Category Archives: PhD thesis

Soon ten years since I defended my PhD: “Date set, opponent accepted! Now the only thing that is missing is the text”

10 years have soon passed since I defended my PhD. Facebook has given me some memories such as “Date set, opponent accepted! Now the only thing that is missing is the text”.  I remember that I had tree months to write the introduction to the text and organise everything around the PhD. The PhD was based on eight papers related to how to work with software engineering (user centred design- UCD) in large organisations, and a large action research project with eight different public authorities. You find the thesis here:

The thesis has three research questions:

  1. What happens when UCSD is introduced in a public authority?

I was also interested in the values and perspectives of people involved in the organisation as well as how UCSD can be introduced through new methods that affect the values and perspectives of the stakeholders including the system developers in the organisation. Therefore, this thesis also aims at understanding the following questions:

  1. How do perspectives of stakeholders in systems development projects affect the work with UCSD, usability and users’ health in the organisations studied?

The final question addresses the issues of how we can address the introduction of UCSD and change perspectives:

  1. What new methods can be used to introduce UCSD and to influence perspectives?


I finished my PhD during a tough period in life, and I had much support from my family, my supervisor Jan Gulliksen and my friends. One of my very best friends Helena Bernáld did the photos for the thesis, and my parents helped me with grocery shopping, cleaning and laundry. In parallel to writing my PhD I was a single mom of three kids aged 2, 6 and 7, see photo. In addition to this I had just bought a house that I renovated and I somehow I pulled off painting my new house. I don’t remember why I though it was so important. Why did I do that!!?? It sounds very crazy in hindsight.

I remember nailing the PhD thesis to a wall in the university building (see photo) and feeling so happy that I pulled things off! A big thanks to everyone that helped me during this period!!

Professor Bodil Jönsson was the opponent at my defence. I remember that the discussion was very nice and that she thought that I had used too many theories and added to much material to the thesis. And she had a point. Somehow the situation in life made the PhD defence seem like something that was possible to control. And I was really not very nervous about it, and writing the thesis was therapy related to life in general. That part is also difficult to understand! I guess people are strange, and I am equally strange myself. 

Keep safe in Corona times!


Half-time seminar by Marie-Therése Crafoord

On the 22nd of November 2019 I was a member of the examination committee for Marie-Therése Crafoord at her half-time seminar. Marie-Therése Crafoord does her PhD education at Karolinska Institutet in Stockholm at the Department of Neurobiology, Care Sciences and Society, Division of Nursing

Marie-Therése Crafoord presented very interesting work with the title:

Patient and health care values – A RCT study in patients with cancer evaluating an interactive ICT-platform for reporting symptom distress during treatment

The PhD thesis will be based on three different studies on a eHealth application for cancer patients. She uses the concept of engagement to look into the user experience and use of the app, and has one submitted paper in that area at the time of the half-way seminar. There are also two other studies planned that will go into her PhD thesis.

The process at a half-time seminar at Karolinska Institutet includes going through and discussing all parts of a PhD, and as a member of the committee I took part of transcripts of records and a description of the PhD education.

Marie-Therése Crafoord has done a very thorough work, and I very much look forward to following her studies in the future. In the discussions it became clear that she is very knowledgeable in her area, and her reflexive way of talking about her work was indeed impressive and will take her a long way!

Examiner of Anders Klingerg’s PhD thesis on mobile teleconsultations in acute burn care

Anders Klingberg has defended his thesis on mobile teleconsultation in acute burn care, and I was one of the external examiners. The PhD is in public health sciences from Karolinska Institutet, but it includes several papers on acceptance and user experience and that is where my  competence is.

The process at Karolinska is that the papers are read and accepted by the committee some months before the defence, and a chair of the committee sees to it that a paper is signed about the quality of the papers. I was the chair this time, and coordinated the others’ comments.

The thesis is based on four papers, of which three were accepted before the defence. The topic of the thesis is super relevant, and the interdisciplinary approach of the research is indeed impressive. The ultimate aim of the thesis is to improve acute burn injury care in South Africa. Congratulations to a very interesting PhD thesis, and an excellent PhD defence!


Anders Klingberg is in the middle of the picture, together with me and Mårten Kildal who also was one of the examiners.

Below is a copy of the abstract from thee thesis – a recommended read! You find the full thesis here:




Background: Burn injuries are a global health problem with severe consequences for those affected and nearly 95% of all burns occur in low- and middle-income countries (LMICs). While minor burns can be treated locally such as at the emergency department, severe burns need transfer to a specialist burns centre. However, non-specialists often lack the training and experience to accurately diagnose and manage burns. While smartphones have been shown to be feasible for remote consultations between frontline providers and burns specialists, barriers may impede successful uptake.

Aims: The aims of the thesis were to deepen the knowledge about referral patterns of patients with burns in resource poor settings, and to study perceptions and experiences among emergency staff’s use of smartphones as a diagnostic support to improve the assessment, initial care and referrals of patients with burns.

Methods: Study I was a retrospective case study of 871 paediatric patients with burns at a trauma unit in Cape Town. Demographic, injury characteristics, and disposition was used to determine whether patients were referred according to local criteria. Study II was a mixed- methods study of the usability of a smartphone app (the Vula app) for burn injury consultations. Twenty-four emergency doctors and four burns specialists were enrolled in the study. A think-aloud study was conducted with all participants and their interaction with the app was video-recorded and later analysed using content analysis. The twenty-four emergency doctors also completed a usability questionnaire. Study III was a qualitative study where semi-structured interviews were conducted with 15 doctors regarding their experiences using the Vula app for burn consultations and referrals. The interview-guide and thematic analysis were informed by the Normalisation Process Theory. In Study IV, fifty-nine frontline health workers completed a questionnaire to assess their intention to use the Vula app. The questionnaire and the analysis were informed by the technology acceptance model (TAM).

Results: Study I. Most referred patients fulfilled the referral criteria. However, of those treated and discharged from the trauma unit, 8 out of 10 children also fulfilled the criteria for referral. In Study II, the usability test and questionnaire showed that the doctors perceived the Vula app to be easy to use and useful. However, some problems were identified mainly related to navigation, and understanding of meaning of icon’s terminologies. Some users also said that predefined options in the app limited their ability to express their clinical findings. Study III revealed several barriers and promotors for successful integration of the Vula app. Promotors included the already prevalent practice of using smartphones, that it was easy to use and the learning opportunity that the app offered. Barriers to successful integration included; inconsistent use of the app across specialities and lack of information, policies and infrastructure to support the users. In Study IV, almost all health professionals used smartphones in their work and were positive towards using Vula. Access to wireless internet and access to smartphones was mentioned to be a barrier.

Conclusions: Identifying patients with burns who are in need of referral is challenging. Mobile teleconsultations is therefore a way of assisting with diagnosis and initial management. The Vula app was easy to use and perceived to be useful, but several barriers need to be addressed for the app to become an integrated part of the practice in emergency care. In settings with considerably fewer resources, these barriers will likely be even more important to address prior to implementation.

Integrating UX Principles and Practices into Software Development Organisations

Just before Christmas Pariya Kashfi successfully defended her PhD thesis on Integrating UX Principles and Practices into Software Development Organisations. This thesis is worth reading for anyone struggling with the integration of UX principles and practices in organisations!

I was on the examination committee for the defence together with professor Natalia Juristo and professor Kaisa Väänäenen. Associate professor Marta Larusdottir was the opponent. Note that this was an all-women committee with a woman opponent!! 

The overall research question for the work was:


How can software companies integrate UX principles and practices into their development processes and organizations?

Pariya Kashfi started the defence by an excellent presentation of her work. The presentation was followed by an in-depth discussion among professionals with Marta Larusdottir. Pariya Kashfi was super good at answering all questions, and managed to do a very good defence. I really enjoyed the discussion, especially since this thesis is in the area of my own PhD, but seven years later and with a focus on UX and not Usability.

The PhD is by publications and included six papers. All papers are available on Pariya Kasfi’s page on Research Gate.

  1. P. Kash?, A. Nilsson, R. Feldt, ?Integrating User eXperience Practices Into Software Development Processes: Implications of The UX Charac teristics”
    PeerJ Computer Science (an Open Access Journal), 3, e130, 2017.
  2. P. Kash?, A. Nilsson, R. Feldt, R. Berntsson Svensson, ?A Conceptual UX-aware Model of Requirements”
    6th International Working Conference on Human-Centred Software En- gineering, 234-245, 2016.
  3. P. Kash?, R. Feldt, A. Nilsson, ?Integrating UX Principles and Practices into Software Development Organizations: A Case Study of In?uencing Events?
    In submission to The Journal of Systems and Software.
  4. P. Kash?, R. Feldt, A. Nilsson, ?Integrating UX Principles and Practices into Software Development Organizations: A Case Study of Challenges and Success Factors”
    In submission to The Journal of Systems and Software.
  5. P. Kash?, R. Feldt, A. Nilsson, R. Berntsson Svensson, ?Evidence-based Timelines for User eXperience Software Process Improvement Retrospec- tives: A Case Study of User eXperience Integration”
    42nd Euromicro Conference on Software Engineering and Advanced Ap- plications, 59-62, 2016.
  6. P. Kash?, K. Kuusinen, R. Feldt, ?Stakeholder Involvement: A Success Factor for Achieving Better UX Integration”
    1st Workshop on Stakeholder Involvement in Agile Development, NordiCHI, 2016.

Kevin Doherty Viva and PhD

In the beginning of December I had the opportunity do discuss Kevin Doherty’s PhD at his Viva voce. Kevin Doherty defended his Ph.D. thesis in Computer Science at the School of Computer Science and Statistics at University of Dublin, Trinity College. The PhD thesis has with the title “Designing the Self Report of Wellbeing in Pregnancy”. The PhD was an impressive piece of work indeed, and Kevin Doherty defended his work in the best possible way!

In the thesis Kevin Doherty presents a contribution to knowledge in the area of design of a mobile application named BrightSelf for self-reporting of psychological wellbeing during pregnancy. The research themes addressed are related to how technology shapes the self-report of wellbeing, how users are engaged in the disclosure of health concerns and how healthcare professionals might act upon reports of psychological well-being.

Many parts of the thesis are worth reading, and I especially liked the work on engagement as a theoretical concept, and also the definitions of the concept wellbeing. My guess is that Kevin Doherty would have a brilliant career in academia if he wants that 🙂


Excellent PhD Thesis by Dr Grünloh

Last week I attended Christiane Grünloh’s great PhD defence. Her thesis is a substantial contribution to knowledge in the area of eHealth services for patients. I especially think that the results related to patient empowerment is interesting and well worth reading.

Chrisitane Grünloh is really an excellent researcher. She is both brilliant and has the grit to pull through qualitative analysis of very high quality. The abstract of her PhD is copied below, and you find the thesis here. Christiane has also written a blog post about it found here. The defence was one of the best I have attended. Not only did Christiane do an excellent job shining like a bright star, her opponent was also brilliant and very well read up on her work. Taken together this was a great learning opportunity for everyone in the audience including me.

The picture for this blog post is borrowed from Twitter and Christiane’s twitter stream. If you need inspiration to write a PhD thesis of the same quality as Christiane has, then follow her on Twitter! 


Healthcare systems worldwide face organisational and financial challenges due to increasing number of people with chronic conditions, increasing costs, and an ageing population. eHealth services have the potential to address some of these challenges, for example, by supporting patients who are engaged in self-care, improving quality of care, and reducing medical costs.

In 2012, Region Uppsala in Sweden launched an eHealth service that enabled patients to access their electronic health records through the Internet. The launch of the service was accompanied by strong criticism from healthcare professionals (HCPs) and was heavily debated in the media. Patients on the other hand were very positive towards the service.

Albeit promising, the potential of Patient Accessible Electronic Health Records (PAEHRs) cannot be realised if HCPs still have reservations towards the service and their concerns are not fully understood. The purpose of this research is therefore to enhance our understanding of how physicians view PAEHR in relation to both their work environment and the level of patient participation. Furthermore, the aim is to shed light on whether their concerns related to patients’ well-being have materialised in practice and how patients view and make use of the service. Finally, this thesis identifies implicated human values and value tensions related to PAEHR.

To enhance our understanding of the physicians’ perspective, semi-structured interviews with 12 physicians in Uppsala were thematically analysed. A national patient survey was conducted to investigate patients’ use of and their experiences with PAEHR. Furthermore, empirical and conceptual investigations were carried out to identify human values and value tensions.

The results of this research show that the physicians’ assumptions and views of PAEHR and its consequences for patients were different from the views and actual experiences of patients using the PAEHR system. The physicians were mainly concerned about potential increase in their workload and that it could be harmful for patients to access their Electronic Health Record (EHR), for example, as it might evoke anxiety or worry. The vast majority of patients appreciated timely access to their results, felt more involved in their care, and read their records to become more involved. The investigation of human values associated with PAEHR identified values such as Ownership & Property, Professional Autonomy, Responsibility, Human Well-Being, Accountability & Transparency, and Trust. Furthermore, value tensions were identified that may occur between direct and indirect stakeholders (here: patients and physicians), or are related to an interpretation of PAEHR.

This thesis contributes to current research on eHealth in Human-Computer Interaction (HCI) by instigating a critical discussion of values associated with eHealth technologies that might be perceived as conflicting given a stakeholder’s framing of the technology. For example, tensions that emerge between values that prioritise placing the responsibility on a physician for their patients versus a value system that prioritises patient autonomy. The findings of this thesis suggest that while policymakers and government agencies adhere to a system of values that place a premium on patient empowerment, paternalistic tendencies are still present among physicians. However, an eHealth service like PAEHR is an important first step towards patient participation. The results of this thesis suggest that the support of patient participation in their own care through PAEHR outweighs the potential harm.


Excellent PhD Thesis by Hanife Rexhepi

Some people are as magic as the sky in the photo for this blog post. These people are more brilliant than the rest of us, and it is a joy to discuss with them and learn from them. One such person is Hanife Rexhepi from Högskolan i Skövde. Not only is she knowledgeable and professional, but she is also a good team player and has great communication skills. I have worked with Hanife Rexhepi in many studies the last years as a part of the DOME consortium.  And I am looking forward to more collaborations in the future.

Next week Hanife Rexhepi will defend her excellent thesis that includes TWO papers awarded “Best paper” which says something about the quality of her work. I am really looking forward to listening to her presentation and to the discussion. I am sure that I will get lots of new ideas and insights! I will bring my iPad and take notes 🙂

Hanife Rexhepi has done research related to information systems in health care. The eight papers in the thesis are from her extensive work in the area, and are based on several research projects. Among other things her thesis contains an interesting study on cancer patients and their use of medical records online. This study has been presented on several occasions, one of which is found here. The study has also been widely discussed in media such as in this well written blog post by Christiane Gruenloh.  Hanife Rexhepi is also very active on Twitter and you find her Twitter account here

See you in Skövde at Hanife Rexhepi’s PhD defence on Tuesday the 22 of May 2018.

A Framework to Design and Evaluate Wearable Interactive Systems for Health – A PhD Thesis by Reem Albaghli

Reem Albaghli from the University of Colorado, Boulder USA, defended her PhD thesis with the title “A Framework to Design and Evaluate Wearable Interactive Systems for Health” last week. I had the honour to be one of the external examiners and attended the defense on video link. The presentation was fantastic, and Reem Albaghli proved herself to be a skilled professional presenter. The thesis is in the area of designing and evaluating the design of wearable devises. Reem Albaghli has done several iterations of her design, and the experiences are synthezised in a framework for designing this kind of systems (the WISE framework). I would recommend to read the thesis if you are interested in interaction design and health, and want to know about the research front in this area.

This is the abstract of the thesis:

Interactive wearable devices—or wearables—are increasingly being used to track the health-related data of their users. The design of such systems is a considerable challenge that stresses the analysis and design techniques of software engineering and human-centered computing and places considerable demands on user experience designers to produce systems that are reliable, accurate, and understandable while also remaining customizable by end users. In my work, I aim to address this situation by developing a design framework that can be used to organize the activities during the development life cycle of a health-related wearable system. The WISE framework proposes a set of heuristics, activities, and principles by which health-related wearable systems can be both designed and evaluated. To demonstrate the power of my framework, I conducted five studies to help design the user interface of a wearable system that helps users visualize their heart rate data and monitor that data for anomalies that may require the attention of a medical professional. Over the course of my five studies, the principles of the WISE framework helped me design visualizations that are easy to understand by users and provide them with value in terms of being able to communicate with their doctors about the health of their heart. To illustrate the generic nature of my iii framework, I have also demonstrated how my framework could be used to design health-related wearable systems that monitor other medical conditions such as depression and Parkinson’s disease

Five Questions for Future PhD students

One could think that doing a PhD at one university would be the same thing as doing it at another university. Well, I can tell you that this is not the situation.

There are many different things that can vary for PhD students, and if you want to do a PhD you need to make sure that you know what you can expect from the department you enroll at.

If you ever consider doing a PhD you have to make sure that the following is clear:

  1. Does the supervisor seem to be a person who you would like to collaborate with?
  2. What is the research project going to be about? Are you going to work in a project with a specification you need to follow?
  3. What kind of PhD courses do they offer at the department?
  4. Who else are you going to work with? Is your supervisor going to be on your project?
  5. What kind of funding is available for conferences, computers etc?

Why are Ambient Assisted Living Technologies so Difficult to Develop?

I was appointed as one of the external reviewer of Jean Hallewell Haslwanter´s PhD dissertation with the title “User-Centered Development of Sensor-based Systems for Older People”. I must say that this was indeed an interesting thesis to read and I strongly recommend it for anyone who is interested in healthcare technology and user-centered design.

Ambient Assisted Living (AAL) is a technology that has been proposed to help society with problems related to an ageing population, as it could support older people to live at home instead of moving into elderly homes. However, despite the fact that many IT projects and companies have been working with the development of this technology, and large amounts have been invested in AAL, few such technologies has reached the market. In her thesis, Jean Hallewell Haslwanter addresses the issue from a user-centered design perspective and her work aims at understanding why AAL technologies have proven so difficult to develop.

The thesis has a substantial empirical contribution as it studies the development of AAL systems. One interesting finding is that the complex and multifaceted descriptions of the users fade away as the project continues, and is replaced by stereotypes of older people. Other contributions include recommendations for practitioners working with development of AAL technology.

Jean Hallewell Haslwanter’s dissertation is a monograph, but she has 13 research papers that are previously published. Many of the papers are conference papers, of which many appear in highly ranked international conferences. There are also conference papers that have been turned into journal papers. If you are interested you can find these publications online at the link.