The value to consider user needs throughout the development of medical devices has been acknowledged in the field of health technology assessment. Yet, user needs are narrowly conceptualised and are mainly examined from an ergonomic perspective. By focusing on the user-device interaction per se with a view to detect use errors and to create design solutions that promote intended use, the dominant approach to user needs research fails to adequately elaborate upon symbolic and practice-related dimensions in the user-technology relationship. Moreover, whilst the examination of user needs from a User standpoint is clearly required, it is also crucial to investigate how the medical device industry understands and addresses this issue, since it is these understandings that will eventually be projected onto the technology. The present research sought to provide a cross-actor account on the issue of user needs by examining the perspectives of two key stakeholders: the users and the medical device manufacturer. Using the example of home blood pressure (BP) monitoring, a qualitative programme of research explored, on the one hand, the process of integrating home blood pressure monitors (HBPMs) into daily life as well as the elements that are conducive to building trust in this technology, and on the other, the practices the medical device manufacturer adopts to capture its users and their needs. The results suggest that people engage with home BP monitoring in an effort to develop an experiential understanding of their health condition reproducing the dominant discourse around the benefits of self-care. Nevertheless, communicating this practice outside the home was not always without tension since concerns around the ascription of undesired identities were expressed. Home measurements were occasionally performed to check the dependability of technology – arguably an unintended device use – indicating the importance of establishing trust in the artefact. Building trust in HBPMs appeared to be a multifaceted phenomenon that was not limited to the perceived trustworthiness of the technology but implicated a network of other trustworthy relationships with humans, institutions and technologies. Medium-to-large medical device manufacturers appear to appreciate the value of a user needs-informed approach to medical device development employing a series of routes, more or less direct and formalised, to reach their user. The challenge for the industry is to synthesise the evidential base deriving from individual user studies to create a higher order knowledge base. The term ‘symbolic’ – also employed in the title of this thesis – signifies people’s representations, reasoning and meanings constructed around the use or production of home medical technology whilst the term ‘practical’ (or practice-related) refers to actions, activities, and routines pertaining to these two aspects.

This thesis is focused on the issues linked with providing highly specialized care to critically ill patients with intra-aortic balloon pump (IABP) in intensive care units. IABP helps these patients overcome period of acute phase of heart failure or overcome period of time necessary before definitive intervention or surgical solution. A nurse has an irreplaceable role from the very beginning of patient's preparation before insertion of mechanical support (psychological as well as physical), assumes the assistance and instrumentation during insertion of heart support, observation during counterpulsation to psychological support of the patient leading to disconnection (weaning). This thesis is divided into two parts. Theoretical part is organized in several theme units focused on description and method principles, main indications, contraindications, and complications occuring with counterpulsation. The next part is dedicated to nurse's role in the problematics of saturation of bio-psycho-social needs of IABP patients. And the last part characterizes the specifics of intensive care. The core of practical part was qualitative research as per defined goals. The main objective was to map demand for quality nursing care in connection with IABP. This aim was reached through definition of four sub-aims and five research questions. The research questions were focused firstly on knowledge preconditions of nurses and problematic areas of care for IABP patients. Secondly, research effort was focused on the area of insufficient needs of patients in the bio-psycho-social area and on quality of information provided to patients. Imaginary centerpiece of research investigation consists of analysis of case studies of patiens, graphic visualisation of their thought map was used to survey the specifics of nursing care. For the evaluation of needs and mapping of patient's awareness the technique of individual half-structured interview with open questions was used. Same was used with nurses for mapping of problematic areas of nursing care. At the same time casuistry was formed as classical method of description followed by analysis of nursing case. Its meaning was to clarify optimization of means, processes and nursing interventions, i.e. mapping the specifics of nursing care of IABP patients. Research group consisted of patients selected intentionally with regards to the research problematics. For a complex conseption of the research the group for qualitative investigation consisted of four patients of cardio-surgery unit and one patient of coronary unit. Research investigation was realized in coronary intensive care units in České Budějovice hospital and Faculty hospital Plzeň and in Cardio-surgery unit of FN Plzeň. Research group for investigation of nursing problematic was formed by nurses of coronary units and cardio-surgery units of above mentioned hospitals. Eight nurses participated in the interviews. The selection of nurses was finalized only after the research topics were developed in detail. At that time sample selection was not bringing any new information any more, hence theoretical saturation of factual reality was reached. Based on analysis of research results within the goal defined and focused on the level of nurses' theoretical knowledge of nursing patients during IABP therapy it was observed that even though nurse's knowledge is sufficient, it is also significantly inconsistent. Relatively vast reserves were found especially in the area of communication with patients, hence in complex care for patient's psychological state.

Inter-ethnic and intra-ethnic violent conflict created a divide in Cyprus (1950-1974) that still exists to this day. This study explores specifically an effect of violent conflict – Missing Persons – and the ‘process of exhumations,’ which is defined as; the recovery of Missing Persons, identification, and reunification of the Missing with loved ones as a key component of peacebuilding via inter-ethnic reconciliation and restorative justice. This process is important for peacebuilding because it empowers individuals, communities, and nation-states to satisfy basic human psycho-social needs in order to deal with the trauma of past violence, to recognize loss, and to seek closure of uncertainty to prevent the transgenerational transmission of trauma and escalation of violence between and within ethnic societies. By interviewing eight experts on the Cypriot conflict about what the ‘process of exhumations’ does in Cyprus, revealed the challenges and successes that may arise during and after the process for sustainable peace. / February 2016

The diploma thesis entitled Specific needs of patients during negative pressure wound therapy, consists of two main parts, a theoretical and a practical part. The theoretical part includes findings from research and publications dealing with the issues of wound healing through local application of vacuum therapy, treatment with other methods of wet healing, the impact of long-term non-healing wounds on human needs and the role of the nurse in this scenario. The practical part of the diploma thesis refers to the quantitative research carried out by 46 respondents who were treated with a negative vacuum method, another method of wet healing or a combined form.