Double doctorate merges health science and architecture

In a collaboration between the Department of Architecture and Civil Engineering at Chalmers University of Technology and the Institute of Health and Care Sciences at the University of Gothenburg, Madeleine became the first doctoral student to pursue a double PhD between the two universities. Her dissertation, completed in June 2025, is based on four sub-studies. These include a nationwide survey of access to outdoor spaces in assisted living facilities across Sweden, as well as in-depth interviews with residents at three such facilities.

The findings were clear: the desire to spend time outdoors was strong.

“They wanted outdoor spaces to be a natural part of everyday life – accessible every day, all year round, in all kinds of weather,” says Madeleine Liljegren.

Residents described features that made it easier to move between indoor and outdoor spaces, such as wide exterior doors with automatic openers. They also pointed to common barriers: narrow balconies, high thresholds, uneven flooring, and a lack of personal support from staff. Interviews with staff revealed a parallel wish – to make greater use of outdoor areas, both as settings for person-centered care, nursing, and rehabilitation, and as spaces where staff could also take breaks and relax.

The nationwide survey showed that access to outdoor areas in assisted living facilities is far from guaranteed. For example, only about half of the nursing homes surveyed had their own garden.

From physiotherapy to landscape architecture

Madeleine’s thesis is part of the OUT-FIT research project, which also involves researchers from the Swedish University of Agricultural Sciences (SLU). Her interest in the topic began at SLU, sparked by a book on garden therapy she encountered as a physiotherapist. After earning a master’s degree in landscape architecture and environmental psychology, she connected with an interdisciplinary research group in Gothenburg focusing on healthcare architecture and healthcare environments. In 2021, she was admitted as a double-degree doctoral student.

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Throughout her doctoral studies, Madeleine has had supervisors from three different universities – something she sees as a privilege.

“It’s been enriching to receive input from all three disciplines, each with its own research traditions, methods, and knowledge,” she says. “Yes, it took time to explain our different approaches to each other at the start of each sub-study, but the results have far exceeded what any of us could have achieved alone.”

Interdisciplinary collaboration with real-world impact

Helle Wijk, professor at the Institute of Health and Care Sciences and one of Madeleine’s supervisors, believes such interdisciplinary approaches are essential for tackling complex research questions.

“Investigating how physical qualities and accessibility in healthcare environments affect well-being, health, and job satisfaction requires expertise in architecture, healthcare science, and landscape architecture,” she notes.

Madeleine’s Chalmers supervisor, Göran Lindahl, professor at the Department of Architecture and Civil Engineering, agrees.

“This project is a great example of how academia can improve quality of life through collaboration,” he says.

Looking ahead

While navigating some administrative challenges along the way, Madeleine hopes she has paved the way for other double-degree students in the future. Now, with both a Doctor of Philosophy (PhD) and a Doctor of Technology, she is moving forward with a broad research network—and a dissertation that speaks to scholars across multiple disciplines, as well as practitioners in elderly care and urban planning.

As part of the OUT-FIT project—though outside the scope of her dissertation—the research team has also developed a proposal for a national strategy to ensure access to outdoor spaces and activities for older adults in assisted living.

By: Malin Avenius