title: Developing a hierarchy of needs for Type 1 diabetes.
abstract: OBJECTIVE
  The aim of this study was to use the concept of Maslow's hierarchy of needs and apply this to Type 1 diabetes.
  
  
  METHODS
  Qualitative methods were employed using semi-structured interviews with 101 people from 13 countries. Grounded theory was used for data collection and analysis, with thematic analysis employed to identify the interviewees' needs.
  
  
  RESULTS
  Sixteen needs were identified and links between these were mapped. Aligning these with Maslow's hierarchy allowed for a hierarchy to be developed for Type 1 diabetes with 'Policies', 'Organization of health system', 'Insulin', 'Delivery of insulin', 'Control', 'Healthcare workers' and 'Information and education' at the base, as they were needed for survival. Next came 'Community, family and peers' and changing roles for 'Healthcare workers' in their approach to care and delivering 'Information and education'. This enabled people to learn how to use 'Insulin', 'Delivery of insulin' and 'Control' flexibly. People's 'Experience' and 'Personality' then helped them 'Adapt' and 'Be open' about their diabetes, allowing for 'Acceptance' and viewing 'Diabetes as something positive'.
  
  
  CONCLUSIONS
  Despite limitations, this work highlights that some needs are required for survival and others for well-being. Some are tangible as they can be directly provided, whereas others are intangible and cannot be provided directly by the health system. These results might be used for policy and practice in identifying needs that are met within a health system or what needs are lacking for the individual to then implement targeted interventions.
authors.affiliation: Division of International and Humanitarian Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Beran
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000628:therapy*; D005260:Female; D006272:Health Facility Environment / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009042:Motivation; D015279:Organizational Culture; D009936:Organizational Innovation; D036301:Qualitative Research; D012649:Self Concept; D012933:Social Identification