Most chronic care happens at home within families, yet health technologies remain individually focused despite research showing family involvement significantly improves outcomes. In Thai culture, intergenerational caregiving is deeply embedded in family practices, creating a gap between collective care values and individual-centered health tools.

Research Question: How might we design for relational use in health data sharing between Thai adult children and their parents managing chronic conditions?

Grounded in data humanism philosophy that values human stories and lived experiences behind numbers, the study explored data intimacy—the closeness that develops when people share personal data with trust and intention so that loved ones can understand and care for each other. Using participatory design and contextmapping methods, four Thai parent-child pairs (n=8) engaged across two research cycles. Families tracked personal health data, participated in paired co-creation sessions, and designed adaptive sharing approaches for different health situations.

Key Findings: Three interconnected perspectives challenge individual-focused health informatics: First, families exhibit four distinct sharing patterns that adapt over time rather than remaining fixed. Second, health data sharing needs shift across four non-linear phases from stable periods to health crises. Third, families use data as collaborative memory-making tools, combining medical numbers with personal stories.

Contributions: These insights reveal how families naturally practice collaborative sensemaking around health data. The research develops eleven design principles organized around three pillars—designing with relationships, adapting to changing health situations, and honoring lived experiences behind data—with potential for translation into practical tools for health technology design and family conversation facilitation across cultural contexts.

While grounded in Thai parent-child dynamics, validation with design students with diverse backgrounds (n=5) suggests these insights could extend to other close relationships managing health prevention or chronic illness across cultural contexts. The Wave of Care (https://wave-of-care.webflow.io/) website communicates findings through storytelling for design practitioners. Future applications may include family conversation facilitation tools, emotionally safer health sharing approaches, and prevention-focused design that supports gradual health communication and connection before crisis points force difficult conversations.

The healthcare sector is under increasing pressure due to rising demand, staff shortages, and fragmented collaboration. To improve coordination and put patients at the center, care pathways are gaining importance. Metro Mapping, a relatively new design service method, offers a promising method to visualise and co-design these pathways in a more collaborative and structured way. However, its adoption in daily practice remains limited, partly due to the lack of a dedicated digital tool.

This graduation project focused on the development of such a digital Metro Mapping tool, aiming to support broader and more sustainable use in healthcare settings. The central question was: how can healthcare professionals effectively optimise care pathways and improve patient care with the support of a digital Metro Mapping tool?

Research
To answer this, I investigated what enables and hinders the adoption of Metro Mapping, and how a digital tool could help overcome these barriers. Insights were gathered through literature research and a wide range of interviews with healthcare professionals, designers, researchers, and advisors. This led to a structured understanding of key enablers, challenges, and barriers, which were clustered to inform a strategic direction. Based on these insights, the following future vision was defined:

“Metro Maps are dynamic documents that are evolving, shared visual blueprints that support coordination, communication and better patient outcomes."

This vision was translated into concrete design principles, outlining what the tool should offer in terms of usability, flexibility, and collaboration. Throughout the design process, I organised
co-creation sessions and interim feedback sessions, making sure that the outcome stayed grounded in real-world needs and constraints. Based on these principles and user input, a wide range of possible features was developed. These were prioritised into two categories:

- Required features: a mix of must-haves and highly desired features, which were included in the prototype
- Future wishes: valuable additions for later development, but with less priority for now

Results
The result is a concept for a digital Metro Mapping tool that incorporates all required features and translates them into a clear and flexible interface. The design includes layered interactions, role-based views, and modular building blocks. Key features include a drag-and-drop builder, clickable layers, filtering per user type, and layers and phases that can be collapsed or expanded. It allows for real-time co-creation, linking files, and navigating through different levels of details. By bringing everything together in one place, the tool reduces duplication, increases clarity, and enables more efficient collaboration.

In validation sessions, stakeholders confirmed its potential to better align care teams, support shared ownership, and improve quality and safety. An IT expert validated its technical feasibility, provided that the interface and data layers are separated and existing IT systems (e.g. Zenya or EHRs) are taken into account.

The report concludes with clear recommendations for next steps, including implementation considerations and collaboration opportunities. This project does not aim to deliver a finished product, but provides a strong, validated foundation for further development of the Metro Mapping tool.

This thesis explores the development of a future framework designed to address the complex and multifaceted issue of homelessness in The Hague. The future framework aimed at creating sustainable, user-centered services. With homelessness on the rise due to factors such as migration, economic instability, and housing shortages, there is an urgent need for innovative, forward-thinking solutions. This research was conducted in collaboration with the D&K advisory team of the Municipality of The Hague, focusing on the reframing of current approaches to create a more comprehensive and effective service design for those at risk of homelessness.

The methodology employed includes the Reframing Method, a design approach that encourages stepping back from conventional perspectives to explore new possibilities. The research involved extensive interviews with experts, observations, and literature reviews, which were synthesized into a future framework that anticipates the needs and challenges of the homeless population in 2035. This framework serves as the foundation for designing services that are not only reactive but also proactive, aiming to prevent homelessness before it occurs. The framework organized the information and resulted in the development of a service design called FliptheScript. The design specifically addresses one of the coping mechanisms identified in the framework. This service aims at early prevention of homelessness by focusing on people who stagnate because of shame, caused by financial issues.

The service design, FliptheScript, was subjected to user testing, which provided positive evidence of its effectiveness in improving the personal narrative of the test subject. The tests revealed that the design successfully engaged users and addressed key challenges identified in the research.

The outcomes suggest that a forward-looking, framework-based approach can significantly enhance the delivery of municipal services, making them more adaptable and responsive to the needs of vulnerable populations. The project demonstrates that integrating such a framework into the design process can lead to more effective interventions, which can be crucial in preventing and addressing homelessness. The findings suggest that by adopting a long-term perspective and focusing on the broader social context, municipalities can create more effective, user-centred services that address the root causes of homelessness. The project concludes with recommendations for further development and an assessment of the overall process, providing valuable insights for future research and design in this critical area.

This project addresses a critical need in palliative care by developing a product that supports children in coping with the loss of a parent. Specifically targeting families with young children, it seeks to provide emotional support during the challenging times of a parent's serious illness and eventual passing, fostering family bonding and memory-making through engaging activities. The primary objective is to help parents and children support each other by creating and sharing personal stories. Through play and storytelling, the project aims to help families build a re-tellable, constant story that can serve as a source of comfort and continuity throughout the grieving process.

The research phase uncovered several critical insights. First, parents often struggle to talk to their children about the illness due to uncertainty about what to say and how to start the conversation. Open communication in age-appropriate chunks is essential for helping children process their feelings. Second, children and parents may feel lonely and isolated during this period. Maintaining family bonds and a sense of support is crucial. Third, children express complex emotions through play rather than words. Providing a safe space for this expression is vital for their coping process. Fourth, children need honesty about the situation to start making sense of their experiences. Encouraging questions and honest answers helps them find meaning. Finally, close physical presence and comfort are necessary for children to feel secure and supported.

The final product, "Treasured Moments," is designed to help families create and preserve memories together. It not only provides tangible records of memories but also creates a lasting legacy that can help children and their families cope with loss through shared storytelling and play. It aims to use the power of personal connection in the face of grief, offering a flexible approach to support families during one of the most challenging times in their lives.

Initial tests demonstrated that the product effectively facilitates family bonding and memory-making. The family was able to engage with the product independently, filling the memory tiles with personal items and stories that held significance for them.
The positive feedback and interest from KIEZO in taking the product forward indicate its potential impact and relevance in the field of palliative care.

As the Dutch population ages, a growing number of elderly are experiencing loneliness and social isolation. Loneliness has far-reaching impacts, contributing to mental health issues such as depression and anxiety, as well as physical health problems like sleep issues. It is vital to explore approaches for prevention and intervention to mitigate its impact.

Art, culture and heritage can play a pivotal role in connecting individuals. Stedelijk Museum Schiedam, which focuses on art, heritage and societal engagement, exemplifies innovative approaches to involving citizens in their
museum. This positions the museum ideally to investigate how art, culture, and heritage can foster connections among elderly. The museums’ dedication to be of relevance to its community further underscores its suitability for this question.

The project follows the double diamond
method. Beginning with an exploration of existing literature on the roles museums
nowadays take on, how art and heritage can be used as a means to connect elderly, and how loneliness affects the lives of elderly, followed by interviews. The insights of this research phase served as inspiration to define the design goal and design requirements for the next phase.

The chosen design goal was formulated as:

Empower individual elderly residents in Schiedam to connect with each other through heritage by adding personal value, taking into account cultural differences.
Ideas were generated through brainstorming sessions, resulting in a museum programme with the goal to empower elderly to exchange memories and form connections, thereby realising their own value. The programme titled ‘Schiedam Vertelt’, is structured into five phases: inviting, stimulating, familiarisation, connecting and appreciating. The programme is intended to be repeated over the years. Within the development of the programme, it was included as requirements to adopt a transformative experience
approach and to include art and/or heritage. The programme was evaluated and updated through brainstorms, conversations,
enactment sessions and user tests.
Ultimately, a guide was created to effectively communicate the findings, outlining each phase of the programme and offering guidelines for programme creators, designers and others interested in implementing it. This guide was evaluated by TUDelft IDE master students and a city programmer from Stedelijk Museum Schiedam.

The report concludes that the initial tested phases of the programme, which represent the first steps toward forming connections, hold promise to engage the elderly. However further adaptations and testing are required, detailed in the recommendations.

Palliative care is becoming increasingly important at Erasmus Medical Center (Erasmus MC) as the hospital sees around a thousand annual deaths due to various conditions. However, the hospital environment has not adequately addressed the psychological, spiritual, and social needs of patients and their loved ones during the end-of-life phase. This TU Delft graduation project, in collaboration with Erasmus MC, aims to explore the unique needs of patients, their families, medical staff and the patient environment in the final days of life. The goal is to develop a sustainable, design-driven concept that illustrates enhanced end-of-life care across different hospital departments.
This research employed a multi-phase design approach using the Double Diamond framework. The Discover phase involved extensive research, including literature reviews, visits to care facilities, patient room analyses and interviews with healthcare professionals. The Define phase synthesized these insights into a framework for the End of Life journey, analyzing the needs and responsibilities of key stakeholders. This analysis led to a future vision, outlining three design directions for improved palliative care. In the Develop phase, a concept was teratively created and evaluated to align with this vision. The design process focused on the design goal: “To create a patient room that supports stakeholders in the End of Life process in facilitating a dignified end of life experience for all involved.” Finally, the Deliver phase presented a proof of concept to illustrate the possibilities of this research, with recommendations for future implementations at Erasmus MC.
The research identified several key findings, categorized into three main design opportunities: improving communication and expectations, enhancing the autonomy of actors involved and balancing the wishes of patients with the resources of the medical team. “De Verhalenhoek" emerged from this process: a cabinet where patients can store meaningful items, facilitating conversations about values and interests between patients, loved ones and medical staff. The concept invites users to personalize the room and serves as a starting point for conversations about the End of Life process. De Verhalenhoek aligns with the goals by creating a welcoming space that encourages discussions about patients' values and the meaning of death, enhancing communication and quality of care. This helps to reveal individual, cultural and religious preferences, allowing medical staff to tailor treatments to patients' whishes and ensuring patients and loved ones feel seen and heard.
The research concludes that integrating thoughtful design into patient rooms can improve communication in end-of-life phases and enhance the sense of autonomy for stakeholders involved. Key recommendations include evaluating the interactions through a pilot study to
assess the impact in the intended setting. This pilot aims to help patients feel more in control and supported in their final days and to better prepare the loved ones for the grieving process. Future research should focus on implementing these design solutions across various hospital departments to broadly enhance the quality of palliative care at Erasmus MC.
This project demonstrates the potential of design to improve End of Life care in patient rooms, making a contribution to the field of palliative care.

Over the past few decades, there has been a significant increase in the number of professional female athletes. One thing that both professional and amateur athletes can experience is the effects of their hormonal cycles. These hormonal cycles can affect their performance, and in return, their performance can affect their hormonal cycle. However, the underrepresentation of female athletes in sports research has resulted in most sports guidelines not reflecting this possible connection between the menstrual cycle and performance, causing female athletes to be unaware of it.

Athletes should be aware of the connection between their menstrual cycle and performance. Female rowers, in particular, experience a rapid increase in training load and they may be hesitant to discuss menstrual problems with their coach due to their relative newness to the sport, which could cause them to perform less optimally or even unhealthily. This project aims to find an alternative approach to support female rowers to build their knowledge using their sports and menstrual data so that they can perform optimally and healthily.

This project followed a research-through-design approach. This meant that knowledge was generated through design activities (Stappers & Giaccardi, 2014). The design activities were performed in three cycles to iteratively increase knowledge and improve a design that supported rowers in understanding the connection between their performance and the menstrual cycle. Each cycle began with a theoretical investigation of current design practices. These practices were then applied during a practical phase. The primary objective of each practical phase was to deploy and evaluate a design prototype with rowers.
The first cycle of research investigated how sports and menstrual data could be implemented in designs for female rowers. During the practical phase, a digital prototype was used with rowers and the evaluations indicated that the design should be simplified and place more emphasis on visualization. After the evaluation, a co-creation session was held which suggested that the design should explore the value of sharing the data.

The second cycle of research explored how tracking could be a valuable experience for rowers. The findings from the first cycle led to a physical design prototype that was again used and evaluated by rowers. The evaluations of the second phase suggested that the design should take a broader view of performance, and the co-creation of the second phase placed more emphasis on having different levels of activities by the rowers to understand the data. The knowledge generated throughout the project was synthesized into a final design.

The final design was a mobile application that would support rowers in exploring the relationship between their performance and their menstrual cycle. By tracking their mental, physical, menstrual, and contextual data on a daily basis, rowers could reflect on their beliefs about this relationship. In conclusion, the continuous implementation of insights constructed with stakeholders led to a design that could support rowers in understanding their experiences with performance and the menstrual cycle.

This project introduces “Ledemaatje,” an interactive product designed to help older adults with mild intellectual disabilities (ID) stay active in a fun, independent way. Physical activity (PA) is essential for one’s well-being, yet barriers like caregiver dependence and limited access often stand in the way for people with ID. Ledemaatje aims to change that by offering a low-barrier, engaging solution that encourages movement and social connection. Developed through participatory design, this project focused on creating an accessible and motivating experience shaped by direct user feedback at every stage.

Research into the context of living with ID and current PA interventions shaped the project’s design goals and criteria, emphasizing autonomy, accessibility, and social engagement. The development phase involved multiple interactive sessions with three older adults with mild ID, living at a residency at the organization ‘s Heeren Loo. Observations and feedback gathered during each session were leading for the design direction of this project. These sessions revealed that performing activities in a group setting were effective in prompting PA but there was still a dependency on external motivation. Further testing focused on understanding user responses to different stimuli, and levels of autonomy,

Ledemaatje’s final design enables semi-autonomous use, allowing residents to interact with the product in a group setting while requiring minimal caregiver support. Ledemaatje uses automated movements, to prompt users to push, pull, and engage with the device, promoting upper-body movements not typically used in daily activities. These interactions are further enriched by sound cues, such as applause, rewarding users and providing a positive interaction experience.

Evaluations with residents and caregiver in a typical residential setting showed that Ledemaatje effectively promotes PA and social interaction. While participants’ motivation varied depending on the task speed and complexity, feedback highlighted the product’s support for resident autonomy and engagement.

In conclusion, Ledemaatje demonstrates the value of user-centered design, providing a low-barrier, enjoyable PA option. Recommendations include refining the product’s automated features to further minimize caregiver involvement and adding adjustable settings to better suit individual capabilities. This project contributes to the development of inclusive, affordable PA interventions for individuals with ID, fostering a more active environment in care facilities.

In today’s fast-paced and increasingly individualistic world, feelings of loneliness and social isolation are becoming more prevalent. For students, navigating group projects can be challenging, not just academically, but also emotionally. Working closely with peers can bring about pressures to maintain a professional front, leaving little room for open conversations about personal struggles or support needs.

Recognizing the growing issues of loneliness and social disconnection in academic environments, the Support Board was developed to foster reflection, open communication, and mutual support within student teams. This project, focused on the Industrial Design Engineering (IDE) faculty at TU Delft, aims to create safe spaces within teams where students can reflect on their support needs, communicate those needs, and offer support to one another. By encouraging dialogue around support-seeking and support-giving behaviors, the Support Board seeks to improve team cohesion and promote a more empathetic and supportive culture within teams, ultimately enhancing both individual mental well-being and team dynamics. This lead to the following design goal:

Increase mental health of IDE students by developing a tool which helps create a supportive (team) environment and, in that way seeks to improve team cohesion

Through an iterative Research through Design approach, the project went through multiple phases of development, testing, and refinement. Initial research highlighted the need for interventions that encourage students to reflect on and articulate their support needs in a structured yet accessible manner. The Support Board addresses these needs by incorporating recognizable archetypes, support tokens, and guided reflection exercises to help team members understand their roles in offering and seeking support.

Pregnancy loss, a prevalent yet often hidden phenomenon, affects one in five pregnancies, triggering emotional challenges like depression and post-traumatic stress disorder in women. This research seeks to shed light on the unaddressed experiences of couples dealing with pregnancy loss and proposes a design solution to foster positive coping mechanisms. The overarching goal is to create tools that enhance the pregnancy loss journey for affected couples.

The research journey commences with an exploration of how partners navigate pregnancy loss individually and collectively. A comprehensive investigation incorporating literature study, expert consultations, and context-mapping sessions with five couples was conducted. The grief experienced both, as a couple and individually, was analysed, revealing the absence of established grieving patterns and rituals specific to pregnancy loss. Additionally, the dynamics and communication within romantic partnerships were impacted, highlighting the need for tailored coping strategies. Lastly, there seemed to be a difference between the perceived experience of loss between the pregnant and the non-pregnant partner, related to the physical act of being pregnant.

The absence of the physical component of pregnancy emerged as a distinct factor influencing the difference in the perceived experience of loss between partners. For the pregnant partner, the mind-body connection becomes disrupted, as a result of the emotional distress such as guilt, blame, and detachment. This disconnection also hindered effective communication between partners and their surroundings, necessitating the creation a design facilitating support through providing the space and the tools to reconnect to the physical body.

The subsequent design phase explored various mediums for achieving the design goal, ultimately culminating in the conception of Eclipse, a transformative theatrical ritual. This ritual consists of three sessions, each centred around a distinct theme, employing elements like warm water, hot stones, cocoons, experience stories, and humming singing to facilitate the reconnection process.

Throughout the design process, numerous evaluation activities were undertaken, including ideation sessions, prototyping, and expert consultations. Eclipse was evaluated through a trial with three experience experts, confirming its alignment with the established interaction qualities and design goal.

In reflection, this thesis not only challenges the conventional Western medical approach but also advocates for a more holistic consideration of mind-body connections. By incorporating non-traditional elements into the coping process, this research counters assumptions regarding the topic of spirituality in research. The envisioned future involves a society that actively listens to the narratives of pregnancy loss survivors, granting them the space and time to grieve without judgment. The now silenced experience stories will be heard.

In conclusion, this research journey navigates the uncharted territory of pregnancy loss experiences, unveiling the complexities faced by couples. The design solution, Eclipse, stands as a testament to the power of transformational rituals in facilitating the healing process. This work contributes to destigmatising pregnancy loss grief, fostering a compassionate and empathetic environment for individuals and couples on this challenging journey.

Research shows family caregivers involved in palliative care are not yet supported to the desired extent. Therefore, the Leiden University Medical Centre (LUMC) started the Oog voor Naasten en Nabestaanden (ON2) project, a Palliantieproject financed by ZonMw. The ON2 project helps healthcare organizations with improving the care for family caregivers in their organization. Currently, the LUMC supports organizations in setting up and carrying out their projects. From 2024 onwards, organizations need to independently use the ON2 toolkit 3.0 to set up their own projects. However, the current ON2 toolkit 2.0 is not guiding and supporting enough for organizations to use it without any external support.

The aim of this graduation project is to create a redesign of the ON2 toolkit 2.0 that supports and guides users throughout the new ON2 trajectory 3.0. Qualitative research is conducted with six healthcare organizations, to map the current ON2 trajectory 2.0, the available support and experiences of participants.

The qualitative research indicates that project teams of different healthcare settings express a preference for compact and visual information, support when orientating and setting up their projects, and a well-structured ON2 toolkit 3.0. Moreover, the willingness of healthcare professionals to provide care to family caregivers plays a crucial role in the successful implementation of ON2.

A desired vision was formulated and used as starting point for the ideation and conceptualization phase. The vision aims at increasing the awareness of healthcare professionals on the added values of ON2 for themselves and making the redesign more accessible, guiding, supportive, inspiring and user-friendly.

The final concept of the ON2 toolkit 3.0 has four main features. Firstly, informing users about the ON2 trajectory 3.0. Secondly, providing the ON2 materials. Thirdly, inspiring users about the ON2 trajectory 3.0 by sharing experiences of participants. Lastly, creating a profile to independently perform the ON2 trajectory 3.0 and set up your own project.

The final concept was tested on the basis of two qualitative interviews and a questionnaire (n=8). The target group was very positive about the concept and experienced the new toolkit as structured, intuitive, clear, user-friendly, visually pleasing, calm and inviting. A roadmap was created for the LUMC to further develop and realize the ON2 toolkit 3.0.

Some limitations in this graduation project are the amount of users that were interviewed and involved in the test sessions, the concept is not tested with all healthcare settings and it was not feasible to test the concept in practice. Therefore, the concept cannot be guaranteed to be effective in every context and for independent use.

It is recommended that the LUMC conducts test pilots with current and new organizations before launching the ON2 toolkit 3.0, and after the launch collects feedback from users to further optimize the toolkit. In addition, the LUMC should make clear agreements with stakeholders about the management and maintenance of the toolkit. Lastly, it is recommended to add content incrementally, starting with the most essential content and adding more content over time to make the toolkit more guiding and supportive.

This research aims to explore the experiences and needs of social support after the teenager’s parental loss within the secondary school environment and proposes a design intervention.

Teenagers perceive grief more intensely compared to younger ages and adults since it aligns with the rapid transitions of their adolescence. In this vulnerable stage it is important to invest in support to prevent negative consequences on their mental health in the long term. Research stresses the importance of social support for the adaptation of bereavement. Considering the social support, schools are crucial organizations, since teenagers spend a large amount of time there.

The current state
In general, teenagers want to be seen, heard, and acknowledged in their loss. At the same time, they do want to be treated the same as their peers. These ambiguous needs make providing support from the school environment complex. Additionally, the community members, such as teachers and peers, often encounter a lack of experience and knowledge in offering social support.

This research identified that the lack of a protocol or uniform plan results in each teenager perceiving different levels of social support. Also, the experienced support decreases over time, even though their desire for support remains.
Bereaved teenagers often rely on chance encounters with individuals within the educational system, such as mentors, teachers, or peers, to determine whether their desired social support needs will be met. Some teenagers do experience a lack in receiving social support, and feelings may arise that there is no space for grieving in the school environment.

The need
Therefore, teachers, peers, and bereaved teenagers need empowerment to initiate and maintain the social support. A design intervention should provide clear pathways to highlight opportunities for support and offer guidance in having supportive interactions.

The design focus
The primary focus of the design is to offer tools to community health workers in order to enhance the social support network in school. This involves facilitating opportunities for bereaved teenagers to easily connect within the school with preferred school staff, the natural helpers. Natural helpers are members of a community to whom other network members naturally turn to for advice, support and other types of aid. The natural helper has thereby their own support from other community health workers within the school, the school social workers, empowering them to offer support.

The design
As a result of the design process, the card set called Handreiking Rouw was developed. The toolbox, provided to the teenager by the school after the loss of a parent, contains a variety of cards presenting feelings, needs, experiences, and suggestions.

Handreiking makes it easier for bereaved teenagers to communicate with natural helpers by providing them with low-key options to get in touch with particular staff members. The toolkit also provides schools with a consistent approach to support bereaved teenagers. This involves providing mentors with instructions on how to welcome these teenagers, enabling teachers to have an empathic understanding of parental loss, and establishing a support network within the school for natural helpers that enables them to provide support to bereaved teenagers.

An extensive evaluation with the involved stakeholders and experts with different backgrounds showed the potential of the design for enhancing social support within the school environment. However, future research is required to evaluate the effectiveness of enhancing social support.

Dementia is a part of our society. One in five people, and for women even one in three, will develop dementia. Dementia has a significant impact on the lives of those affected, as well as their loved ones. This design project focuses on the impact of dementia on the adult children of a parent with Alzheimer's disease.

Once a parent is diagnosed with dementia, a complex situation occurs that forces the adult child to adapt to - and cope with - this new situation. A situation in which three processes can be distinguished: dementia and its effects, the social connection(s) between them or others and the grieving processes. These three processes create a complex reality as each of them are unpredictable, unique to the individual, and influences and intertwines with the other processes. To understand and to design for this complex world; several research and design activities have been conducted to map this context that the child and parent with dementia are in. These activities aimed at involving the perspective and experience of both experience and dementia experts.

Due to Alzheimer's, the brain cells of the parent are damaged, affecting their behavior, thinking, and emotions. There are three stages, in which the parent first mentally and later physically deteriorates. The dementia in the parent's brain brings many changes and losses, especially of great impact on the adult child in the long term.

It is noteworthy that there are many formal caregivers involved in the care of the parent with dementia. The experience of support provided by these formal caregivers to the adult child depends on the individual characteristics and approach of the caregiver. There is a clear need from the perspective of formal care for tools and strategies to better understand and support the loved ones of the patient. Within the informal social circles of the adult child, differences in coping mechanisms can sometimes manifest themselves in not experiencing the desired support.

Because grief is often associated with loss through death, anticipatory grief that accompanies dementia does not always receive the attention it deserves. Anticipatory grief for the adult child is unique to the individual, unpredictable, and ambiguous. Providing space for this form of grief is crucial because it can lead to a healthier and less intense grieving process after the parent's death. Talking to others, sharing experiences, acquiring knowledge, and having social support are all important factors in creating this space.

The exploration of these three processes through various research activities has led to the discovery of a phenomenon: the "period of acknowledgement". This period is characterized by the realization of the adult child that dementia is a progressive disease that cannot be avoided. They also come to understand that it is the disease that is changing their parent, and not the parent themselves. Acquiring knowledge about dementia and grief, and reflecting on their personal experiences, is essential in developing this period of acknowledgement.

The design goal for this project is based on this period of acknowledgement: “to enable the adult child whose parent is dealing with dementia to discover the impact of the dementia on themselves with the help of knowledge about dementia and grief, thereby increasing the awareness and creating more room to grieve over time.”

Various ideas were generated in brainstorming sessions, translated into physical prototypes to be tested with adult children, and further developed in co-creation. These design activities resulted in the development of a tangible reflection tool called "grip", which aims to provide space for adult children to explore and share their personal experiences and emotions related to the impact of dementia on their lives.

The grip tool facilitates conversations between the adult child and a conversation companion with tangible words to visually represent experiences, emotions, and losses related to dementia. It allows for the exploration of coping strategies and the development of new ways of coping, and it aims to provide social support and space for the adult child to share their grief. Overall, the grip tool aims to enable the adult child to better understand the impact of dementia on their lives and increase their awareness, creating more room to grieve over time.

However, further research will be needed to test and improve the impact of grip. Design recommendations for improving the tool have been given, such as simplifying the design, improving usability, testing with people in the avoidance phase, testing the effect on the long term, and creating a more inclusive design. In addition, suggestions have been made for implementing grip in the future.

Grief is a complex experience without a specific endpoint. It follows a unique path for each person. Many support sources are available, but finding support that fits is difficult. This inspired Verening Leven met Dood to develop the Rouw Wegwijzer, an online platform that provides personalised grief support. The focus of this thesis is to develop the platform from a user-centred perspective, specifically focusing on emerging adults who have lost a parent while not residing at home, a demographic for whom grief can wield a disruptive, life-altering impact.

The idea that grief has a set route and an end status of acceptance is a persistent, untrue belief in society. This shapes how bereaved think about their grief, how they are supported and what they expect from support. Contrary to this misconception, grief does not have a definitive end-point; rather, it involves a gradual and evolving understanding of the loss.

Effective grief support refrains from attempting to “fix” grief but rather acknowledges the bereaved and their experiences. Conversely, unhelpful support consists of offering unsolicited or paternalistic advice and attempting to solve the grief, approaches that contradict acknowledgement.

In this thesis, several research and design activities have been conducted to understand what grief is and what kind of support is considered supportive. Additionally, co-designing activities with the target group were conducted to find out what services are desirable for an online grief platform and how the interaction with the platform should be.

It was identified that grief support can have many forms, but usually is shaped as conversations or text. However, talking about grief can be difficult, due to the topic being taboo, making the bereaved untrained in expressing themselves and their needs. Generative sessions with the target group revealed “Recognition” as a promising design direction. Bereaved can expand their emotional vocabulary, by recognizing their emotions and experiences in the expressions of others, ultimately leading to a deeper comprehension of their grief. This led to the following design goal: “We want to offer bereaved emerging adults a place to explore their (understanding and expression of) grief, via recognition in others’ understanding and expressions.”

The final design is a platform that leverages recognition to uncover and identify grief experiences that might be difficult to put into words. It allows users to explore what is important for them while exploring and collecting varied content about grief, captured in texts, audio, images and videos. Based on the collected content, and the themes discussed in it, an overview is created of which themes seem relevant for the user. Then, per theme, the user can access information and support.

The platform’s unique approach, transitioning from “exploring based on feelings” to a “structured and supportive” overview of relevant information and support, received positive feedback, with participants of the us-er test describing it as inspiring, clarifying and enlightening. However, usability issues hindered the user experience. Recommendations on how to improve the usability of the platform are made. Additionally, recommendations for further development of the Rouw Wegwijzer are given.

Under the influence of COVID-19, teleconsultation has been applied widely by hospitals and clinics. The value of teleconsultation for the management of chronic diseases is being explored as well. It is widely proved that building a trustworthy relationship between doctors and patients is the key point for long-term care. However, in the new context of teleconsultation, the interaction between patient and doctor has changed dramatically. The expansion of physical distance and the involvement of new technologies have affected the building of trust. Therefore, studying patient trust building in a digital context is crucial to implementing teleconsultation for the long-term management of chronic diseases in the future.

Through a contextual study of the challenges and opportunities in healthcare and technology, a future vision of teleconsultation was generated in the Understand stage (Chapter 2) as the background for implementing the trust design. A literature review was then conducted for an in-depth understanding of patient trust in teleconsultation, identifying the characteristics, consequences, and predictors of trust.

At the end of this chapter, a distinction was made between trust attitudes and trust behaviors. The pathways by which trust attitudes influence the three focused patient behaviors (ITU, Continuity, and Adherence) were demonstrated through a conceptual framework explaining the scenario in which trust attitudes and behaviors are consistent.

The reasons for the inconsistency of trust attitudes and behaviors were explored in the Explore stage (Chapter 3) through qualitative research. Four patient archetypes were first classified according to whether patients' attitudes and behaviors were consistent. The trust-related attitudinal and behavioral characteristics of each archetype and the respective needs were then elucidated through interviews to address the scenario of inconsistency.

In addition, combining the findings of the theoretical study in Chapter 2 and the user interview insights in Chapter 3, five categories of factors that promote patient trust were identified. Considering the design feasibility and value in teleconsultation, the focus scope for the design of this project was positioned.

In the Design stage (Chapter 4), the findings from the research resulted in six design strategies to help designers design for patient trust. The six strategies were further discussed and categorized along three dimensions: the covered influencing factors, the implementation stage corresponded with patient behavior phases, and the value priority for four patient archetypes.

In the Deliver stage of the project (Chapter 5), patients and designers were invited to evaluate both the research outcomes and the design strategies. Ultimately, all research outcomes and final design strategies on trust were presented on an online website to provide design guidance and inspiration for future trust designers.

Death is and endlessly interesting and relevant topic. After all, every human will encounter it one way or another. The common denominator among the many cultural and ideological perspectives on death is the cessation of all biological processes of an organism. But beyond that come rituals, values, and beliefs, all of which are subjective and open to interpretation. This graduation project was about what this subjectivity means for children. Children generally start developing more abstract questions about life and death at the age of 9 to 11. How can we educate children on something that we cannot fully describe and define ourselves?

This graduation project was conducted in collaboration with Nederlands Uitvaart Museum Tot Zover, a museum that aims to encourage people of all ages to reflect on death, mortality, and bereavement. For a couple of years, the museum has had the ambition to increase their impact on children’s death education with an experiential concept that operates outside of the museum walls. This ambition aligned with my own in the overall project goal: I aimed to design the narrative concept of a Tot Zover pop-up exhibition for 9- to 11-year-old children about the subjective aspects of death.

From the project goal, I derived the main research question: How do 9- to 11-year-old children currently learn about the subjective aspects of death and how could storytelling make a positive contribution? Among other activities, I conducted literature research and contextmapping sessions with schoolchildren. I concluded that children currently learn about the subjective aspects of death – now classified as the psychological and metaphysical aspects – in isolation, since the topic is not often discussed. A positive change could be made through storytelling: telling stories to a group of children invites them to share their own experiences, fantasies, and reflections, which promotes feelings of comfort, and which may enrich the perspectives of the listening children.

I used the research insights to form a central theme which the narrative concept should discuss. I defined that the concept should ask children what death means to them instead of teaching them what to think or believe. Children should see that death has many faces and each one may be open to interpretation. Contrary to the current situation, death should not be something the children wish to avoid, but an approachable entity. The concept should present children with a diverse and colorful spectrum of death stories, which may contradict one another or take the children out of their comfort zones.

The theme, using the narrative blueprint called the hero’s journey, was implemented in my design goal: to give 9- to 11-year-old schoolchildren space to: (1) explore death stories, (2) embrace that such stories, in their variety, may be authentic and personal, and (3) explore their own stories. I defined that, through the interactions with my concept, children should feel adventurous, imaginative, acknowledged, and connected.

The criteria led to the design Mijn Eigen Hein, the narrative concept for an exhibition that travels across locations of the OBA (Public Library of Amsterdam). It is a result of an iterative ideation and conceptualization phase, where developing a detailed narrative was complemented by designing the interactables that would bring that narrative to life.

While interacting with the concept, children explore death stories embodied through a collection of 10 Hein masks that represent contrasting perspectives on the subjective aspects of death. They learn to embrace that death can be many things, and that anyone is free to form their opinion. In the climax of their journey, they express their own stories by making their own Hein and add it to the digital collection by scanning it in a presentation ritual.

The design outcome is a storyboard of the children’s learning journey, concept art for the exhibition scenography and prototypes of the learning materials and the collection of Hein masks.

The concept was evaluated with positive results through a prototype test with schoolchildren and through feedback meetings with experts of experience design. I concluded that Mijn Eigen Hein fulfills the design goal. Children understood the story’s moral, and they could use the mask as a canvas for their personal stories. Although it was found that not all children share their deepest ideas, I argued that even those children learn during the journey by hearing their classmates’ diverse stories. The interaction qualities could unfortunately not be evaluated through the test with children, as I found that they do not yet possess the linguistic skills to reflect on their interactions and experiences on the required level of abstraction.

Mijn Eigen Hein has the potential to be a viable way of contributing to death education beyond Tot Zover’s museum walls, by which this project accomplishes its main objective. I would, however, recommend the museum to place the embodiment design concept’s technology high on the priority list. Moreover, Tot Zover will need to attract funding and further develop the narrative with the OBA and possibly other partners if the project is scheduled to launch in September 2023.

In its academic context, the project has generated new insight on the merits of storytelling in death education of 9- to 11-year-old children. More specifically, making use of this age group’s inherent fantastical worldview, although controversial in children’s psychology, proves to make an effective and fitting contribution to breaking the death taboo. If the concept was implemented on a large scale, I could imagine that it would help to shape a generation that is open-minded about other death perspectives and that gives death a healthy place in their lives.

Religious transition includes a spectrum of experiences that harbours a myriad of challenges. Though it is a non-linear process, every religious transition starts with a critical questioning of religious norms that one has been exposed to.

Reasons for questioning vary from traumatic experiences with religious others to cognitive and moral dissonance and contradictions in the sacred scriptures. Questioning brings the urge to discuss the contested aspects of one’s religion with others in the religious spheres. However, people questioning some aspects of their religion are usually discouraged in their inquiry because being critical of one’s religion is seen as heresy and a transgressive action to be avoided.

The lack of space to discuss critical questions with religious others can result in a feeling of loneliness and loss of relatedness. In the meantime, religious doubts can culminate while one suffers from uncertainties about their religion. Not being able to find answers to resolve their religious doubts makes some fear that they might lose their religious faith and get astray.

Still, one’s critical stance and positive feelings toward their religion can co-exist even after disavowing religion. Leaving one’s religion doesn’t always cause complete abandonment. Instead, people may be eager to learn from other believers to take a different angle on their former religion.

The goal of the project is to assist people in their religious transition process. More specifically, the aim is to support people critical of their religion in exploring whether to be at peace with their faith by providing them with a safe space to create their own unique understanding of their religion. To conclude, the Explore Your Perspective app encourages people to go beyond the binary perspectives dominating their religious transition experiences.

For many people, experiencing intimacy and sexuality is an important aspect of the quality of life. People who are suffering from incurable cancer are no exception (Wang et al., 2018). Often patients encounter a shift from focus on diagnosis and treatment, to emphasis on psychosocial support when cancer treatment is no longer effective. When it comes to intimacy and sexuality, these topics are experienced as difficult to discuss for both patient and healthcare specialist. To improve the quality of life of patients with incurable cancer, the GPS project, which stands for Conversations About Psychosocial Needs, Intimacy and Sexuality (Gesprekken over Psychosociale behoeften, intimiteit en Seksualiteit) was founded by the Amsterdam UMC. Their goal is to help and support nurses and clinical nurse specialists (CNS) improve their knowledge and skills about signaling and discussing psycho-social needs, intimacy and sexuality with patients with incurable cancer by putting together a training program.This graduation project focuses on designing for the online learning environment the GPS project set up, to effectuate awareness among nurses and contribute to a better understanding of the patient’s needs and questions about intimacy and sexuality in this important phase of the end-of-life. The aim is to make the online learning environment the base of their training in order to develop conversation skills and be engaging, inspiring and effective. To achieve this goal, extensive research has been done on the needs of nurses and CNS. By using the method Context Mapping interviews are conducted which have led to uncovering their barriers and enablers towards discussing intimacy and sexuality with patients with incurable cancer. Supported by literature and multiple Co-creation sessions with stakeholders, this has led to a design for a preparatory exercise within the online learning environment which is called: “The sea of experiences”. In an empathetic way, the exercise encourages the participants to think about their own abilities when it comes to discussing this topic, complemented by showing different perspectives on barriers and enablers. An evaluation of the concept with the target group showed that the exercise helped them to have a better understanding of the patients’ needs, feel supported and have the right mindset by feeling inspired to go through the rest of the online learning environment. As a result of the evaluation, recommendations are formulated with regard to the form and content of the concept. After complying with the recommendations, the concept should be ready to be implemented in the online learning environment of the GPS project. To conclude, the concept is a valuable step towards improving communication about intimacy and sexuality between healthcare specialists and patients, and therefore contributes to improving the quality of life of patients with incurable cancer.

People are reluctant to talk about death. However, death is going to happen, so it is important to discuss the topic while people still can. Discussing death on a more regular basis is beneficial for all people involved. End-of-life conversations can be held to discuss wishes and decisions concerning death and dying. However young adults do not feel the urgency. They can discuss subjects in relation to the end of life. These conversations can help to reflect on life, help to learn to support each other when needed and are meaningful for all people involved. In short, it can improve the quality of life and the end of life. Therefore, it can as well be beneficial for young adults to talk about death.

The goal of this project is to discover what can be designed in the context of Museum Tot Zover, in order to stimulate young adults to talk about death more often. The following design goal is formulated for this project: “I want young adults to feel stimulated to engage in conversations with friends about death, by fantasizing about afterlife, learning that talking and thinking about death can be enjoyable.”

Literature reviews and a field study have been conducted to gain background knowledge on the topic, explore the context and understand the young adults, in order to design a concept that reaches the design goal. The field study consisted of a survey filled in by young adults. In addition, interviews were conducted in order to find deeper understanding behind the results from the survey. From the field study could be concluded that young adults associate death with negative emotions as sadness, loss, insecurity and fear. They fear the impact their death has on loved ones, are worried to suffer from mental illness or experience physical pain at the end of life. Moreover, they are not ready to die just yet. They are still young and therefore do not feel the urgency to talk about death in this stage of their lives. Conversations about death are perceived as difficult and uncomfortable.

On the base of the study an Immersive Experience is designed which aims to create a positive association with death in order to stimulate young adult friends to talk about death. The installation is called: The Space To All Places. When entering The Space To All Places, visitors make the transition from life to death, entering the surrealistic world of the dead, where they rise above the clouds and are stimulated to fantasize and talk about their vision on an afterlife. The concept is tested with young adults, who all reacted positive on the experience. It is a positive experience that sparks interest in the topic ‘death’ and in each other.

This concept is designed for Death ceremonial museum Tot Zover and hopefully and incentive for other researchers and designers to help change people’s attitude towards death.

THE BRIEF & HET TUSSENLAND
The moment a patient receives the diagnosis of an incurable disease, it often feels like their whole world collapses. One patient explained this feeling as entering the in-between-land, the transition period from ending curative care and entering the end-of-life care. This in-between-land feels like entering an unknown land where you do not know the way and do not speak the language. Hospice Bardo expressed an interest in supporting these patients using the technology Virtual Reality. Therefore, this thesis aims to create a place for people where they can safely land in these tumultuous times and feel welcome to engage and open up to the 'in-between land' using Virtual Reality.

RESEARCH & DESIGN GOAL
During this thesis, research activities have been performed to get insight into the patient's wishes and needs. Literature research and explorative interviews were performed to get insight into the patient's journey after the diagnosis of an incurable disease. The interview panel consisted of patients, loved ones, care professionals, and experts in the palliative world. The insights of this research have been clustered and led to fourteen criteria that support the design goal.

IDEATION & CO-CREATION
The criteria were used as an inspiration for the ideation. Four students worked on this project in a hack-a-thon of Young Medical Delta and created a framework that complemented this research, leading to the final design. This framework exists out of five worlds that all answer to a different need: The forest, the library, the home, the communal space, and the beach.

THE FINAL DESIGN | THE ENTRANCE TO HET TUSSENLAND
The Tussenland is a digital platform that will be offered to the patient after the bad news. In this thesis, only the entrance to The Tussenland is designed. 'The Entrance to The Tussenland' is a forest-like environment in Virtual Reality where people are welcomed and shown around by a guide. The patients own a tree where their experiences grow as blossoms on their tree. The tree can be shared, enabling others to enter this world and comment on these experiences.

EVALUATION
For the final design, a prototype was evaluated by the panel. The panel was pleased with the meaningful interactions that were created in the design. It felt like a safe way to let people be welcomed and immersed in this new magical world. The participants felt like it was a tool that enabled them to express their thoughts, give them information and offer consolation in a meditative world.

IMPLEMENTATION
A service system map and roadmap were created for the future development of 'The Entrance to The Tussenland.' The three milestones in this roadmap are the pilot, launching 'The Entrance to The Tussenland', and further development of The Tussenland.

DISCUSSION & LIMITATIONS
However, the platform still needs to be developed as a full-service VR application. It is now a demonstration of what it could look/feel/sound like.
'The Entrance to The Tussenland' is not a concept meant for everyone because not every patient wants to engage the in-between-land.

CONCLUSION
In conclusion, the platform and service 'The Entrance to The Tussenland' supports patients after the bad news conversation by letting them safely land in the in-between-land.