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Psychosocially Supportive Design- Scandinavian Health Care Design
Abstract
The major purpose of this paper is to discuss the basic ideas and criteria underlying contemporary health care design. Special attention is given to the growing shift in biomedical attitude from a largely pathogenic concept of disease to a more salutogenic perspective. This shift should not only lead to a stronger integration of building design and care philosophy but also result in an enhanced quality of medical care and strengthened health processes. Traditionally, the pathogenic perspective has tended to consider patients as objects and concentrated on individual "sick parts" of the human body, which were further and further divided into smaller parts and separately treated. Consistent with this perspective, health care facilities have been interpreted as medical-technical environments oriented toward the physical needs of the treated body part. From this perspective the main requirement placed on health care facilities has often been interpreted narrowly as the reduction of the risk of exposure to disease. Comparatively little priority has been given to calming the patients and making them feel relaxed in spite of traumatic hospital experiences and starkly institutional care environments. Other consequences of the pathogenic perspective have been that psychological, social and spiritual needs of patients have been largely disregarded in the design of Health care facilities, and often marginalized in the philosophy of delivering care. The emphasis on functional efficiency, together with the pathogenic conception of disease and health, has often produced health care facilities that are not psychosocially supportive. In recent years, however, a different perspective has emerged leading to a new paradigm. The modern disease concept is no longer narrowly pathogenic; rather, disease is seen as multifaceted and having a variety of causes or elements. The salutogenic perspective, which focuses on health promoting processes, has become much more central to the consideration of care philosophies and in the creation of new health care facilities. In this new paradigm, the focus is on the patients: along with their physical health needs the patients' psychological and social health needs are given major emphasis in the delivery of care activities and in the design of health care environments. Future research needs to develop care philosophies that focus on a broader concept of health, thus creating an awareness of the importance of psychosocially supportive design.
... Contudo, os avanços da ciência e das tecnologias médicas foram transformando os estabelecimentos de saúde em ambientes cada vez mais controlados e esterilizados, dando primazia a operacionalidade, tendo sido classificados como ambientes medico-técnicos (Dilani 2001;Ulrich 2001) ou hospitais tecnológicos (Toledo 2006). Nesta perspectiva, o espaço hospitalar direcciona-se para o atendimento das necessidades físicas da parte do corpo a tratar e para a redução do risco de exposição à doença -perspectiva patogénica (Dilani 2001;Ulrich 2001). ...
... Contudo, os avanços da ciência e das tecnologias médicas foram transformando os estabelecimentos de saúde em ambientes cada vez mais controlados e esterilizados, dando primazia a operacionalidade, tendo sido classificados como ambientes medico-técnicos (Dilani 2001;Ulrich 2001) ou hospitais tecnológicos (Toledo 2006). Nesta perspectiva, o espaço hospitalar direcciona-se para o atendimento das necessidades físicas da parte do corpo a tratar e para a redução do risco de exposição à doença -perspectiva patogénica (Dilani 2001;Ulrich 2001). Comparativamente, pouca atenção é dada à experiência stressante e traumatizante que resulta da exposição a uma enfermidade e a um ambiente hospitalar (idem). ...
... Comparativamente, pouca atenção é dada à experiência stressante e traumatizante que resulta da exposição a uma enfermidade e a um ambiente hospitalar (idem). Neste sentido, as necessidades psicológicas, sociais e sensoriais dos doentes têm sido amplamente ignoradas e marginalizadas na concepção de estabelecimentos de saúde, produzindo espaços que do ponto de vista social e psicológico são pouco inclusivos (Dilani 2001). As consequências de um desenho desajustado e pouco familiar dos ambientes hospitalares são negativas para os pacientes Barach 2006), que vêem afectados o seu processo terapêutico, o tempo de internamento no hospital e o seu bem-estar geral; para os funcionários, que em situações de contínuo stress profissional não encontram no hospital oportunidades de descompressão; e para os familiares/visitantes, pois vivem situações de ansiedade pela condição clínica dos seus familiares, e não encontram no hospital lugares adequados ao relaxamento e ao convívio com os seus doentes. ...
The main focus of this dissertation is the study of the garden as a therapeutic place, highlighting its contribution to the humanization of hospitals, enhancing therapeutic processes and patients wellbeing, increasing staff satisfaction and the quality of services provided by them, and offering better conditions of comfort and support to families and visitors.
A literature review on healthcare institutions gardens history as been made, underlining its importance towards the establishment of the concept of therapeutic garden, demonstrating that on several periods in history nature and, gardens, in particular, were interpreted as therapeutic agents, healing places and promoters of pain and stress relief. Next, we identify the specific and possible benefits of therapeutic gardens on health and wellbeing of hospital users with special focus on hospital patients. However, for those benefits to occur, the planning and design of the therapeutic garden as well as its integration with the hospital as a whole are of crucial importance. Therefore, a set of guiding design principles for these spaces are presented, to be applied in a flexible way in hospitals.
Taking into consideration that a void exists in this subject in Portugal, contradicting the international tendency, as project and construction of therapeutic gardens is concerned, a case study, the Pedro Hispano Hospital in Matosinhos, is presented here as a small contribution and incentive towards the implementation of therapeutic gardens in Portuguese hospitals. A design proposal applies the therapeutic garden design principles presented in this work to the outdoors of Pedro Hispano Hospital, opposing and going beyond the present situation.
We have concluded the therapeutic garden is an effective tool, able to promote and consolidate the objective of hospitals humanization and through it expand the concept of health, maximizing the quality and intensity of positive interactions presented to the user.
Abstract in Portuguese (original)
Esta dissertação tem como objectivo principal o estudo do jardim como espaço terapêutico salientando o seu contributo para a humanização dos hospitais, nomeadamente, no que respeita à melhoria dos processos terapêuticos, ao aumento do bem‐estar dos pacientes, ao aumento da satisfação pessoal dos profissionais de saúde e da qualidade dos serviços prestados por eles e à melhoria das condições de conforto e bem‐estar de familiares e visitantes.
Assim, foi feita uma revisão de literatura da história dos jardins associados a instituições de saúde, sublinhando a sua importância para o conceito de jardim terapêutico, mostrando que em muitos períodos da história a natureza e os jardins em particular foram interpretados como agentes de terapia, locais de promoção da cura e do alívio da dor e do stress. De seguida, identificámos os benefícios concretos e prováveis dos jardins terapêuticos para a saúde e para o bem‐estar dos diversos utilizadores dos hospitais, com especial enfoque no paciente. Contudo, para que estes benefícios ocorram, o planeamento e o desenho do jardim terapêutico e a sua relação com o todo hospitalar revelam‐se de extrema importância. Deste modo, foi apresentado um conjunto de princípios orientadores do desenho deste tipo de espaços que possam ser aplicados de uma forma flexível em hospitais.
Considerando que Portugal não está a acompanhar a tendência internacional, existindo um vazio no projecto e na construção de jardins terapêuticos em hospitais, foi apresentado um estudo do caso do Hospital Pedro Hispano em Matosinhos, que pretende constituir um pequeno contributo e um incentivo à criação de jardins terapêuticos em hospitais portugueses. Neste sentido, estudou‐se uma proposta de aplicação dos princípios de desenho de jardins terapêuticos, descritos no trabalho, aos espaços exteriores do Hospital Pedro Hispano, que contraria e suplanta a situação existente.
Concluímos que o jardim terapêutico é um instrumento capaz de promover e de consolidar o objectivo de humanizar os hospitais e que através dele é possível reforçar o conceito de saúde e maximizar a qualidade e intensidade de interacções positivas que um utilizador pode beneficiar.
... While evidence-based design recommendations advise taking steps to improve psychosocial outcomes (Dilani, 2000; National Association of Children's Hospitals and Related Institutions (NACHRI) & the Centre for Health Design (CHD), 2008; Keane & Viner, 1998), the term psychosocial is seldom defined. The Segen's Medical Dictionary (2012) suggests that psychosocial refers "to a person's psychological development in, and interaction with, a social environment." ...
... Physical recommendations linked to the term psychosocial begin to demystify how this concept is being understood and applied in spatial terms. Dilani (2000) has suggested that psychosocially supportive environments are those that "enhance people's capability to better cope with stress" (pp. 31-33). ...
... The recommendation to cluster patient rooms (Dilani, 2000) has been enthusiastically adopted within new pediatric hospital construction (in Australia, e.g., see Royal Children's Hospital and Monash Children's Hospital). While findings from environmental psychology may prime researches to anticipate positive social outcomes associated with this cul-de-sac arrangement of patient rooms, including an increased sense of community, it is important to recognize that the stress and uncertainty associated with a hospital visit renders findings from other contexts largely nontransferable. ...
Objective:
Models of patient and family-centered care advocate catering to psychosocial needs when designing healthcare facilities yet there is little evidence available to determine how the built environment can cater to psychosocial needs. This article highlights the obstacles to overcoming this knowledge deficit in the pursuit of evidence-based guidelines to inform social provisions within the pediatric hospital setting. It will propose a working definition for psychosocial space and identify new research directions to enhance understandings of the relationship between social space and well-being.
Background:
While traditional multibed ward configurations afforded opportunities for peer support relationships to develop, both for patients and caregivers, the contemporary preference for single-occupancy rooms intensifies the need to critically examine social spaces within the pediatric hospital.
Methods:
Research suggests a correlation between social support and well-being. This article reviews the research underpinning contemporary understandings of this relationship; it positions literature from sociology, environmental psychology, and evidence-based design to highlight the limitations of this knowledge and identify where additional research is required to inform evidence-based design guidelines for psychosocially supportive spaces within pediatric healthcare settings.
Conclusions:
Evidence regarding the therapeutic value of social support within the pediatric hospital is not sufficiently sophisticated or conclusive to inform guidelines for the provision of social space with pediatric hospitals. There is an urgent need for targeted research to inform evidence-based design guidelines; this will demand a broad disciplinary approach.
... The search keywords were "environmental quality", "hospital environment", "hospital design", "hospital public spaces", "salutogenesis", "salutogenic environment", "SOC", "patients", "satisfaction" and the combination of these terms to find relevant articles to three main concepts: hospital environment quality, salutogenic approach and patients' satisfaction. Since the salutogenic design indicated by Dilani (2000) at the beginning of the 21st century, the review included Hospital salutogenic public spaces studies published between 2000 and 2020. It is noticeable that the database search that combined all three concepts resulted in no relevant paper. ...
... In this way, public spaces with a SOC enhancement may promote patients' satisfaction. It is noticeable that theories of psycho-social supportive design represented by Alan Dilani (2000) and salutogenic architecture by Yan Golembiewski (2010Golembiewski ( , 2017 also emphasize on salutogenic approach as an applicable theory that seeks how the physical environment affects well-being factors to achieve health promotion. These theories confirm a strong connection between the personal SOC and physical environment characteristics (Dilani, 2009;Ziegler, 2014, p. 10;Golembiewski, 2019). ...
Purpose:
This study aimed at the identification of perceptional environment properties in hospital public spaces that can affect salutogenic components and patients' overall satisfaction and suggested a conceptual framework.
Design/methodology/approach:
A systematic review focused on specific steps to clarify the impact of public spaces' environmental quality on patients' satisfaction through the salutogenic approach. Searches were conducted in five databases and four scientific journals.
Findings:
Five perceptional environment components of hospital public spaces: physical–psychological comfort, visibility, accessibility, legibility and relationability can be related to three indicators of salutogenic approach: manageability, perception and meaning and can be evaluated in patients' overall satisfaction: desire to use hospital again, to recommend the hospital to others, to prefer hospital to other healthcare environments and to trust in the hospital.
Originality/value:
Despite studies on healthcare environments, there is a lack of research on the salutogenic approach in hospital public spaces. Therefore, this paper focuses on the environmental quality in public spaces as an influence on patients' satisfaction with the salutogenic perspective to create a health-promoting environment.
... Beauty is dependent on user knowledge, taste, and culture background, and thus, interior design may affect users' senses (Dilani, 2001). Undoubtedly, the findings of the present qualitative study are generalizable to other environmental contexts. ...
... In this research study, people may react toward the environment by sifting impressions through their cultural background (Farbstein & Kantrowity, 1978). What we consider to be beautiful is dependent on environmental user knowledge; tastes, culture background, and interior design may affect users' minds and senses (Dilani, 2001). From culture perspectives, interior designer should consider cultural aspects which must be recognized, for instance, it is important to know how patients are using hospital rooms and how the design can assist its user. ...
Background
A predominant notion among researchers is that hospital room design and decor are subject to the designer’s expression of self, which is contrary to evidence-based studies showing that design and decor can impact patient health. The aim of this study was to examine whether improvement in quality of healthcare provided in hospitals could be achieved through the convergence of expertise of healthcare professionals and hospital room designers.
Methods
This was a prospective study to identify the impact of hospital interior design features with a focus on single occupancy rooms. Volunteers were recruited through advertisements and the study was conducted at the Tripoli Medical Center. Responses were analyzed using a three-dimensional computer-aided design software to help respondents accurately map their preferences and visualize outcomes.
Results
Participants preferred an aesthetically pleasing hospital room environment that included art and bright colors, window views, and the need for personalization, technology, mobility, and flexibility, all of which improved satisfaction and happiness. Of these, participants’ preference for technology as a cause for satisfaction and happiness was a novel finding.
Conclusion
Designers of hospital room interiors should plan and create an appealing single occupancy room for increasing user satisfaction and patient wellness.
... 30 presents of disease are initiated in genetic background but 70% of them are originated in environmental factors, Optimal design of the environment can prevent pathogenic factors that lead to disease (Dilani, 2001). ...
... As such, it gives a general account structure that rises above the singular contrasts among individuals, and the separation between conclusions, conditions, ecological variety, etc. Salutogenic hypothesis is in this way helpful for 'expansive stroke' approaches to catching the prosperity and wellbeing/sickness spectra, and thusly, it is helpful for overseeing aberrant, perplexing, dark or obscure factors in health conditions (this multifaceted nature embodies the health impacts of the physical condition). Since Salutogenic hypothesis has this more elevated amount legitimacy that bodes well past the explicit discoveries of specific investigations and structure mediations (Dilani, 2001), it gives a premise to educated basic leadership in the nonappearance of explicit learning, or at whatever point conditions are excessively unpredictable to propose simple arrangements. ...
Iran is faced the huge of the population of elderly in next decade, and it caused the changing planning in healthcare facilities, for instance, the hospital is the one of main residence of them, but the big question is that what should be the design of this facility? The theory of healthcare salutogenic believes how the design of the environment to order either promotion health and getting wellness for humankind, in this study the theory of salutogenic are defined and this important question will be answered how this salutogenic design can be used in the design of healthcare buildings for the ageing people.
... After decades of research on the healthcare physical environment it is hard to ignore the fact that it has an impact on users' outcomes (e.g., Ulrich et al., 2008). However, despite the significant advances in the science of medicine, or perhaps because of them, hospitals, with their life-saving equipment, procedures, and technologies, are often perceived as sterile, intimidating institutions (Ulrich & Gilpin, 2003), and environmental qualities of buildings that could promote the health process have been largely neglected (Dilani, 2001). Finally, the premise that a healthcare facility be designed as a "curing machine" for medical conditions, rather than as an environment to promote wellness for the individual is being challenged (Arneill & Devlin, 2002), and a new generation of hospitals seem to be adopting this revised perspective. ...
... An important component of this philosophy is the creation of an aesthetic, comfortable, soothing, and home-like environment conducive to well-being (Casparia, Erikssonb, & Naden, 2006;Martin et al., 1998), the benefits of which have already been confirmed through research (e.g., Devlin, 1995). The movement toward humanizing healthcare settings is also taking place in Europe (e.g., Dilani, 2001;Gesler et al., 2004). For instance, the recent Private Finance Initiative program of hospital building in the UK has been accompanied by a vigorous debate over what constitutes good hospital design for different stakeholders (Gesler et al., 2004). ...
... This exploratory study addresses an extant gap in the literature focusing on children and adolescents' experience of hospital isolation due to their cancer treatment. Providing social opportunities for hospitalized children and youth has been associated with positive outcomes including decreased stress and improved well-being (Alvarez et al., 2020;Dilani, 2000;McLaughlan, 2018). Such opportunities include informal support gained through shared accommodations, and/ or creating physical spaces that promote interaction such as game rooms, music rooms, and/or cafés (Curtis & Northcott, 2017;McLaughlan, 2018). ...
Children and adolescents with complex medical conditions are often uprooted from their environments and isolated in hospital while undergoing treatment. Little is known about how they perceive this isolation and its subsequent impact on their relationships with peers, both during and after isolation for treatment. This study describes the experience of hospital isolation from the perspectives of children and adolescents with a malignant brain tumor. The use and impact of information and communication technologies (ICT) as a possible bridge for contact is also explored. Following a qualitative approach utilizing interpretive phenomenological analysis, in-depth interviews were conducted with eight youth participants who had undergone treatment for medulloblastoma. Data analysis generated three main themes: (1) transforming children and relationships, (2) hospitalization in a digital world, and (3) ICTs as a promising bridge back to school. Study findings provide insight into the experience of hospital isolation for children and adolescents, while highlighting the positive social as well as academic outcomes of frequent, open ended ICT use throughout hospital isolation. This is timely, given the context of the COVID-19 pandemic and its resulting isolation. Considerations for hospital social workers to promote relationships and connection, while facilitating a smooth transition as these children return to school are included.
... Diante desse novo contexto, surgem requisitos para o planejamento de estabelecimentos de saúde que prestam suporte psicossocial aos seus usuários. Assim, há uma necessidade por estudos empíricos que verifiquem, investiguem e identifiquem fatores capazes de promover apoio psicológico e bem-estar ao usuário, pois está comprovado que o ambiente exerce influência sobre o comportamento humano (DILANI, 2001). ...
Resumo Em arquitetura, humanizar significa oferecer espaços mais qualificados aos usuários, com estímulos ambientais que propiciem bem-estar. Estabelecimentos de saúde públicos raramente oferecem espaços para que os pacientes circulem, além do quarto de internação. Esta pesquisa busca investigar quais são os elementos ambientais essenciais para a humanização desses espaços através de revisão de literatura e um estudo de caso em hospital público. Assim, realizou-se uma revisão de literatura para elencar possíveis elementos capazes de gerar maior conforto e bem-estar físico e psicológico aos usuários, e aspectos relacionados à psicologia ambiental foram abordados para melhor compreensão do comportamento dos usuários. A pesquisa, de caráter investigativo, foi realizada por meio de um estudo de caso, com o apoio de diversos métodos quali/quantitativos, como: visita exploratória, inquirição, observação do comportamento e análise dos traços físicos - imprescindíveis para auxiliar na definição dos atributos prioritários. Os métodos foram aplicados com a finalidade de avaliar o ambiente, identificar os usuários e suas atividades. Pode-se concluir que os elementos ambientais considerados como essenciais são em sua maioria aqueles inerentes à própria arquitetura. Ao projetar ambientes de saúde, que possuem usuários fragilizados, devem-se levar em conta seus anseios e suas necessidades para garantir uma permanência satisfatória.
... In this new paradigm, the focus is on patients: with their physical, psychological and social health, and greater emphasis is placed on the performance of care activities and on the design of health care settings. Future research has to develop the philosophy of care that focuses on a broader concept of health, thus creating an awareness of the importance of psychosocial support design, context and the environment [6]. ...
Medicine tends to be a holistic discipline, according to which the individual should be treated as a whole and provide comprehensive biopsychosocial health care and also in relation to the environment. The effects of climate change on the disease burden require the doctor to make a "situation diagnosis": that is, to get an idea of the interaction of man with his context. From the general medical care level there are a number of possibilities of including the environmental nuance in clinical tasks with patients, which have protective and health promoting effects, individually and with global ecological repercussions: 1) The therapeutic contexts (those places, situations or contexts that achieve both physical and psychic environments associated with an improvement of health or well-being): the healing power of the environment and nature (green spaces, forests, parks, open spaces, and gardens personal, walking-for-thinking, living with a companion animal); 2) To be aware of the ecological repercussions of the "micro" decisions: Ecological and environmental effects of the prescription of certain drugs, of the dietary advice, preventive approaches for patients in the consultation that are based on environmental measures (as in osteoporosis, prevention of skin cancer, etc. 3) Promote the human factor: contextual circumstances in the relationship which can condition listening, and therefore, diagnosis and intervention; 4) Change the perception of the environment: mental landscapes, through artistic creation, etc and 5) Pharmaceutical contamination of nature, secondary to polypharmacy and therapeutic non-compliance: generalized contamination of river systems worldwide with antibiotic compounds, pharmaceutical contamination at sea, drug contamination is concentrated in insects and passes to the Predators. In short, in general medicine, tasks carried out at a small caliber level can subtly tilt the world towards ecology, dignity, compassion, and health.
... However, from the point of view of general medicine, the focus is on patients (with their physical, psychological and social health) and on their environment or context. 1 This vision concerns the understandings of what it means to be human, as physically embodied individuals and as persons within their social context or "landscape context". As the medical humanities open to new conceptualizations of being human, the nature of "context" demands greater interrogation. ...
... According to Harnack& Fest, interaction is a communication process as a process of interaction between people to reach the objective of intrapersonal and interpersonal integration (Dilani, 2009). In the context of medical care, content of interaction among doctors, paramedics, and patients is the condition of patients' helath status after getting medication during inpatient period in Mamami hospital. ...
BACKGROUND: The latest challenge of hospital service system in Indonesia now adays is the controversy of views about health service quality between health provider with patients andfamilies. Patients as the ultimate assessors measure the quality from medical care started up to the patients get cured without any physical defect. Mean while, the health providers as the health suppliers see the quality of health service from the using of medical scientific standard up to the curing of sickness.PURPOSE: The paper analyzes the controversy of health service quality between the Providers and patients in Mamami Hospitaluse BPJS (Badan Penyelenggara JaminanSosial) as a Social Insurance Administration Bureau in Indonesia.METHODS: Observational survey with cross sectional. Independent variables: sympathy and empathy, interaction, environment quality. Dependent variable: health service quality. Variables measurement: Likert scale. Population and sample: BPJS inpatient for 3 days in Mamami hospital. Sample number: 200 respondents taken with purposive sampling.RESULT: The three independent variables effect health service quality. Significant point of sympathy and empathy (β = 490; α = 0.00); environment quality (β = 180; α = 0.48); interaction with patients (β = 233; α = 0.18).CONCLUSION: Controversy of viewseliminated in modern health service system. Mixed service between medical care and cognitive service is the answer. The providers come in and get inpatient service in the room for patients with psychological deficiency. The mixed of service have impacts in the change of patients’ status: from consumers to customers. The resultant for health service institutions is profitability.
... However, color research has lacked a theoretical framework to uncover color meaning perceived by the occupants in an environmental setting. Recently, studies (Arneill & Devlin, 2002;Dilani, 2001;Evans, 2003;Kaya & Crosby, 2006;Nadler-Moodie & Gold, 2005;Schweitzer et al., 2004;Tivorsak et al., 2004;Zeisel et al, 2003) have tried to define healthcare users' physiological, psychological, and social reactions to color in healthcare settings and to make suggestions for design practice. However, the findings of these studies were often less reliable because the projects lacked an approach that considered the cultural context that included the occupants' cultural backgrounds. ...
Color planning in today's healthcare environments is a challenge for interior designers due to the diverse occupants who may establish different meanings of environmental colors based on their backgrounds and life experiences. Researchers have shown the close relationship between color perception and patients' mental and/or emotional attitudes. Moreover, studies have shown that certain colors can affect some people as stressors while the same colors can be positive distractions to others.
This exploratory qualitative study investigates the significance of culture in the ways people interpret and establish color meaning in healthcare environments. The theoretical framework of this study is based on Blumer's (1969; 2004) discussion on symbolic interaction between humans and environments. Specifically, the relationship between a role of `the self' and cultural influences was analyzed to investigate people's interpretation and establishment of color meaning in healthcare environments. A semi-structured interview questionnaire and a color palette instrument were developed and used to collect data from a sample of 13 female and 12 male Koreans living in Twin Cities, MN and ranging in age from 25 to 39. A research model based on the theoretical constructs of symbolic interaction--the self, objects, social interaction, and joint action--was used to formulate interview questions. Five color palettes were based on the five primary interior color combinations in the Korean tradition and used to assess the subjects' meaning assigned to color in the cultural context. The interview data were analyzed to determine the role of the constructs of symbolic interaction--the self, object, self-interaction, and social interaction--in Koreans' meaning establishment of color in healthcare environments.
Findings include: 1) Color as an abstract object appeared to be related to self-interaction, and color as a physical object and a social object was related to social interaction; 2) the subjects' concepts of healthcare color were based on their personal experiences and cultural backgrounds. Care/warmness, stability, and vitality seemed to be established in the subjects' self-interaction, and hygiene status, comfort from familiarity, professionalism, and users' characteristics were established through the subjects' social interaction. The subjects did not seem to consider `healing' as a concept of healthcare color.
... Design is seen as complementary to the healing effects of drugs, policies, and technology [6]. It is therefore important to identify factors in the physical environment and, through design and architecture, create meeting points that can promote spontaneous social interaction and social support [7]. Yelland et al realized that the reliance of detecting and managing women with particular psychosocial issues during pregnancy results in this aspect of care being given less priority postnatally than may be ideal [5]. ...
... In fact, there have been explicit and implicit reflections of the salutogenic paradigm to theories that were used to study care environments. The explicit use of the salutogenic paradigm can be followed in the theory of supportive design that was developed in the light of research findings from healthcare environments (Ulrich 2001;Dilani 2001). ...
... The salutogenic movement in architecture derived from the theory of Aaron Antonovskys' sense of coherence and the impact of stress perception in environments theory (Antonovsky 1979), lead to Alan Dilani postulating the psychosocially supportive design approach and today defined as Salutogenic design. The association of psychological impact indicators to assigned design markers aimed at defining human health response; Comprehensibility, Manageability and Meaningfulness (Dilani 2001). Furrow & Vanderkaay further developed this social science approach to measure architecture and health outcomes in proposal piece 'Salutogenic spaces: Designed to thrive (Farrow, T., Vanderkaay, S. 2013). ...
Pre-design considerations and assumptions are made prior to embarking on climate change adaptation and mitigation strategies for urban areas. Responsive and effective strategies should be informed by an understanding of potential climate change hazards and existing vulnerabilities. It is also important that limitations and resources that may influence the design and implementation of climate change strategies are acknowledged and addressed. The Urban Resilience Urban Resilience Assessment Framework (URAF) has been developed to identify and structure these pre-design considerations to inform the development of urban climate change adaptation and mitigation strategies. This paper describes the development of the URAF. It also critically reviews framework as a methodology for supporting the development of climate change strategies. The review indicates that the URAF provides a robust means of identifying key issues prior to the development of climate change strategy and therefore helps to ensure that these are addressed, and appropriately integrated, in strategies. However, it finds that the URAF in its current form only provides outline guidance and recommends further development of the framework to ensure that this becomes more comprehensive and effective.
... Lebih lanjut hasil analisis menunjukkan korelasi yang dominan ditunjukkan oleh korelasi antara kualitas hunian dengan kualitas dukungan sosial dengan derajat korelasi berada dalam katagori sedang. Korelasi ini didukung dengan apa yang dikemukan Dilani (2001) bahwa kualitas hunian yang baik akan berdampak positif bagi kesehatan dengan cara penyediaan ruang dan tempat untuk interaksi sosial antar individu. Cattan dan Tilford (2006) juga memperkuat pendapat tersebut dengan menjelaskan bahwa kualitas hunian yang di disain secara tepat dapat mempromosikan interaksi sosial dan partisipasi mendukung perkembangan jejaring sosial, dukungan sosial, kepekaan masyarakat, kompetensi masyarakat dan kepekaan terhadap tempat (sense of place). ...
... Figure 7: Apartment Building Liesing Brewery, Vienna Source: Coop Himmelblau 2011 natural design and environment aspects on health, well-being, and human effectivity is confirmed by many relevant researchers (see Parsons 1991; Heerwagen 2000; Dilani 2009; Herzog, Maguire, and Nebel 2003; Orians and Heerwagen 1993; Chatterjee 2013, 48–53). Concerning the influence of cognition-and knowledge-depending factors, analyses show that aesthetic evaluations emerge immediately based on emotional reactions rather than cognitive consideration and that they often are processed unconsciously (see LeDoux 1996; Hasse 2012). ...
Evolution shaped our eyes and brains, and the conditions of natural environments and processes-far exceeding human control options-determined which of our perceptional competences were suited best to find our way and to survive in woods or savannas. The act of recognizing and interpreting patterns of natural appearances, transitions, and metamorphoses was-and still is-the daily bread of our visual perception. Our associative intelligence stores and cross-connects this stream of experience; by analogy, it uses these patterns to decode the unknown and the unfamiliar, to find the most appropriate and probable accordances as a reference for forthcoming interactions. Gestalt psychology and psychology of perception have investigated the emergence of separable forms out of the visual field and preferences of stimulus selection. But the more complex question of evaluation, meaningful classification, and integration of forms and structures within our visual experience still is an interdisciplinary challenge for aesthetics, semiotics, psychology, philosophy, and architectural/design theory and discourse. In this article, parameters of instantaneous visual attraction associated with properties of natural environments (e.g., anthropomorphic, biomorphic, or dynamikomorphic aspects) are described and systematically related to general modes of visual perception. They are exemplified by means of tangible design matters, and methods are discussed regarding how they can be made applicable and teachable. The idea of perceptual organization by patterns of transition and metamorphosis, outlined by psycho-morphology, is transferred to aesthetics and thus complements the terms "anthropomorphism" and "biomorphism" with the new term "dynamikomorphism." A differentiated system of perspectives on design phenomenons that is able to define and to create successful design is outlined.
... Der große Einfluss von naturnahem Design und natürlichen Environments auf Gesundheit und Wohlbefinden und menschliche Effizienz wird durch viele namhafte Forscher bekräftigt (vgl. Parsons 1991;Heerwagen 2000;Dilani 2009;Herzog, Maguire, Nebel 2003;Orians, Heerwagen 1993;Chatterjee 2013, S. 48-53). se schnellstmöglichen empathischen Zugang zu den Potentialen unserer Umwelt. ...
Strömungen“ ist der Titel des ersten Aufsatzsammelbands
dieser interdisziplinären Forschungsreihe, mit der die
Hochschule Coburg – ihrem Leitbild entsprechend – fachübergreifendes
Denken anregen möchte.
Wissenschaft kann ihre Relevanz letztlich erst in enger
Vernetzung ihrer Disziplinen entfalten. Es ist besonders die
Einbettung in größere Zusammenhänge, die Wissenschaft
überhaupt erst für die Komplexität der realen Welt fruchtbar
und anwendbar macht.
Da „alles fließt“ (nach Heraklit), ist auch die beständige Entwicklung,
das Emergenzpotential und der dynamische Charakter
der Wirklichkeit für die Wissenschaften ein essentieller
Bezugsrahmen. „Strömungen“ stellt diesen gemeinsamen
Betrachtungswinkel in den Mittelpunkt: Vertreterinnen
und Vertreter von sieben Fachdisziplinen widmen sich einer
dynamischen Weltperspektive. Sie beleuchten den Begriff der
Strömung aus Sicht der Alten Geschichte, der Designtheorie,
der Kulturwissenschaft, des Maschinenbaus, der Mediävistik,
der Sprachwissenschaft und der Wirtschaftswissenschaften.
... Mintz 1972 also studied the effects of aesthetic surroundings by prolonged and repeated experience in "beautiful" and "ugly" room [31]. Similar studies have been made in hospital environments [7,12,13,44]. Dilani [13,14] studied work environment´s influence on hospital staff, and Caspari et al (8] studied patient's opinion of healthy hospital environments. * Recent studies on aesthetics on other workplaces are rare. ...
Associations between self-reported needs for aesthetic and ergonomic improvements were studied to analyse a possible impact of aesthetic needs on job performance as compared to ergonomic needs in 11 occupational groups. Employees at Swedish broadcasting company were invited to participate in a cross sectional study. 74% (n = 1961/2641) fulfilled the inclusion criteria. Demographic data from company files and a pre-validated questionnaire were used. 'High rank' and 'low rank' aesthetic and ergonomic needs were compared. The perceived needs for aesthetic and ergonomic improvements showed significantly different distributions (p<0.001). Aesthetic needs were more frequently reported. No gender related differences were observed. Differences between occupational groups were shown (p=0.006, 0.003). 'High rank' needs for aesthetic and ergonomic improvements were similarly associated to psychological demands, stress, pain and age. 16/24 factors showed significant differences between 'high and low rank' aesthetic needs, whereas 21/24 between ergonomic needs. Sick leave was stronger related to ergonomics. The study results show a relation between not only work place ergonomics but also work place aesthetics to health and well-being. Future work health promotion and prevention may benefit from the inclusion of workplace aesthetics.
... Access to computers has increased dramatically over the last two decades and recent advances in new technology opened up new possibilities for persons with cognitive impairment (Orpwood, 2008). Dilani (2001) pointed out the importance of integrating a human perspective with the latest developments in technology to advance health care in the future, which is in line with the concept of "design for all" (Tahkokallio, 1998) that aims to design environments that can be used by everyone. Memory impairments, however, can make it more difficult to learn how to use electronic aids. ...
ABSTRACT The general aim of this thesis was to better understand and describe the experiences of occupations in the context of daily life and the meaning of actions in different places (training apartment, rehabilitation setting, home and workplace) for persons of working age with acquired brain injury (ABI) during a rehabilitationprocess ,The aim of the study I was to investigate how persons with acquired brain injury experienced their 1-week stay in an apartment fitted with electronic aids to daily living (EADL). Eleven participants with acquired brain injury (of working age) were interviewed on the last day of their stay. A phenomenological method was used during analysis. The findings are presented in a meaning structure comprising 4 main characteristics: Plunging intothe EADL-equipped environment, landingand feeling comfortable with the new environment, incorporating the “new” in daily activities, and taking off for the future. ,The aim of study II was to identify what characterized the lived experience of memory impairment in daily occupations during the first year after acquired brain injury. Four participants, aged 22-61, were interviewed over four occasions during the first year after acquiring a brain injury. A phenomenological method was used during analysis. The findings are presented in a meaning structure comprising 4 main characteristics that reflects the temporal process of rehabilitation over a year: 1) A chaotic life-world,2 ) struggling for a coherent doing in new contexts, 3) conscious strategies in new contexts, and 4) achieving new habits. ,The aim of study III was to describe the meaning of actions in different places during one year of rehabilitation after stroke. Qualitative interviews with seven persons, aged 42-61, done over the course of a year were analyzed using a grounded theory method. Seven categories emerged and were presented in overlapping phases as: 1) Workplace in mind, 2)experiences at home enabling reflection,3) rehabilitation setting creates uncertainty, 4) retrieving inspiration
... A feeling of safety and control in the physical environment is a psychosocial factor which may reduce various stress symptoms. Psychosocially supportive living and working environments may strengthen the individual's ability to manage situations which are often experienced as demanding (Dilani, 2001) ...
... Hospitals across the world are beginning to display art on their walls to facilitate wellness with little research to guide their selections (Dilani, 2001;Ulrich & Gilpin, 2003). One art installation at Duke Medical University, a rooftop sculpture called The Bird Garden, caused patient complaints; ultimately the installation was removed because of its counter-therapeutic effect (Ulrich, 1999). ...
Nature images are frequently used for therapeutic purposes in hospital settings. Nature images may distract people from pain and promote psychological and physiological well-being, yet limited research is available to guide the selection process of nature images.
The hypothesis is that higher degrees of presence and/or influence in the still photograph make it more effective at holding the viewer's attention, which therefore may distract the viewer from pain, and therefore be considered therapeutic. Research questions include: (1) Is there a significant difference in the level of perceived presence among the selected images? (2) Is there a significant difference in the level of perceived influence among the selected images? (3) Is there a correlation between levels of presence and levels of influence?
109 college students were randomly assigned to one of four different image categories defined by Appleton's prospect refuge theory of landscape preference. Categories included prospect, refuge, hazard, and mixed prospect and refuge. A control group was also included. Each investigation was divided into five periods: prereporting, rest, a pain stressor (hand in ice water for up to 120 seconds), recovery, and postreporting. Physiological readings (vital signs) were measured repeatedly using a Dinamap automatic vital sign tracking machine. Psychological responses (mood) to the image were collected using a reliable instrument, the Profile of Mood States.
No significant statistical difference in levels of presence was found among the four image categories. However, levels of influence differed and the hazard nature image category had significantly higher influence ratings and lower diastolic blood pressure readings during the pain treatment. A correlation (r = .62) between presence and influence was identified; as one rose, so did the other. Mood state was significantly low for the hazard nature image after the pain stressor experience.
Though the hazard image caused distraction from pain, it is nontherapeutic because of the low mood ratings it received. These preliminary findings contribute methodology to the research field and stimulate interest for additional research into the visual effects of nature images on pain.
Decisions made in health care architecture have profound effects on patients, families, and staff. Drawing on research in medicine, neuroscience, and psychology, design is being used increasingly often to alter specific behaviors, mediate interpersonal interactions, and affect patient outcomes. As a result, the built environment in health care should in some instances be considered akin to a medical intervention, subject to ethical scrutiny and involving protections for those affected. Here we present two case studies. The first includes work aimed at manipulating the behavior of persons with neurocognitive impairments, often in long‐term care facilities. This is done to ensure safety and minimize conflicts with staff, but it raises questions about freedom, consent, and disclosure. The second concerns design science in service of improved outcomes, which involves research on improving patient outcomes or the performance of health care teams. There is evidence that in some ICU designs, certain rooms correlate to better outcomes, giving rise to questions about equity and fairness. In other cases, a facility’s architecture seems to be putting a finger on the scale of equipoise, raising questions about the intentionality of clinical judgment, freedom of choice, and disclosure. As a result of this innovation occurring outside the boundaries of traditional care delivery and oversight, important ethical questions emerge concerning both the individual patient and patient populations. We discuss, analyze, and make recommendations about each and suggest future directions for these and related issues.
History suggests that departures from accepted design practice can contribute to positive change in the delivery of mental healthcare, the daily experience of hospitalised patients and public perceptions of mental illness. Yet the question of how architecture can support the therapeutic journey of patients remains a critical one. The availability of evidence-based design literature to guide architects cannot keep pace with growing global demand for new forensic psychiatric hospital facilities. This article reports a global survey of current design practice to speculate on the potential of three new hospitals to positively improve patient experience. A desktop survey was conducted of 31 psychiatric hospitals (24 forensic, 7 non-forensic) constructed or scheduled for completion between 2006 and 2022. This was supplemented by advisory panel sessions with clinical/facilities staff, alongside architectural knowledge obtained through workshops with architects from the UK and the USA, and the inclusion of Australian architects on the research team. Data analysis draws on knowledge from architectural practice, architectural history and environmental psychology, arguing that there is a responsibility to integrate knowledge from across these disciplines in respect of such a pressing and important problem.
Pradhan Mantri Awas Yojna - Urban (PMAY-U) was launched by the Government of India in 2014 with the objective of "Housing For All" to eligible urban families by year 2022. The validated demand under the scheme stood at 1 crore houses across all states and union territories.
A massive spurt in housing activities as resulted, and it is reported that already 15 lacs new dwelling units are built and occupied. Another 40 lacs are under construction. While speedy and affordable construction is of uppermost importance, it is also to be noted that, India is a multi-climate country. the diverse geo-climatic conditions demands tailor-made solutions for the country across the boundary. A standard prototype is bound to fail as it is essential to make housing climate balanced to reduce dependence on mechanical means of lighting and ventilation.
The Ministry of Housing and Urban Affairs (MoHUA) defines affordable housing according to different income brackets as follows: (i) Economical Weaker Section (EWS) with income level less than INR 3 lac p.a. and a dwelling unit size up to 30 sq.m, (ii) Lower Income Group (LIG) with income between INR 3 lacs to 6 lacs , dwelling unit size up to 60 sq.m (iii) Middle Income Group I (MIG-I), with income range INR 6 - 12 lac, dwelling unit size 90 - 120 sqm and (iv) Middle Income Group II (MIG-II), with income range INR 12 - 18lac, dwelling unit size 110 - 150 sqm. A housing unit is considered affordable if the EMI or rent does not exceed 30 percent of gross monthly income of buyer.
Under such challenging boundary conditions of (a) geo climatic diversity, (b) low affordability, (c) size constraint and with the view t o bring in variety and flexibility in unit design., the task of this housing manual was taken up for EWS and LIG households from for the eastern part of our country viz. West Bengal and Odisha.
Post occupancy evaluations were conducted on already occupied housing schemes across the two states. Field measurements were taken to assess the indoor livability conditions like lighting, ventilation and sound insulation parameters at different zones within dwelling units and also at common spaces like staircase, landings. The responses on space adequacy and general satisfaction were analyzed and a prioritization of factors was done to give design inputs. It is expected that this manual will be a handy tool for producers and policy makers of housing and also serve as a guide book for students in architectural institutes.
In India, health care sector offers massive growth potential and a chance to capitalise on its expansion, especially as the country sees a rise in the incidence of lifestyle-related diseases. A growing elderly population paired with a rise in income levels also emphasizes the need for better facilities in the country. Historically, it has been the role of architects, planners, and designers to interpret the needs, wishes, and capabilities of those who will use their buildings.
Today, a need has been felt for specialized behavioral sophistication in facility design to properly determine functional and ergonomic requirements and to translate them into the language of design and ultimately into bricks, mortar, and operating practices.
The researcher has selected super – specialty hospitals for conducting the study since these spaces are being used by people belonging to all age and socio – economic group. Three numbers of super – specialty hospitals which render preventive, curative and palliative services were selected.
The researcher has tried to identify the components of a therapeutic environment that
would present a conducive setup for rendering optimum level of curative and palliative
care within hospitals in Urban Indian context.
Methods have included observations, interviews, and activity or behavior mapping as tools for understanding behavior of people in a practical situation and for determining user preference or attitude.
The findings of this research implies that no longer should the ethics of healthcare be viewed exclusively through the lens of physician-patient dyad but architects associated with hospital design bear equal responsibilities. It was established by earlier researchers that architecture, which heals, requires a milieu that allows harmony - with nature and components of healing architecture include adequate daylight, sound of water and aroma along with other elements of visual aesthetics like colour, nature, and artwork. However, the current findings highlight issues like psycho – physical vulnerability of patients and family stress associated with hospitalization.
It focuses on the non-medical needs of family members and visitors as an important factor in deciding the merits of specific designs and policies for hospital architecture.
The research concludes by highlighting importance of factors which are closely linked with generating a sense of trust and faith on the hospital set up, familiarizing the patients and their relatives with hospital working system and process of treatment. It also highlights the need for comforting them through various rejuvenating elements, helping in negating the fear of the unknown through information dissipation and counselling.
The purpose of this study was to analyze and understand the mechanisms of physical activity obstructions in hospitalized cancer patients by investigating their physical activity levels, previous exercise experience levels, and exercise recognition. A survey was conducted for 194 hospitalized cancer patients using a questionnaire. In addition, we performed exploratory factor analysis, frequency analysis, reliability analysis, and hierarchical multiple regression analysis, using SPSS Statistics for Windows, Ver. 23.0. The results were as follows: (1) The physical activity level of the previous exercise participation experience (EPE) group had a greater effect on physical activity obstructions compared with the non-experience (NE) group. (2) The results for the effects of exercise recognition on the physical activity level and physical activity obstructions indicated that exercise recognition in the two groups increased the relative effects on physical activity obstructions in all variables except for the physical obstructions of the EPE group. Consequently, the physical activity level, exercise experience level, and exercise recognition in those patients were confirmed to be the major factors affecting their physical activity obstruction. Therefore, in this study, we provided quantitative data required for establishing healing environments based on motion.
مقدمه: محیط کالبدی بیمارستان، شامل عناصر و مولفه هایی است که ارتقاء آنها، از منظر طبیعت گرایی، موجب بهبود کیفیت
محیط درمانی و همچنین ادراک بهتر و رضایتمندی کاربران، میشود. لذا، این تحقیق با هدف ارتقای کیفیت محیطی فضاهای
درمانی با رویکرد طبیعت گرایی در راستای سلامت و رضایت است. مورد پژوهی (بیمارستان شریعتی تهران)است .روش پژوهش: این تحقیق توصیفی، از نوع پیمایشی و همبستگی میباشد. با مصاحبه و پرسشنامه از کاربران درمانی بیمارستان
شریعتی، تاثیرات ارتقاء محیط و طبیعت سبز درعرصه عمومی آن تحلیل شد. انتخاب جامعه آماری از روش نمونه گیری کوکران
ضریب خطای 1 / 0 و استفاده از رگرسیون خطی توسط نرمافزار تحلیلی آماری - spss برای تجزیه و تحلیل پاسخ ها صورت گرفته
است .یافته ها: برای بررسی فرضیه تحقیق و بطور کلی آزمون مدل مفهومی پژوهش، که عوامل کالبدی محیطی و غیرکالبدی -
میتوانند بر بهبود کیفیت محیط فضای درمانی از منظر طبیعت گرایی، تاثیر داشتند از رگرسیون چندمتغیره به روش گام به گام
استفاده شد. بر اساس نتایج بدست آمده، در تحلیل عوامل کالبدی محیط داخلی، چهار شاخص به عنوان مهمترین پیشبینی کننده ها
و در خصوص عوامل کالبدی محیط خارجی، نیز دو شاخص مصداق داشت. در بررسی مهمترین عوامل غیرکالبدی نیز مدل
رگرسیونی شش عامل مهم بدست داد .نتیجهگیری: نتایج تحقیقات، مشخص نمود که عوامل کالبدی محیطی درکیفیت محیط، موثر بوده. رضایت کاربران از کیفیت -
محیط، اثبات گردید و در نهایت، نتایج تحلیل نمودارها بر وجود همبستگی بین متغیر کیفیت و رضایت دلالت داشته است .کلید واژه ها: کیفیت محیط، فضای درمانی، طبیعت گرایی، بیمارستان شریعتی.
Different physical factors in a hospital setting can have qualitative and quantitative effects on the hospitalization of patients. In other words, the proper hospital is not only faced with medicinal needs, but also with the movement, social, evolutionary and emotional needs of patients, should also be considered in the architectural design. Hospitalization is a stressful experience for children that can lead to emotional isolation, various regressive behaviors, prolonged crying, disturbed sleep patterns and a variety of devastating conditions that become angry at being exposed to such attacks. Accordingly, the present study aimed to identify environmental factors affecting children’s morale in stress reduction in hospital environment besides physical and functional analysis of six different children’s hospital samples in the world. In this paper, systematic review method was used for initial recognition and also descriptive-comparative method was used to express the effective features in the design of case samples architecture. The results of the studies indicate that environmental and physical factors have a significant impact on reducing children’s stress in a hospital environment, at the same time paying attention to the attractiveness, readability and simplicity of functional spaces for them.
Within healthcare environments, evidence-based design (EBD) studies often seek to identify architectural design strategies capable of affecting a reduction in patient anxiety. Yet, the theory of affect is seldom discussed. The definition of affect employed herein refers to a spatial capacity to elicit certain subjective, sensory experiences, and to communicate what dispositions and agencies are enactable in a place. Within this article, we examine the relevance of affect to the field of EBD and present findings from a pilot study where 68 participants were asked to experience and document their responses to three virtual architectural environments with varying aesthetic characteristics. Finally, we provide a discussion of the implications of these findings to the field of EBD and reflect on the affordances of virtual reality (VR) as a method for investigating affect. The discussion is supported by selected data from a corresponding study conducted by the authors within a cancer centre.
Objective:
This review explored different conceptualizations of health promotion in the context of, and in relation to, outpatient building design.
Background:
Today's healthcare organizations are implementing holistic healthcare approaches such as health promotion, while simultaneously increasing their outpatient services. These health promotion approaches, focused on empowering people to take control of their health, are expected to have implications for the outpatient healthcare building design. Yet there is limited knowledge what these may be. A review of the literature on the current state of the art is thus needed to enable and support dialog on future healthcare building design.
Method:
A scoping review of 4,506 papers, collected from four databases and three scientific journals in 2015, resulted in 14 papers relating health promotion to building design and outpatient healthcare. From the subsequent content analysis, multiple common themes and subthemes emerged.
Results:
The review reveals diverse range of health promotion interpretations, three health promotion perspectives (health behavior, health equity, and sense of coherence), associated design approaches, design objectives, health-related outcomes, building features, and solutions.
Conclusions:
While diverse health promotion perspectives might merely represent variations in focus, these differences become problematic when relating to building design. To support further dialogs on development of health promotion in, and in relation to, the build environment, there is a need to strengthen the health promotion vocabulary. Further research is needed to compare different design approaches and how these can be combined to minimize contradicting implications for building design.
This chapter introduces the emerging literature on salutogenesis in corrections workers. Correctional officers have one of the most stressful jobs in our society yet have been largely neglected in occupational safety and health research. Correctional officers are at increased risk for cardiovascular, musculoskeletal, and posttraumatic stress disorders, and suffer from suicide rates nearly triple of those observed among the general population and in other related occupations. Actuarial tables indicate a 12–15-year life expectancy gap between correctional officers and the general population. In an effort to examine some of the root causes of these health problems in corrections, we begin by reporting findings that emerged from a focus group study on correctional officer stress, and highlight why Antonovsky’s theory is so relevant to correctional officers. Existing research is then reviewed that provides evidence for the potential role individual sense of coherence and salutogenic health promotion programs could play in mitigating the effects of workplace stress. A set of recommendations are made for planning salutogenic interventions in corrections, including assessing the organizational health climate and correctional officers’ perceptions of the health-promoting qualities of their workplace. Salutogenic aspects of a programmatic approach that has been used successfully to engage corrections staff in the design of workplace interventions to benefit both worker health protection and promotion are reviewed, and an experimental officer-led health mentoring program is described that was shaped, in part, by application of salutogenic principles. Future research needs and application areas in corrections are also discussed.
Introduction: Child hospitalization is one of the sources of anxiety for both the child and his/her parents. Among the strategies for reducing anxiety, non-pharmacological strategies are as important as pharmacological. The purpose of this study was to compare the effectiveness of educative story-books and face-to-face education on anxiety of hospitalized children and their mothers.
Methods: The research project had a quasi-experimental design with pre-test and post-test. The subjects consisted of 81 hospitalized children, aged six to nine years old and mothers in Sabzevar, who were not selected randomly by method. Data collection tools were demographic information questionnaire, Scale of Facial Self-Reported Anxiety and the State Anxiety Inventory. Data were analyzed using SPSS (version 20) and Descriptive Statistics, Shapiro-Wilk, Chi-Square, Paired Sample T Test, Wilcoxon, Mann-Whitney U, Kruskal Wallis, Analysis of Variance (ANOVA) and Honestly Significant Difference (HSD).
Results: After the intervention, the results of this study showed that there was a significant difference in anxiety of children, between the educative story-book group and routine group (P-value = 0.006). However, the differences between the educative story-book with face-to-face education groups and face-to-face education with routine groups were not significant (P-value > 0.05). There were significant differences in anxiety of mothers between the educative story-book with routine groups (P-value < 0.001) and face-to-face education group with routine group (P-value = 0.001). However, the difference between the educative story-book and face-to-face education groups was not significant (P-value = 0.079).
Conclusions: The results demonstrated that educative story-books and face-to-face education could reduce the mothers’ anxiety. It can be recommended as a popular, practical and efficient tool to prepare children for hospitalization.
In contemporary society, spa has become one of the important healing spaces. As the present urban life has been more and more complex and competitive, space of recreation and healing are dramatically increased in terms of its number as well as location. In the past, there were three kinds of spa visitors. The first was the people who visited spas for medical reasons. The second was the people who visited spas for leisure and refreshment. The third was for social gatherings like in the ancient Rome. In present time, these three reasons are mixed together. As the spa program became rich and various, visitors tends to seek an appropriate spa environment that suits their needs. This is the main background for contemporary spa designs. In any case, concept of healing has been always the core element in spa. Light and sense have vital role to make a unique spa design. This paper aims to study different light and sense applications in contemporary spa designs. Specific focus is to find how light and sense in spa designs act to create a healing environment. 4 spa projects built in Europe after 2000 were selected and were analyzed based on the 4 light and sense characteristics. In conclusion, case analysis was summarized to suggest future possibilities.
Warum ziehen Sie eine bestimmte PKW-Marke einer anderen vor? Oder fahren eine Harley Davidson? Trinken Sie Coca Cola? Oder lieber italienisches Mineralwasser? Für welche Marke entscheiden Sie sich, wenn Sie Pizza, Schokolade, Kleidung oder Körperpflege einkaufen? Welche Fluggesellschaft wählen Sie für einen Langstreckenflug nach Asien? Warum favorisieren Sie ein Hotel? Genau an dieser Schnittstelle zwischen „touchpoint“ und Mensch entfalten sich die Bedeutung und die Wirkung einer Marke. Oder auch die Macht und Magie einer Marke.
There is increasing recognition of the need to treat not only patients but also families and carers with dignity, particularly at times of stress. New hospital design includes rooms variously labelled 'Quiet', 'Family' or 'Interview' for these purposes. This paper reports on the design process used during the development of the New South Glasgow Hospitals to meet user and service owner needs. The artist leading the project utilised a biophilic design approach and a participatory process of working to both understand users' issues and also to involve users in the design of elements of the scheme.
The care of older people in Sweden has undergone several major reorganisations during the past decade. The healthcare organisation, governed by the county councils, previously had the responsibility of providing care services for elderly people. However, the local municipalities have taken over that duty since 1992. The obligation of the health services is now restricted solely to medical issues. The present study focused on the understanding that politicians and managers have about caring for older people. A section of Stockholm with a population of 320 000 inhabitants was studied. The authors hypothesised that differences in understanding might have an impact on the services of care which older people receive. Interviews were conducted with eight leading politicians and 12 managers responsible for elderly care services. The main focus of inquiry concerned the participants’ understanding of caring for older people. The results indicate that politicians and managers in elderly care sometimes have divergent views on how the care should be developed and produced to best serve older people. Five themes of understanding elderly care services and eight contradictory statements among the respondents were identified. A follow-up group session with the respondents was conducted to discuss the results of the interviews. The different ways of understanding elderly care services showed a complex and fragmented organisation lacking clear goals, structures and leadership. However, the authors found a willingness among respondents to collaborate with one another, as well as indications of positive attitudes toward improving healthcare, domiciliary and nursing care of older people.
Hospital environments have recently received renewed interest, with considerable investments into building and renovating healthcare estates. Understanding the effectiveness of environmental interventions is important for resource utilisation and providing quality care.
To assess the effect of hospital environments on adult patient health-related outcomes.
We searched: the Cochrane Central Register of Controlled Trials (last searched January 2006); MEDLINE (1902 to December 2006); EMBASE (January 1980 to February 2006); 14 other databases covering health, psychology, and the built environment; reference lists; and organisation websites. This review is currently being updated (MEDLINE last search October 2010), see Studies awaiting classification.
Randomised and non-randomised controlled trials, controlled before-and-after studies, and interrupted times series of environmental interventions in adult hospital patients reporting health-related outcomes.
Two review authors independently undertook data extraction and 'Risk of bias' assessment. We contacted authors to obtain missing information. For continuous variables, we calculated a mean difference (MD) or standardized mean difference (SMD), and 95% confidence intervals (CI) for each study. For dichotomous variables, we calculated a risk ratio (RR) with 95% confidence intervals (95% CI). When appropriate, we used a random-effects model of meta-analysis. Heterogeneity was explored qualitatively and quantitatively based on risk of bias, case mix, hospital visit characteristics, and country of study.
Overall, 102 studies have been included in this review. Interventions explored were: 'positive distracters', to include aromas (two studies), audiovisual distractions (five studies), decoration (one study), and music (85 studies); interventions to reduce environmental stressors through physical changes, to include air quality (three studies), bedroom type (one study), flooring (two studies), furniture and furnishings (one study), lighting (one study), and temperature (one study); and multifaceted interventions (two studies). We did not find any studies meeting the inclusion criteria to evaluate: art, access to nature for example, through hospital gardens, atriums, flowers, and plants, ceilings, interventions to reduce hospital noise, patient controls, technologies, way-finding aids, or the provision of windows. Overall, it appears that music may improve patient-reported outcomes such as anxiety; however, the benefit for physiological outcomes, and medication consumption has less support. There are few studies to support or refute the implementation of physical changes, and except for air quality, the included studies demonstrated that physical changes to the hospital environment at least did no harm.
Music may improve patient-reported outcomes in certain circumstances, so support for this relatively inexpensive intervention may be justified. For some environmental interventions, well designed research studies have yet to take place.
ResearchGate has not been able to resolve any references for this publication.