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.

Studiens syfte var att undersöka hur ett föräldraskap som är good enough beskrivs och definieras av personal på ett utredningshem för barn och föräldrar. Metoden som användes var en semistrukturerad fokusgruppsintervju med ett urval av personal från ett utredningshem. Resultatet analyserades utifrån socialkonstruktionism och ett genusperspektiv. Resultatet visade att utredningspersonalen hade en samstämmig definition och beskrivning av när ett föräldraskap är och inte är good enough. Fokusgruppen delade uppfattningen om att ett good enough föräldraskap innebär att föräldrar behöver visa personalen förändringsförmåga och förmåga till att mentalisera kring barnets behov utifrån ett åldersadekvat bemötande. Informanterna ansåg inte att de gör skillnad på mödrar och fäder gällande ansvarsfördelning. Utifrån socialkonstruktionistisk teori diskuterades huruvida det är möjligt för föräldrar att visa personalen efterfrågade föräldraegenskaper då utredningshemmets sociala konstruktioner av vad det innebär att vara good enough förälder kan kollidera med föräldrarnas. / The aim of this study was to investigate how a parenthood that is good enough is described and defined by personnel at an assessment home for children and parents. The method used was a semi-structured focus group interview with a selection of personnel from an assessment home. The result was analysed based on social constructionism and gender perspective. The results showed that the assessment personnel had a consistent definition and description of when a parenthood is and is not good enough. The focus group shared the notion that a good enough parenting means that parents need to show the personnel the ability to change and the ability to mentor about the child's needs based on age-sensitive treatment. The informants did not consider that they make a distinction between mothers and fathers regarding the division of responsibilities. Based on social construction theory, it was discussed whether parents can show the requested parenting skills when the social construction of the assessment home of what it means to be good enough parent may collide with the parents.