This project started with the assumption that some people do not continue to perform their exercises independently after they have visited the physiotherapist. Through the application of different service design methods, the underlying problem was explored and new service solutions were developed and presented with a prototype and scenario. The project was limited to the user group of patients with osteoarthritis who are being treated through physical activity. Osteoarthritis is a very common joint disease in Sweden which affects the cartilage and causing pain. Observations and interviews were directly conducted at the physiotherapists to gain insights on what supports, encourages and prevents the patient to perform their exercise independently. Research was done on the entire journey of the patient, starting when they seek help and ending when they are to manage the treatment on their own. All the steps were presented in a Customer Journey. The insights from the research were presented with key insight, two personas called Gunilla and Bosse representing different types of patients and an Emotional Journey showing their experience of their journey. The ultimate problem definition was done collaboratively with physiotherapists and patients by discussing their unique experiences and frustrations. A key pattern among the problems was information exchange so the ultimate problem was defined: “When, where and how should the information exchange take form so that the patients understand the support, the importance of exercise and are presented with individual adjusted exercises?” It was answered by patients using an Information Journey and giving data to the final solution. The new service solution aims at improving the information exchange between the physiotherapist and the patient, as a step to encourage the patient to perform their exercises. The project also presents a better understanding for the patients experience when meeting with the healthcare. The project was done in cooperation with Experio Lab in Karlstad, with Olga Sabirova Höjerström as supervisor. Experio Lab is a section of County Council of Värmland and works with service design within the healthcare. This project is the degree project of the Bachelor of Science in Innovation and Design engineering at Karlstad University. The project covers 22,5 ECTS credits and extends from January to June in 2018. The supervising teacher is Postdoctoral Researcher Jakob Trischler and examiner of the course is Professor Leo de Vin. / Projektet startade i problematiken kring att patienter inte utför sina ordinerade övningar efter besök hos fysioterapeut. Genom tillämpningen av olika tjänstedesign metoder undersöktes orsakerna och en lösning utvecklades som presenterades med en prototyp samt ett scenario. Projektet begränsades till målgruppen patienter med artros som behandlas genom fysisk aktivitet. Artros är en väldigt vanlig ledsjukdom som påverkar brosket i knät och ger upphov till smärtor i leden. Genom observation och intervju på Fysioterapimottagningen i Kristinehamn samlades data in kring vad som ger stöd och uppmuntrar eller förhindrar patienten att göra sina övningar. Hela patientens resa undersöktes, från att de söker hjälp till att de fortsätter sin behandling på egen hand. Alla steg i resan redovisades i en Costumer Journey. Insikterna från undersökningen presenterades genom viktiga insikter. Två persona, namngivna Gunilla och Bosse, som representerade två olika patienttyper och en Emotional Journey som visade deras upplevelse av sina respektive resor. Den slutgiltiga problemdefinitionen fastslogs tillsammans med fysioterapeuter genom diskussion av deras erfarenhet kring erfarna problem och patienternas upplevelser. Ett genomgående mönster bland problemen var informationsutbyte så den slutgiltiga problemdefinitionen löd: ”När, var och hur ska informationsutbytet vara så att patienten förstår stödet, vikten av träning och är erbjudna en individuell anpassad träning?” Den var besvarad av patienter genom en Information Journey vilket gav data till den slutgiltiga lösningen. Den nya tjänsten är skapad för att förbättra informationsutbytet mellan fysioterapeut och patient, som ett steg i att uppmuntra patienten att utföra sin träning. Projektet presenterar även en större förståelse för patientens upplevelse i deras möte med sjukvården. Projektet utfördes tillsammans med Experio Lab med Olga Sabirova Höjerström som handledare. Experio Lab är en del av utvecklingsenheten på Landstinget i Värmland och tillämpar tjänstedesign inom vården. Arbetet har gjorts i kursen Examensarbete för högskoleingenjörsexamen i Innovationsteknik och design (MSGC12) på Karlstads universitet. Projektet innefattade 22,5 hp och varade från januari till juni, 2018. Projektet har handletts av Jakob Trischler och professor Leo de Vin har varit examinator.

Objective: To explore differences between conventional medicine (COM) and complementary and alternative medicine (CAM) regarding the attitude toward and the perceived use of shared decisionmaking (SDM) from the health professional perspective. Methods: Thirty guideline-based interviews with German GPs and nonmedical practitioners were conducted using qualitative analysis for interpretation. Results: The health professional–patient-relationship in CAM differs from that in COM, as SDM is perceived more often. Reasons for this include external context variables (e.g. longer consultation time) and internal provider beliefs (e.g. attitude toward SDM). German health care policy was regarded as one of the most critical factors which affected the relationship between GPs and their patients and their practice of SDM. Conclusion: Differences between COM and CAM regarding the attitude toward and the perceived use of SDM are attributable to diverse concepts of medicine, practice context variables and internal provider factors. Therefore, the perceived feasibility of SDM depends on the complexity of different occupational socialization processes and thus, different value systems between COM and CAM. Practice implications: Implementation barriers such as insufficient communication skills, lacking SDM training or obedient patients should be reduced. Especially in COM, contextual variables such as political restrictions need to be eliminated to successfully implement SDM.