Background The use of mobile health apps is now common in diabetes self-management and acceptability of such tools could help predict further use. There is limited research on the acceptability of such apps: use over time, the factors and features that influence self-management, how to overcome barriers, and how to use an app in relation to health-care personnel. In this study, we aimed to obtain an in-depth understanding of users’ acceptability of a mobile app for diabetes self-management, and to explore their communication with health-care personnel concerning the app. Methods The study had a qualitative descriptive design. Two researchers conducted 24 semi-structured in-depth interviews with adults with type 2 diabetes who had used a digital diabetes diary app for 1 year, during participation in the Norwegian Study in the EU project RENEWING HeALTH. We recruited the participants in a primary health-care setting. The transcripts of the interviews were analyzed using qualitative content analysis on developing themes, which we interpreted according to a theory of acceptability. We used NVivo 11 Pro during the process. Results The users’ acceptability of the app diverged. Overall, the responses indicated that the use of a digital diabetes diary requires hard work, but could also ease the effort involved in following a healthy lifestyle and better-controlled levels of blood glucose. Crucial to the acceptability was that a routine use could give an overview of diabetes registration and give new insights into self-management. In addition, support from health-care personnel with diabetes knowledge was described as necessary, either to confirm the decisions made based on use of the app, or to get additional self-management support. There were gradual transitions between practical and social acceptability, where utility of the app seems to be necessary for both practical and social acceptability. Lack of acceptability could cause both digital and clinical distress. Conclusions Both practical and social acceptability were important at different levels. If the users found the utility of the app to be acceptable, they could tolerate some lack of usability. We need to be aware of both digital and clinical distress when diabetes apps form a part of relevant health-care. Trial registrations Self-management in Type 2 Diabetes Patients Using the Few Touch Application, NCT01315756, https://clinicaltrials.gov/show/NCT01315756 March 15, 2011.

The unpredictability and taboos of irritable bowel syndrome made these people suffer, feel constrained and dependent. Dignity was preserved both by sacrifices and taking command. Healthcare personnel should allow patients to talk about their suffering and discomfort to decrease their experience of suffering. Our study contributes to a more nuanced understanding of life with this unpleasant companion, the suffering it creates and the threats to dignity and health.

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Aim To develop a theoretical explanation for the daily life problems and challenges perceived by those living with type 2 diabetes. Design and methods We used a grounded theory approach with a constant comparative method to discover a framework with the core concept of struggling between “ought to do” and “want to do” and related concepts. Results The struggle to self‐manage and maintain new habits can be more or less difficult depending on the patient's perceived conditions. We identified three situations illustrated in a diagram: one where there is less struggle to let go of old habits, a second where there is more of a struggle to balance between what individuals want to do and what they ought to do and a third where they are giving up struggling. Study findings show that healthcare personnel must consciously seek to understand how patients perceive their own situation.

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