Decisions with Impact on Energy Reduction Opportunities : Swedish manufacturers and buyers of new single-family houses

This article discusses some of the complexities of human decision-making. It aims, in particular, at relating the nature of decision-making to the illusory dichotomies of change and stability, individual actions and cultural sharing. Serving as an illustration to the discussion of the article is ongoing fieldwork in contexts of buying, selling and constructing pre-fabricated detached houses in the central Sweden, and the very specific question of how decisions to install one kind of heating-system rather than another come about. A common reductionism is to narrow down the understanding of decisions about heating systems and energy consumption to conscious choices made by individual householders. I have asked myself whether, on the contrary, anyone actually makes such decisions at all. Perhaps some of these decisions are merely outcomes of interaction between different individuals with their respective responsibilities and focuses of interest.

What is important for you? A qualitative interview study of living with diabetes and experiences of diabetes care to establish a basis for a tailored Patient-Reported Outcome Measure for the Swedish National Diabetes Register

OBJECTIVES: There is a growing emphasis on the perspective of individuals living with diabetes and the need for a more person-centred diabetes care. At present, the Swedish National Diabetes Register (NDR) lacks patient-reported outcome measures (PROMs) based on the perspective of the patient. As a basis for a new PROM, the aim of this study was to describe important aspects in life for adult individuals with diabetes. DESIGN: Semistructured qualitative interviews analysed using content analysis. SETTING: Hospital-based outpatient clinics and primary healthcare clinics in Sweden. PARTICIPANTS: 29 adults with type 1 diabetes mellitus (DM) (n=15) and type 2 DM (n=14). INCLUSION CRITERIA: Swedish adults (≥18 years) living with type 1 DM or type 2 DM (duration ≥5 years) able to describe their situation in Swedish. Purposive sampling generated heterogeneous characteristics. RESULTS: To live a good life with diabetes is demanding for the individual, but experienced barriers can be eased by support from others in the personal sphere, and by professional support from diabetes care. Diabetes care was a crucial resource to nurture the individual's ability and knowledge to manage diabetes, and to facilitate life with diabetes by supplying support, guidance, medical treatment and technical devices tailored to individual needs. The analysis resulted in the overarching theme 'To live a good life with diabetes' constituting the two main categories 'How I feel and how things are going with my diabetes' and 'Support from diabetes care in managing diabetes' including five different categories. CONCLUSIONS: Common aspects were identified including the experience of living with diabetes and support from diabetes care. These will be used to establish a basis for a tailored PROM for the NDR.