This graduation project explores how designers, developers, and researchers can comprehend the elements and interactions that influence the successful implementation of innovation in cancer-care contexts, considering its inherent complexity.
Using a "Research through Design" methodology, data were collected through literature research and interviews with 4D PICTURE team members. Analysis and synthesis of information was done through an iterative process using giga-mapping techniques.
The result from the research is a GIGA map illustrating the complexity of the cancer care path, encompassing seven domains, 30 elements, and over 50 connections that impact technology implementation in this context. By understanding the systemic complexity of cancer care contexts, designers, developers, and researchers can develop technologies that enable successful implementation in the desired settings.
These insights can expand the knowledge on the complexity of implementation in cancer-care contexts, complementing existing literature in implementation science.

This research project created a tool designed to empower "brussen", the siblings of children with special needs, aged 7 to 12 to improve their visibility and recognition among their peers through play. Often overlooked within their families due to the primary focus on their siblings' needs, brussen face unique challenges regardless of the type of special need. They can find recognition and support in each other, but the term "brussen" is not widely known, complicating their ability to connect with peers. This project adopts a participatory design and research-through-design approach, engaging brussen in co-design sessions to ensure their perspectives shape the final outcome.

The research highlights the importance of visibility among brussen, with empowerment and play emerging as key elements within the design process. The design activities themselves contribute to knowledge generation, which helps to better understand the complex context of brussen. The project developed a personalized "ByBrus backpack" with velcro buttons, allowing brussen to express their identities and control their visibility in a playful manner. This personalization provides a sense of ownership and autonomy, as the buttons symbolize the unique stories, emotions, and experiences of the brussen. Through this approach, brussen can show their unique experiences, ultimately enhancing their visibility. By addressing the need for social recognition and support, the ByBrus backpack aims to create a sense of community and mutual understanding among brussen, contributing to their overall well-being and resilience.

In special needs families, family dynamics are slightly different from the dynamics in other families. A child with special health care or educational needs requires a lot of attention and special care treatment from all family members. The parents‘ attention is mainly shifted to the care needs of the brother or sister and the siblings are mostly on their own (Okma, Naafs, Vergeer, & Berns, 2014). In Germany, 6.1 % of all children between 10 and 18 years old are officially caring for one of their family members. This means that in every school class at least 1 to 2 pupils are affected (Bühring, 2018).
Literature points to a wide range of positive as well as negative influences on the
emotional well-being of these siblings taking over care responsibilities at home, namely anxiety, depression, behavioral and social issues, but also strengths of character, such as empathy and kindness (Giallo et al., 2014, Martinez et. al, 2022, Milevsky & Singer, 2022).

This project focused on the personal experiences of siblings at a young age (6-12 years) growing up alongside a child with special needs. By conducting literature research, context mapping according to Sanders & Stappers (2012) with children, and
supplementary interviews with parents the following underlying core values of siblings have been identified: 1. Feeling understood, 2. The need for adult attention and feeling cared for, 3. Just being themselves. Briefly, growing up with a special needs sibling comes along with the challenge of truly feeling and acting like a child.
These insights resulted in the design vision and goal for Ontzorghuis, a Dutch organization offering workshops, retreats and reflective tools for special needs families: Designing for playful and engaging experiences to support siblings (age 6 -12) to assume their role as a child by empowering and facilitating the sibling through interpersonal connections. Through a research-through-design approach (Stappers & Giaccardi, 2017) the essential interactions of playfully sharing secrets in the form of affirmations and personal wishes with each other, were identified. The final design proposal resulted in the storytelling tool “Robin” to create a special bond between siblings and their parents. The playful tool enables children and their parents to create secret and surprising stories together that may involve personal needs or dreams of the child covered in the personality of Robin. The storylines are built upon research insights and the final story aims to serve as a conversation starter to understand the child’s perception and wellbeing of the current situation.
A limitation of this project is that within the scope of this master thesis the final design proposal could not be evaluated with siblings in order to try out the interactions, nor the intended context, the sibling’s home. Therefore, it is recommended to further evaluate the different parts of the design proposal in collaboration with siblings, their parents and sibling experts to prove the effectiveness in diverse contexts in order to create space to feel like a child.