Wearing Care. Design for Patient Agency and Everyday Care Practices through Wearable Digitally Interconnected Therapeutic Devices

The dissertation investigates how design practices and processes can foster patient agency within healthcare ecosystems that are increasingly shaped by digital transformation. It argues for the importance of adopting a systemic perspective on healthcare by outlining the ongoing shift from cure to care and examining the multifaceted relationships that emerge among actors, practices, and artefacts. Central to this exploration is the role of Digitally Interconnected Therapeutic Devices (DITD) prescribed for therapies requiring high compliance and daily integration into patients’ lives. The research adopts an experience-based approach and is structured as exemplary research through three design cases. The first case examines a sensor-embedded facemask designed for paediatric patients undergoing orthodontic treatment for Class III malocclusion. The second explores the redesign of compression stockings for individuals with venous insufficiency as part of a product–service ecosystem. The third investigates continuous glucose monitoring devices used in diabetes management. Together, these cases demonstrate how design can move beyond performance-driven engineering to support more holistic experiences of care, enhance patient engagement, and contribute to responsible innovation in medical device development. Across the design cases, the dissertation shows that patient agency is not a matter of individual control or self-optimization, but a relational capacity co-produced through interactions among patients, devices, clinicians, data, and care environments. Care emerges across individual, social, and planetary scales, shaped by design decisions that influence responsibilities, visibility, and everyday practices. Methodologically, design methods are framed as boundary tools that mediate collaboration and integrate experiential and tacit knowledge. By articulating a set of design, the dissertation offers a care-oriented framework for envisioning DITD that sustain meaningful and responsible healthcare practices.