eHealth solutions at home are gaining interest and relevance in healthcare; however, they face challenges in sustaining motivation for therapy due to difficulties in creating meaningful connections between technology and people receiving care. In this article, we explore how embodied agents in eHealth interventions could be designed to establish a motivating relationship with people in the context of home-based stroke rehabilitation. We studied this potential by referring to the need for social relatedness in Self-Determination-Theory (SDT) and how this translates to the design of embodied agents’ characters, the collaborations they afford and the partnerships they establish over time. In co-creative ideation sessions with stroke survivors, this potential was explored, resulting in an interactive prototype of ‘Edo the Coach’, i.e. an embodied agent for home-based upper extremity stroke rehabilitation that was evaluated by stroke survivors in their home contexts. Based on the insights gained, we reflect on the potential of using SDT for designing embodied agents that foster motivational relationships between patient and agent as an answer to the growing demand for eHealth-supported self-care within an increasingly digitized healthcare context.@en

Purpose: eHealth-based exercise therapies were developed to increase stroke patients’ adherence to home-based motor rehabilitation. However, these eHealth tools face a rapid decrease in use after a couple of weeks. This study investigates stroke patients’ motivation for home-based upper extremity rehabilitation with eHealth tools and their relation with Basic Psychological Needs. Materials and methods: This is a qualitative study using thematic analysis. We conducted semi-structured interviews with stroke patients with upper extremity motor impairments, who were discharged home from a rehabilitation centre, after they interacted with a novel eHealth coach demonstrator in their homes for five consecutive days. Results: We included ten stroke patients. Thematic analysis resulted in eight themes for home-based rehabilitation motivation: Curiosity, Rationale, Choice, Optimal challenge, Reference, Encouragement, Social Support and Trustworthiness. Those themes are embedded into three Basic Psychological Needs: “Autonomy”, “Competence”, and “Relatedness”. Conclusion: Eight motivational themes related to the three Basic Psychological Needs describe stroke patients’ motivation for home-based upper extremity rehabilitation. We recommend considering those themes when developing a home-based eHealth intervention for stroke patients to increase the alignment of eHealth tools to the patient’s needs and reduce motivational decreases in home-based rehabilitation.

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Childhood cancer is a disruptive life event that creates high levels of stress and anxiety in families. It turns everyday routines up-side-down, and can block the child’s psychosocial development when families have difficulties to emotionally cope with this potentially traumatic event. D’Olivo developed three interactive objects aimed at preserving space for quality time and stimulate interpersonal communication between family members. These objects were deployed in the homes of children who are receiving cancer treatment in order to better understand how families responded to them, and whether they were appropriate to support their situation. The broader question addressed by the work is ‘how can vulnerable users be empowered by design in sensitive settings?’. Tactfulness was found to be a critical expressive design quality of such objects, leading to the idea of Tactful Objects as a design perspective on interactive artefacts that function in sensitive settings. According to this perspective, designing tactful objects for sensitive settings means to design objects that behave like sensitive partners, establish a balanced collaboration with people, resemble familiar characters and maintain a discreet presence in the context where they are introduced. The thesis discusses the practical value of Tactful Objects in healthcare as well as the methodological implications of conducting Research-through-Design in sensitive settings. @en

Advances in biodesign offer opportunities for developing materials for everyday products from living organisms, such as fungi, algae, and bacteria. Gaining widespread acceptance of new materials from the general public can be a lengthy process, making biodesign a high-risk pursuit with potentially significant economic, ecological, and social impacts. In this article, we conceptualize the notion of materials framing—combining knowledge from materials science, product design, and innovation management to create a communications strategy that accelerates popular adoption of novel materials. Which of its qualities will help orient users’ understanding of the new material? What is the best way to present those qualities? An extensive analysis of nine biodesign companies’ text and visual web communications revealed three core materials framing categories: material origins, fabrication processes, and material outcomes. We argue that these three categories expand the audiences’ focus beyond mere outcomes to include an organism's design potential—a lens with which to gain a more comprehensive view of the possibilities the material from a living organism affords.

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Purpose: It is important to support families in dealing with the distress that comes along with the diagnosis and treatment of childhood cancer. Therefore, we developed a playful tool that families can use at home to support their family functioning and safeguard their normal family life. We pilot tested this new tool called Mr.V and describe how families used and evaluated the tool, and how it could be further improved. Methods: Mr.V is an interactive dispenser that looks like a spaceman and proposes family activities. These activities are suggested by family members themselves and dispensed by the machine at unexpected moments. Mr.V produced data on how it was used, and a questionnaire and a semi-structured interview were used to evaluate the experiences of families and the potential of this tool. Results: Ten families with a child with cancer between 5 and 9 years old (M_age = 6.7 years) who were in active treatment (mixed diagnoses) participated (n = 47; n_patients = 10, n_siblings = 9, n_parents = 16). All families used Mr.V for multiple days and were very satisfied with the tool regarding its acceptability, feasibility, and potential effectiveness. They also had suggestions on how the tool could be further improved. Conclusion: Mr.V is an acceptable and feasible tool that can be implemented by families independently at home, regardless of their level of need for support. Mr.V promoted family activities and therefore has the potential to support family functioning and normal family life at home. Future research should further investigate the effectiveness of this tool.

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This contribution illustrates the Research through Design process of Mr.V the Spaceman, a tactful object meant to support families of children with cancer maintain a healthy domestic life during stressful times. By recounting insights from the field and unfolding changes to the original artifact over a period of two years, the paper illuminates how an understanding of tactfulness has emerged and developed into a key design quality for this work. This complex and entangled process of making is surfaced and illustrated by a rich and scrupulous annotation of the artisanal craft and technological explorations that led from the original Mr.V prototype to what is now Mr.V the Spaceman.@en

In the field of Human-Computer Interaction (HCI), there is an increasing interest in designing for well-being. With this contribution, we introduce Tactful Objects as a design perspective on interactive artifacts that empower people in sensitive settings. We explore the concept of tactfulness by designing two interactive artifacts addressing the needs of families dealing with childhood cancer. The first, Mr.V, is an interactive dispenser to stimulate social activities in the family. The second, AscoltaMe, is a kind of walkie-talkie to enhance communication between family members. Eight families in treatment were invited to try out one of these artifacts at home. We report on how they perceived the objects’ impact on family life, how they used and appreciated the objects and how the objects embedded at home. The findings highlight that Tactful Objects enable people to act with respect for their vulnerabilities and circumstances by establishing partnerships and collaborations that are inviting and appropriate for the setting in which they are embedded. We then reflect on the contribution of the work for research in healthcare and design for other sensitive settings. We conclude by presenting the limitations of the study and provide directions for future work.

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Supporting teamwork in healthcare is a way to foster both the quality and safety of care, and better working conditions for all the team members. Although increasing attention is paid to this topic on a general level, there is less knowledge about its unfolding in orthopaedic units and its translation to interventions. OBJECTIVE: To identify concrete opportunities for teamwork intervention through a design thinking approach by analysing the teamwork dynamics of an orthopaedic team. METHODS: An adaptation of the learning history method, comprising shadowing, observations and interviews involving 26 orthopaedic team members at a top clinical teaching hospital in the Netherlands, was applied. A thematic analysis was conducted to derive themes that describe team dynamics and to subsequently extrapolate opportunities for intervention. RESULTS:We identified five themes and translated them into four design opportunities for intervention, namely: a) Improve daily rounds by reducing cognitive overload and promoting confidence; b) Improve collaboration by building empathy; c) Connect the patient with the professional team; and d) Support changes by fostering learning. Suggestions for concrete actions are presented for each opportunity. CONCLUSIONS: Opportunities to improve teamwork among healthcare professionals, specifically those in orthopaedics, revolve around the creation of common knowledge, the fostering of mutual understanding, and the design of tools and activities that support these processes.

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Design research in healthcare can be demanding. We report on eight challenges that designers and design researchers face when working on healthcare projects. We conducted four workshops with design researchers active in healthcare: six PhD candidates, a mixed group of thirteen design researchers, twelve design students, and eight design practitioners. Participants shared critical events from recent projects and reflected collaboratively to identify common challenges across different design approaches or disciplines. An analysis of the workshop materials resulted in eight themes of challenges, divided into three clusters. The first cluster, challenges in practice, includes (1) conducting fieldwork, (2) involving end users, and (3) dealing with sensitive situations. The second cluster, managerial challenges, includes (4) managing relations, (5) building understanding, and (6) communicating value. Finally, in the third cluster, generic challenges, includes (7) attuning to time and financial restrictions and (8) establishing rapport. This overview can contribute to design education and practice by helping both novice and experienced designers recognize and anticipate potential hurdles when engaging with the complexities of the healthcare environment.@en

What can design do to address adverse life events like childhood cancer? Cancer is not just a health matter—it strains family relationships and profoundly disrupts the stability of everyday routines. In this article, we introduce a socio-ecological perspective that untangles the systemic complexity of the challenges families face when confronted with childhood cancer. We use this lens to identify potential design opportunities for reconfiguring a “new normal” in their lives. We present and discuss the results of a participant observation of childhood cancer survivors at a large support group conference. These findings we analyze and organize into five themes corresponding to specific coping strategies: accepting the transformation of one’s body, avoiding avoidance, maintaining interest in social activities, retaining a sense of belonging to one’s social networks, and dealing with social stigma. These themes reveal opportunities for design innovation in sensitive settings that traverse the fields of interaction design, developmental psychology, and pediatric oncology.@en

This pictorial describes the process and rationale behind the design features of AscoltaMe (in Italian, "listen to me"). This is a computational object imbued with the intent to help families overcome the emotional barriers they may experience during a disruptive life event, as they attempt to maintain healthy communication. With a focus on the object's material qualities and temporal form, the pictorial introduces and visually outlines tactfulness as the fundamental characteristic that enables objects designed for sensitive settings to be intentful in ways that are appropriate and sensitive.@en

In this workshop paper we propose a preliminary design framework on how to enhance the development and wellbeing of teenagers with cancer through playful experiences. We aim to make a contribution on how to foster psychological and social development through play and how ambiguity and connectedness can be applied as a design strategy. The paper concludes with a discussion on how ambiguity and connectedness can generate playful experiences in a design and which research questions we need to tackle to develop the framework further.@en