When you are ill, a visit to the hospital is often a stressful and worrisome experience. Especially when you are a child and you cannot fully understand or imagine what is going to happen to you. A clinical environment that contains ‘scary’ looking medical equipment does not make you feel at ease. On the contrary, this can be experienced as confronting and can create anxiety. This master thesis focuses on improving the treatment experience of children that visit the Reinier de Graaf hospital. The research that was done during this project gives insight in to the aspect that have a negative and positive influence on the experiences that children currently have when visiting the hospital for treatment. It shows that, at the children’s department of Reinier de Graaf, the medical staff already provides good support to children and their parents, by preparing them for and guiding them through treatment with care. This ensures a reduction in the initial stress and anxiety experienced by the child. However, the medical appearance of their treatment room causes the child and its parents to feel uncomfortable. The high amount of negative stimuli that is present in the treatment room, caused by the medical equipment, reinforces the initial stress of the child. This is in conflict with the effect that the medical staff tries to achieve and negates their efforts. In this master thesis a solution to this problem is explored, which resulted in the concept of Treatment Tales. Treatment Tales transform a visit to the treatment room into an engaging and lively experience for children and their parents. This is achieved by turning the room into a fantasy world that comes to life during their time in the room. It is visualized with an illustration on the wall, which becomes dynamic with the use of projection and audio fragments of calming nature sounds. A short tale is printed to introduce the story behind the dynamic illustration. This tale can be read to the child before or during the treatment. Treatment Tales makes children and their parents feel more comfortable before and during the procedure and reduces their level of stress and anxiety. The ultimate goal is to improve the treatment experience and to decrease risk of traumatic experiences. This is achieved by creating a friendlier atmosphere in the treatment room, by providing a distraction for the children, and by providing opportunities for the parents and the other people in the room to be engaged. Altogether these components provide a system that creates a layered experience by providing visual, audio, physical, and interactive distractions. This is desired, as the research that was done within this project has shown that a layered and dynamic experience captures the attention for a longer period of time. Additionally, it provides a solution that stays interesting for children that visit the hospital on a regular base, because the animations and the stories can be easily changed and updated. Overall, Treatment Tales provide an easily implemented and effective solution to transform a clinical treatment room to a child-friendly environment.

The planet cannot keep sustaining our linear economy much longer. Industries are moving circular to reduce environmental impact. The kitchen industry has to change. CIK (the Circular Kitchen) is a research project that develops a circular kitchen: a product-service system for tenants in social housing in the Netherlands. The product is aimed to be market ready in 2022 and should have significantly less negative environmental impact. The partners in this project are material suppliers, part suppliers, a kitchen manufacturer, a contractor, housing associations and tenants. For a functioning and viable design, all stakeholders must cooperate. This graduation project started with investigating what tensions the circular kitchen might bring for social housing tenants and finds a solution for this. With an integral approach, the life of the tenants in the kitchen was researched along with the changes that the circular kitchen brings. All aspects of design were taken into account: technology, business and people. The approach for this project, an ‘iterative representation of the basic design cycle’, is combined with methods from service design and user-centered design. This project is divided in three consecutive cycles. Every cycle contains different phases: framing, envisioning, realisation and validation. In each cycle the design is iterated and refined. The assignment and problem definition form the basis and starting point for analyses. CIK, the stakeholders, and the background of the problem are researched. ‘Design A’ is evaluated in user research. The context of the problem was investigated by using literature studies and context-mapping with tenants. The context-mapping sessions provided a holistic view on the life of the user in the kitchen. It appeared that tenants differ in their perception of the kitchen. Their kitchen has an emotional or functional role and their activity in the kitchen are either individually or socially focused. These findings are visualised in a framework that shows four types of social housing tenants (Figure 1). Additionally, shared values were found among this research group (Figure 2). In cycle B new knowledge that was retrieved from user research is framed to start refining the design. The service- side of CIK needed development: new insights were translated into an integral service concept that tackles conflicts that can arise between circular interest and the tenants. The input of the evaluation of the design with the major stakeholder - the kitchen manufacturer - resulted into the introduction of a new partner that drives the organisation as a whole: Het Keukencollectief. An intermediary that guides all stakeholders and is the key to a successful and fertile business. Cycle C is focused on detailing the intermediary (Het Keukencollectief), the service, and the front-end of the service (digital web-app). Research demonstrated that the business should focus on both the basic kitchen and on upgrade possibilities. This formed the basis of a newly created digital platform. A final evaluation of the front-end design of the service showed that the design was attractive for the tenant and functioned as envisioned. To conclude, this report describes a user-centered design process in multiple iterative cycles resulting in a design proposal for a service system to facilitate a circular kitchen for social housing in the Netherlands. The most important addition to the current project is the design of the intermediary ‘Het Keukencollectief’ with the front-end service design.

Shared decision making is a process in which healthcare professionals and patients decide together on the course of the treatment. Shared decision making enables evidence and patients’ preferences to be taken into account. It improves the patient’s knowledge, understanding and patient-healthcare providers communication. However, various barriers for implementing shared decision making for patients with advanced heart failure were found, which consist of unclarity, uncertainty, lack of training, and lack of time. This thesis focuses on improving the shared decision making process at the Cardiology department at the Amsterdam UMC, location VUmc. Observations and interviews were conducted in the Cardiology department at the VUmc. In order to find similarities and differences between literature research and the current context. Interviews show that shared decision making partly applies to the current decision making process: although healthcare providers share plenty of information with the patient and family, they share it mostly verbally. Treatment options are explained to the patient multiple times, but no information is given in the written form. The booklet “Deciding with heart” was created to support the communication between healthcare providers and patients in the shared decision making process. It provides information about life-prolonging treatments for patients with advanced heart failure and sensitise them in individuating their values and preferences tackling two of the barriers found in the research: limited understanding amongst people with heart failure and unclarity of the roles in the care team. The booklet can be used to explain the patients’ prognosis and their treatment options in order to support them in the decision making process. The booklet helps to start a conversation between nurses and patients about making the best choice. The booklet was positively evaluated with nurses from the department of Cardiology in the VUmc and the outpatient clinic, and with patient representatives. Patients should receive the booklet during the consultation with a cardiologist, a nurse or a heart failure nurse. The shared decision making process can be improved when physicians decide to stop curative treatments; the booklet should be handed to the patient before in order to empower the patient in making a treatment choice using shared decision making principles. The booklet can help improve the shared decision making process at the Cardiology department at the Amsterdam UMC, location VUmc. Further research and development are needed to implement the booklet in the Amsterdam UMC effectively, location VUmc to improve the shared decision making process.

Door middel van het vak Onderzoek & Ontwerpen, opgezet door de Stichting Technasium, ontwikkelen leerlingen vakoverstijgende competenties. Het is noodzakelijk dat leerlingen deze competenties zelfregulerend leren ontwikkelen; dit verhoogt de effectiviteit van het leerproces. Doel van het onderzoek was om een bijdrage te leveren aan de ontwikkeling van praktische handvatten, voor leerlingen en docenten, om het zelfregulerend ontwikkelen van competenties in groepen binnen het technasium te kunnen ondersteunen. De ontwikkelde handvatten bestaan uit een combinatie van een Competentiemonitor en een POP-formulier (persoonlijk ontwikkelplan). De Competentiemonitor wordt gebruikt om de ontwikkeling van de leerling visueel in kaart te brengen, over een langere periode, om sterke en zwakke punten te identificeren en leerdoelen te kiezen. Voor deze Competentiemonitor is gebruik gemaakt van een indeling in zes competentieclusters, en twintig daaronder gegroepeerde competenties, zoals opgesteld door de Stichting Technasium (Van den Brink, 2016). Het POP-formulier ondersteunt het leerproces tijdens een projectperiode door middel van prompting op drie momenten tijdens het project, volgens de drie fasen (forethought-, performance- en self-reflection phase) van het cyclisch proces van zelfregulatie volgens Zimmerman (2000). Het onderzoek is gedeeltelijk uitgevoerd in samenwerking met de Stichting Technasium. De methode is getoetst in de lespraktijk op het technasium van het Calandlyceum in Amsterdam, door middel van design-based research (DBR). Met het oog op triangulatie is gebruik gemaakt van een mixed-methods opzet. Voor het kwantitatieve deel van het onderzoek is dezelfde anonieme vragenlijst drie keer afgenomen onder 200 technasiumleerlingen van het Calandlyceum. De interventiegroep (3e en 5e klas) heeft gedurende twee projectperiodes (kwartalen) gewerkt met de nieuwe methode, en de controlegroep (2e, 4e en 6e klas) heeft gewerkt met de methode die voorheen al werd gebruikt op het Calandlyceum. Het kwalitatieve deel van het onderzoek bestond uit semi-gestructureerde interviews met 16 leerlingen van de interventiegroep over hun ervaring met het werken met de nieuwe methode, en groepsgesprekken met 8 leerlingteams, waarin hun leerproces en het ingevulde POP-formulier werden besproken. Uit de resultaten blijkt dat de methode een positieve invloed heeft op alle vier gemeten dimensies: (1) metacognitieve kennis over de competentie-ontwikkeling, (2) attitude jegens werken aan competentieontwikkeling met aangereikte methode, (3) volgen van drie stappen van cyclisch proces volgens Zimmerman (2000) en (4) intensiteit van samenwerken ten behoeve van persoonlijke leerdoelen. Resultaten van het kwalitatieve onderzoek hebben de resultaten van het kwantitatieve deel van het onderzoek bevestigd. Belangrijke aspecten van de methode zijn de specifieke gedragsbeschrijvingen in de monitor, visuele weergave van het niveau van competenties en de progressie van de ontwikkeling, structuur en prompts in het POP-formulier en het daardoor effectiever in groepsverband samen kunnen werken aan de persoonlijke ontwikkeling – leerdoelen werden (in de succesvolle gevallen) binnen het team bij de start besproken en de taakverdeling werd hierop aangepast door de teamleider. Het praktisch nut van, onder andere, de theorie van Zimmerman (2000) is bevestigd door de gemeten positieve effecten van de methode. De methode is geschikt voor de O&O-lespraktijk. In de discussie worden aanbevelingen gedaan voor doorontwikkeling van de Competentiemonitor en inzet van de methode in de lespraktijk.

This graduation project focused on lowering the environmental impact in which warm beverages were drunk at NS stations by motivating user to use reusable cups. It was explored why customers currently do not use reusable cups at NS stations, which solution space can be used to motivate customers to use a reusable cup and how NS can implement this solution space in the NS context. Different research activities were conducted to under why customers are not using reusable cups now and how NS can motivate thee users. By analysing the results from observations, user interviews and context mapping. Based on the findings 5 barriers were found why customers are not using reusable cups. Next to these insights 4 personas were created and it was also found how NS can improve the customer experience of drinking a warm beverage at their stations. Based on these insights two solutions spaces where formulated which were compared to the paper cup. It was concluded that the deposit cup system would be the best reusable cup system for under the right circumstances, but that a user owned cup and a paper cup still have their place. Because there is no cup deposit system that fits the needs of NS stations the following design goal was formulated: Design a cup deposit system that has a return rate of at least 98.5% and motivates customers that buy a warm beverage at NS stations to use a reusable cup instead of a single use paper cup, by taking their drivers into account, while at the same time fitting inside the constraints of the NS retail system. This will lower the environmental impact of cups for warm beverages sold at NS stations. Next to the design goal a design vision was formulated to illustrate how customers should feel when these the system taking each persona into account. Based on the design goal and the design vision multiple concepts were created from which one was chosen and further detailed into a final concept. This final concept was evaluated with experts within NS, see figure FIX ME. To implement the final concept a road map was made.