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In the rehabilitation of chronic and severe illnesses, it is common to use paper-based questionnaires to capture experiences of symptoms associated with illness or treatment. Managing such instruments consumes time, and offers care professionals a narrow space of possible actions toward the patients. The purpose of this paper was to report the initial concerns we encountered in the early phases involving a dynamic instrument in nursing practice. 

This project is based on the Self Management Assessment Scale (SMASc) with the purpose to provide digital support that enables personalized work methods with the patient. With SMASc, patients answer questions on a mobile phone, tablet or computer. The compiled result is provided instantly before the patient-nurse consultation. SMASc is here understood as an interactive artefact with dynamic affordances. A dynamic instrument manifests a theoretical foundation aligning to the use situation, is programmable and digitally distributed, and offers individually compiled datafied views that connect the person's situation and the theoretical apparatus - in this case, a person's need for self-management support. 

The data this report builds on was produced during two project meetings and throughout the design and development of the instrument prototype. Data analysis approach applied was an analysis focusing on emerging concerns surfacing from discussions that followed the introduction of the prototype. 

We found that the nurses cared for the development of their practice and strived to advance and steer it in a more nursing-oriented direction. They did not fully comply with the instrument's item formulations and how these should or could be used. Further work has to be done to involve more stakeholders in the future work so that everyone feels engaged and can put their views on the design of the instrument, and on the implementation work itself.