dialectic of sameness and the Other, of the identity and the recognition of the participants, thus gives rise to a debate, simultaneously theoretical, ethical and political, focused on the relational space associated with care.

Bakgrund: Covid-19 är en luftburen infektionssjukdom med hög smittorisk som främst överförs via droppsmitta. Nationella samt internationella försiktighetsåtgärder har framtagits i syfte att minska smittspridningen av viruset. Folkhälsomyndigheten har skärpt rekommendationerna för gravida samtidigt som omprioriteringar görs inom hälso- och sjukvården. Syfte: Syftet med denna studie var att undersöka barnmorskors erfarenheter av att arbeta i patientnära vård under virusutbrottet covid-19. Metod: Studien var en tvärsnittsstudie med kvantitativ ansats. Datainsamling har gjorts via en webbenkät som besvarats anonymt. Resultat: Av de 159 respondenter som svarat på studien upplevde majoriteten en ökad stress samt en oro att bli smittad av covid-19 och föra smittan vidare. En femtedel av barnmorskorna upplevde ett nedsatt psykiskt välbefinnande. Slutsats: Riktlinjer på nationell nivå för simulering, skyddsutrustning och tydlig information för barnmorskor kring arbetet i patientnära vård under covid-19 efterfrågas. Detta i syfte att skapa trygghet i arbetet, att inte bli smittade eller föra smittan vidare. / Background: Covid-19 is a highly contagious airborne infectious disease which primarily spreads via droplets when throat or nasal secretions are released into the air. Precautions have been implemented worldwide with the intent to minimize the spread of the disease. The Public Health Agency of Sweden has implemented new and improved recommendations. Purpose: The aim for this study was to investigate the midwife’s firsthand experiences working intimately with patients during the outbreak of the covid-19 pandemic. Method: The study was a cross- sectional study with a quantitative method. The data was gathered throughout anonymous online questionnaires answered by midwives in Sweden. Result: Of the 159 respondents in the study, the majority reported an increased level of stress and anxiety related to becoming ill or transferring the virus to others. One in five respondents experienced a decrease in mental wellbeing. Conclusion: National guidelines for midwives regarding practice simulations, protective gear and comprehensive information concerning the work in near proximity to the patient was desired. Midwives called for this to ensure a safe working environment, and to avoid transferring the virus to their colleagues and patients.

<p><b>Background:</b> Shared decision-making (SDM) increases patients’ involvement in their healthcare, extending the goal of patient-centered care provision. However, SDM is underexplored in women’s reproductive health, where choices about contraception and pregnancy are frequently value and lifestyle-dependent. Furthermore, limited research exists on SDM outside of the patient-physician dyad, preventing insight into how non-physician community-based healthcare professionals (HCPs) engage women in practice. Finally, little research takes a social-ecological approach to SDM, despite interaction of multiple levels of influence in women’s reproductive healthcare decision-making. Therefore, the purpose of this study was to explore women’s and HCPs’ experiences with SDM, including the various factors associated with how women make their reproductive healthcare choices.</p><p> </p><p><b>Methods: </b>This study consisted of three distinct, but interconnected phases. Phase 1 consisted of 6 focus groups (Sept-Dec, 2019) with women aged 18-45 living in Indiana who sought community-based or private healthcare for women’s reproductive healthcare needs. Phase 2 included 20 key-informant interviews with non-physician HCPs (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women’s reproductive healthcare. Focus groups and interviews were audio-recorded, transcribed, and analyzed using an expanded grounded theory framework. Constant comparative analysis identified emergent themes in both phases. Phase 3 consisted of an online survey. Women (18-45 years) living in Indiana who sought reproductive healthcare completed the survey (N=432). Multiple linear regression, chi-square analyses, and structural equation modeling were utilized to identify ecological factors associated with pregnancy and contraceptive shared decision-making.</p><p> </p><p><b>Results:</b><i> Phase 1)</i> Participants (n=22) wanted to be invited into healthcare discussions. Additionally, they wanted conversations to proceed organically, where HCPs listened to their needs, and supported and validated their choices. Though these behaviors did not always occur, they provided recommendations to enhance these experiences. Additionally, participants described quality of time was more important than quantity of time during appointments. Prior negative healthcare experiences specifically tied to HCP-interactions decreased women’s healthcare engagement. Additionally, social support system experiences were influential on women’s choices. Race also emerged as impactful toward decision-making, including Black women feeling less respected in care and making choices about their reproductive healthcare to ensure their voices were heard, such as enlisting Black doulas. <i>Phase 2)</i> HCPs noted patient-centered care was important to community-based care. They also noted the importance of contextualized decision-making approaches to ensure they could meet women’s varied needs. Results identified that outcome-oriented SDM concepts, including patient buy-in and investigative listening, were important for increasing SDM. HCPs suggested SDM improved healthcare experience beyond one visit. <i>Phase 3) </i>Structural equation modeling revealed access, social support, and patient-HCP relationship had significant relationships with contraceptive and pregnancy SDM. These models demonstrated good global and component fit, suggesting the importance of context in women’s health choices. Further, regression results demonstrated SDM was associated with higher reproductive healthcare quality. Additionally, utilizing community-based healthcare for reproductive health was associated with decreased contraceptive SDM scores.</p><p> </p><p><b>Conclusion: </b>Findings from this study provide practical considerations for extending SDM work in women’s reproductive health. In particular, results supported shifting SDM beyond the patient-physician dyad to include non-physician HCPs and HCPs in community-based healthcare settings. Women frequently access these services when seeking reproductive healthcare; thus, findings improve our understanding of the practical considerations researchers, policy-makers, and HCPs must make when promoting SDM in these settings. Furthermore, results revealed SDM use across multiple touchpoints, including community-based services, is imperative for women to achieve partnership in their healthcare. Thus, SDM provides a broader opportunity to enhance patient involvement across the spectrum of women’s reproductive healthcare. Incorporating women’s contextual needs and preferences improves HCPs’ insight into women’s experiences to further personalize care. Findings emphasize the importance of decisional space that include the various factors, agents, healthcare settings, and options that exist in reproductive health decision-making as these can shape women’s choices, and, subsequently, their SDM experiences. This mixed methods study allowed thorough insight into multiple stakeholder groups engaged in healthcare decision-making; thus, the results offer guidance on the verbiage, resources, and strategies to engage in SDM and strengthen patient involvement reflective of women’s lifestyle needs and HCPs’ existing workflow. Findings drive SDM practice into community-based healthcare and position it as the standard of care across healthcare settings.</p><br>

Situation of families in which a child with spinal muscular atrophy was born, is the topic of this thesis. This rare genetic disease affects neuromuscular system of children and shortens their lives. In most severe cases the failure of respiratory functions comes in the first year of child's life. This thesis is focused on support that Czech system of social and medical services provides to families with this disease. Next, it looks into needs of these families and examine the extent to which the system is able to saturate them. Very important point in this research is also families' perception of quality of care. The research was implemented with use of qualitative methods, mostly by semi-structured interviews which followed families' journey through the system of social and medical services. Then there is a comparison of experience of families with theories, policy and other normative framework and suggestion of steps that should be taken to improve families' satisfaction with services they receive concerning the child's disease. Key words: spinal muscular atrophy, rare diseases, patient's autonomy, patient- centered care, patient journey, quality of care.

This study explored the needs and challenges faced by diabetics and healthcare personnel in the context of diabetes consultations in Sweden, with the aim of identifying improvements for Clinical Decision Support Systems (CDSS). Given the global prevalence of diabetes, understanding the use and implications of CDSS in patient consultations is crucial. This research aimed to fill that knowledge gap by exploring ways to improve CDSS, considering the needs of both diabetics and healthcare workers. A qualitative approach was used, including 12 interviews, 1 observation, and 6 document reviews. A thematic analysis revealed four key themes which highlighted various challenges and needs, experienced from both diabetics and healthcare personnel. The underlying causes of these challenges were linked to recent technological advancements and the increase in available data points. This results infrustration, suboptimal care outcomes, and an increased reliance on alternative solutions by both parties. The DeLone and McLean IS Success Model was used to identify potential technological solutions and provides a clear recommendation on what needs to be improved for future solutions. The findings contribute significantly to understanding the utilization of CDSS in diabetes care and associated challenges. The study is particularly relevant for healthcare personnel, diabetics, policymakers, entrepreneurs, and scholars interested in healthcare information systems. Future studies should focus on generalizing these findings by exploring other healthcare systems and to what extent this findings are applicable for type 2 diabetics, as well as practically exploring how new systems can address the identified needs in this study. Ultimately, this study contributes to the potential for improved care and quality of life for diabetics. / Denna studie utforskade behov och utmaningar som diabetiker och sjukvårdspersonal står inför i samband med diabeteskonsultationer i Sverige, med målet att identifiera förbättringar för kliniska beslutsstödssystem (CDSS). Med tanke på diabetes globala prevalens, är det avgörande att förstå användningen och implikationerna av CDSS i patientkonsultationer. Denna forskning syftade till att fylla detta kunskapsgap genom att utforska möjligheter att förbättra CDSS, med hänsyn till både diabetikers och vårdgivares behov. Kvalitativa metoder användes, inklusive intervjuer, observationer och dokumentgranskningar. En tematisk analys identifierade fyra nyckelteman som belyste flera utmaningar och behov från både diabetiker och sjukvårdspersonal. De underliggande orsakerna till dessa utmaningar var kopplade till tekniska utveckling och ökningen av tillgängliga datapunkter. Detta resulterade i frustration, suboptimala vårdresultat och en ökad användning av alternativa lösningar från båda parter. DeLone och McLean IS Success Model användes för att översätta behoven till tekniska krav för potentiella framtida lösningar. Studiens resultat bidrar till förståelsen av användningen av CDSS inom diabetesvård och relaterade utmaningar. Studien är särskilt relevant för sjukvårdspersonal, diabetiker, politiker, entreprenörer och forskare som är intresserade av hälso- och sjukvårdsinformationssystem. Framtida studier bör fokusera på att generalisera dessa resultat genom att undersöka andra sjukvårdssystem och i samband med typ 2 diabetes, samt utforska hur mer praktiskt utveckling av nya system kan gå till för möta de identifierade behoven i denna studie. Slutligen bidrar denna studie till potentialen för förbättrad vård och livskvalitet för diabetiker.

No description available.