Towards healing through digital nature in critical care and beyond: An integrated approach to design nature-based aesthetic experiences to promote delirium prevention and patient wellbeing

The transition in the focus of care from health to a broader concept of wellbeing has sparked a growing interest in creating healing environments and integrating nature as a means to enhance wellbeing. Fueled by digital technology, simulated nature environments, which refer to digital nature, became available to bring benefits of nature experiences to people with contextual and physical barriers. This thesis focuses on the potential of digital nature to benefit healthcare settings, particularly for vulnerable patients in intensive care units (ICUs), by transforming the ICU into a healing environment that promotes patient wellbeing and delirium prevention. While the potential of digital nature is promising, little attention has been paid to understanding how diverse nature experiences foster healing in individuals. Furthermore, there is a lack of actionable insights for designers to effectively incorporate these findings into the design of products and services.
This thesis explores nature experiences, focusing on their therapeutic potential, and investigates how designers can systematically apply nature-based stimuli into the design process to support patient wellbeing, incorporating digital technology. This thesis covers fundamental research into nature-based stimuli and the aesthetic experiences they evoke, context research into ICU patient experiences, a literature review on ICU delirium prevention technologies, and a multi-stakeholder co-creation workshop for synthesizing insights and creating a vision and digital solutions for a healing ICU environment. A series of design tools and frameworks that explain the working mechanisms and elements in nature that bring about healing experiences are conceptualized. The thesis also proposes two design concepts for ICU and post-ICU patients as examples of integrating insights from our findings. Seven individual studies have been conducted, resulting in seven journal and conference publications, six of which are published and one currently submitted.
This thesis contributes to healthcare design by enabling design researchers and practitioners to utilize the aesthetic experiences of nature as a tool to assess care needs and create new interventions that actively support patient wellbeing and healing. These explorations are conducted in collaboration between the Interaction Design Lab at the University of Twente and Philips Research.