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View Through a Window May Influence Recovery from Surgery

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Abstract

Records on recovery after cholecystectomy of patients in a suburban Pennsylvania hospital between 1972 and 1981 were examined to determine whether assignment to a room with a window view of a natural setting might have restorative influences. Twenty-three surgical patients assigned to rooms with windows looking out on a natural scene had shorter postoperative hospital stays, received fewer negative evaluative comments in nurses' notes, and took fewer potent analgesics than 23 matched patients in similar rooms with windows facing a brick building wall.
... In this research field, the work of Ulrich (1984) is significant because it initiated a round of empirical analyses that lasted for decades. In that 1984 study, it was found that patients' recovery times were shorter for patients who had an immediate view of nature, of trees than it was for patients who faced a white wall (Ulrich, 1984). ...
... In this research field, the work of Ulrich (1984) is significant because it initiated a round of empirical analyses that lasted for decades. In that 1984 study, it was found that patients' recovery times were shorter for patients who had an immediate view of nature, of trees than it was for patients who faced a white wall (Ulrich, 1984). This suggests that there is an equilibrium or balance between a patient's physical body and nature. ...
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The purpose of this paper is to construct a theoretical framework for designing healing environments by drawing from existing research. The approach of the paper surveys the literature on how elements of the design have been brought to bear on healing. This effort leads to a holistic approach that considers multiple dimensions of healing as both an individual and social process. The findings of the paper are harnesses that knowledge to provide a theoretical framework based on three design strategies: 1) supporting strategies that use specific elements to reinforce physical health, vital life energy, and psychological well-being; 2) balancing strategies that are oriented toward harmonizing those elements; and 3) nourishing strategies that address emotions, spiritual life, and the soul. Originality, in summary, this paper traces efforts to harmonize individual human health with the built environment across time and uses related knowledge to crystallize a new theoretical framework. It is hoped that this survey of the literature may add to holistic and systemic understandings of healing environments.
... NHS Trust published a study of the art and science of creating environments that prevent illness, speed healing and promote well-being (Macnaughton et al, 2005) in There are many evidences linking design of built environment have direct impact their patient's satisfaction of the perceived overall quality of care. The physical ambient environment refers to the elements of environment that patients can sense, for example, outside views to nature (Ulrich, 1984), colour (Gray et al, 2012;Ulrich et al., 2008;Siddiqui et al., 2015), noise, can improve patient's satisfaction. On the other hand, some environmental features such as presence of accommodation for family, and personal spaces for privacy matters to patients (Alkazemi, Bayramzadeh & Alkhubaizi, 2018). ...
Research Proposal
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This research studies wants to explore the positive impact an environment could have in terms of both interior and architecture of a hospital to help patient feel they are in ‘retreat’ yet feeling at home-ness. Patients will always to try find the sense of connectedness, familiarity and continuity especially when they are facing the unknown. Thus, patient will try to create a spatial re-orientation to fit in to the new environment. Healthcare delivery system, caregiver must not separate the environmental context from the act of care. Attention must also be given in the architecture spaces in order to be conducive to privacy, dignity, homeliness and hopefulness. After all, spaces in a hospital are not created for just functionality, but also to add to the richness of patient’s journey. Without doubt, patient’s satisfaction is not necessarily felt satisfies when they walk out the hospital feeling cured, but its about how personalized, humanized the whole patient journey.
... The impacts of greenspace on people are generally considered to be positive ones, many of which are measured with respect to their contribution towards the improvement of human health. For instance, many studies have reported how green infrastructure can directly impact human health, from reducing recovery time after surgery [16] to decreasing blood pressure [17,18]. While a majority of papers examined reported positive benefits of GI Shanahan et al. (2015) [19] highlighted the presence of studies that found no association between mortality and greenspace coverage and one case that found higher mortality in proportionally greener cities. Maas et al. (2009) [20] also reported mixed results on how morbidity was related to the amount of greenspace present within a 1 km radius. ...
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Green infrastructure refers to connected corridors of greenspaces within and beyond urban areas. It provides sustainable ecosystem goods and services for people and wildlife, enhancing their wellbeing and protecting them against climatic extremes. However, the exact contributing factors to the betterment of green infrastructure are not systematically examined at a national level. This study aims to identify what helps improve biodiversity and the recreational value of green infrastructure. The study uses hotspot analysis, ordinary least squares (OLS) regression and geographically weighted regression (GWR) to understand the spatial patterns of the relevant variables and outcomes. Findings suggest that high wildlife species richness was reported in Forestry Commission woodlands and country parks, whilst doorstep greens and village greens returned poor species richness. The recreational value of greenspace was affected the most by certain types of greenspace (e.g., woodlands) as well as the percentage of urban cover. They indicate that biodiversity is generally high in areas away from urban centres, while access to greenspace in an urban space brings us high recreational value. These results indicate that green infrastructure is a complex system that requires the right balance between different priorities and services.
... Environment and Behaviour [7][8][9]. Construction and Environment [10][11][12][13], Lighting Research and Technology [14][15][16][17][18][19] as well as the Human Factors, Ergonomics and Medicine [20][21][22]. One of the key undertakings in this research area was an interdisciplinary project initiated by the National Research Council of Canada under the name "The Physiological and Psychological Effects of Windows, Daylight and View at Home: Review and Research Agenda" [23]. ...
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Standards specifying the requirements for daylight in shaping the interiors of residential buildings do not cover issues related to visual perception and the role of light as a carrier of images of the outside world. The general recommendations in this regard, given in the 2018 European Lighting Standard can hardly be considered an unambiguous, precise normative regulation. According to the author, the inalienable element of the view through the window is the image of the sky, which is the basic reference in human perception of the space of the external environment. The aim of the research is to identify the main determinants for ensuring access to the sky view from apartments in housing estates with high intensity of development. The analyzes are based on the author's simple graphical research methods capable of simulating the visual perception of images of the external environment space through a window. The key parameter in the analyzes is the vertical viewing angle, called the sky view entry angle. Its minimum value set at 7.5°C is of fundamental importance in shaping the geometric relations between neighbouring buildings. The research results oblige, in the context of the paradigm of sustainable housing development, to recognize the criterion of access to the sky view from residential interiors as a mandatory design guideline.
... The locations which were selected in this research have strong links with nature, which can be strengthened by the use of art. As stated by various researchers, nature has a restoring effect on people, which can contribute to both their physical and mental health (Ulrich, 1984;Ellard, 2015). Therefore, promoting this connection can be beneficial. ...
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Empathy-the projection of a subjective state into an object using one's imagination, so that the object appears to be infused with this state-can be experienced not only on an interpersonal level but also with animals, machines, ecosystems and places. The importance of empathy in design and other place-related practices is currently acknowledged by researchers and designers. The aim of this research was to develop a theory-grounded artistic research approach using Artificial Intelligence (AI) based tools in order to stimulate connection with a place and induce empathy with the place. The first section of the article presents a literature analysis and systematisation in connection with place, empathy, and human-place relationships. Selected theoretical landscape models are analysed in order to reveal the theoretical premises for human-place relationships involving empathy. The second section includes the presentation of the proposed methodology for artistic research, the application of the methodology in two historical localities for recreation (Panemune and Kulautuva) situated in and around the city of Kaunas (Lithuania), and an assessment of the results using an approach based on self-reflection and autoethnography. The research proves that it is possible to develop artworks using AI-based tools to create a connection between human beings, places and artificial intelligence. The creation of the artworks induced biophilic and topophilic reactions to the places chosen by the creators, as well as the experience of the genius loci and empathy with the places in which the artistic research was carried out.
Chapter
Several Evidence Based Design studies highlighted the impact of natural elements in the form of Healing or Therapeutic Gardens on patients health and wellbeing. A significant number of users within hospitals and socio-sanitary facilities is represented by medical doctors and nurses. They also spend a significant amount of time inside healthcare buildings and are subject to different risks factors, such as burnout. Aim of the research is to investigate the impact that Healing Gardens have on doctors and nurses perceived wellbeing and to provide tools and strategies for design implementations. A qualitative empirical study has been conducted on a sample of seven case studies selected among national and international Therapeutic Gardens inside socio-sanitary facilities or nursing homes. Both primary and secondary data have been used. The study demonstrates that Therapeutic Gardens can have a positive impact on hospital staff perceived satisfaction, relax improvement and willingness to work with the patients. Different recommendations and design suggestions have been proposed for the improvement of therapeutic open spaces usage. Future research on the topic are encouraged to involve a wider and more various sample.
Chapter
Recent rapid urbanization is associated with increased stress and reduced sense of well-being. The environment where one lives, works, learns and plays affects us. Overwhelming research now links nature contact with positive mental and physical health and social outcomes. Healing landscapes provide the necessary nature contact. By combining new scientific evidence and ancient intuitive wisdom the potential of a healing landscape can be realised. Evidence-based therapeutic landscapes impact diverse outcomes, including heart disease, dementia and depression. Co-benefits of design for well-being accumulate upstream and down. Addressing socio-environmental factors through design interventions leads to better health outcomes, faster. Standard design practice no longer matches the multi-disciplinary theories that intersect at well-being, requiring a focused, new design culture to offset and mitigate impacts of urbanization. This chapter reviews the evidence to show well-being as a sound principle of design, to create a design paradigm on which designers are prepared to act.
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The enriched garden concept, an innovation in geriatrics. Societal expectations underline the importance of offering nursing home résidents an environment that is favorable to health and quality of life. Experimental studies conducted on the enriched environment have shown interesting perspectives without, however, transposing them to the living environment of the older persons. The enriched garden is an innovative concept in geriatrics, resulting from translational research that could provide encouraging answers to the question of improving the living environment in psycho-geriatric institutions.
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Subjects viewed sixty color slides of either (1) nature with water, (2) nature dominated by vegetation, or (3) urban environments without water or vegetation. The information rates of the three slide samples were equivalent. Measurements were taken of the effects of the slide presentations on alpha amplitude, heart rate, and emotional states. Results revealed several significant differences as a function of environment, which together indicate that the two categories of nature views had more positive influences on psychophysiological states than the urban scenes. Alpha was significantly higher during the vegetation as opposed to urban slides; similarly, alpha was higher on the average when subjects viewed water rather than urban content. There was also a consistent pattern for nature, especially water, to have more positive influences on emotional states. A salient finding was that water, and to a lesser extent vegetation views, held attention and interest more effectively than the urban scenes. Implications of the findings for theory development in environmental aesthetics are discussed.
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The therapeutic value of landscape in giving opportunity for 'spiritual renewal' through closer contact with nature has been the basis for much of the scenic conservation movement and lies behind a universal concept of National Parks as providing recreational resources for urban populations. This belief is tested in a series of classroom studies. -C.Laverick
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This study assesses the effectiveness of two stress-reducing strategies in a field setting. The first strategy consists of a coping device which entails the cognitive reappraisal of anxiety-provoking events, calming self-talk, and cognitive control through selective attention. The second strategy consists of supplying information about the threatening event along with reassurances for the purpose of producing emotional inoculation. Patients about to undergo major surgery were exposed to either the coping device, the preparatory information, both strategies, or neither. The prediction that the coping device would effectively reduce both pre- and post-operative stress was confirmed. An analysis of the nurses' ratings of preoperative stress showed a significant main effect for the coping device. There was also a significant main effect for the coping device on postoperative measures (number of pain relievers requested and proportion of patients requesting sedatives). The preparatory information, however, did not produce any significant effects on these postoperative measures.
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The current need for energy conservation has forced some fundamental re-evaluation of building design. One aspect that has come under much review is that of building fenestration. Although windows provide daylight and ventilation, they also can allow undesirable heat gain and loss. In the past, the provision of light and fresh air were essential functions of windows. A building was uninhabitable without windows. Now however, these functions can be fulfilled by artificial lighting and mechanical ventilation. As a result, a number of people have suggested that a substantial reduction in the size of windows, or their complete elimination is desirable in order to reduce excessive energy consumption. Nevertheless, even though a windowless building might be the best solution for eliminating energy loss through windows, there is considerable evidence that this may not be very desirable for the people in the building. In an attempt to delineate some of the functions of windows, the literature on the reaction to both the presence and the absence of windows was surveyed. In the first section, the psychological reaction to windowless buildings is examined to determine if the absence of windows in a building exerts any noticeable effect upon the occupants' behavior or attitudes. In the second section, the various characteristics of windows are reviewed to define some of their functions and benefits. (123 references) (from Introduction)
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Anxiety, depression, and pain were psychometrically assessed in 67 abdominal surgery patients on the day before surgery, on the first postoperative day, and on the third postoperative day. Patients were divided into kidney donor, kidney recipient, and general surgery groups, and a multi-variate analysis of variance was performed in order to compare the trends of response over days across groups. There were significant group differences in the pattern of scores over the three days. Trait anxiety was related to post-surgical pain, anxiety, and depression in general surgery and renal recipient patients, but not in kidney donors. Results suggest that the meaning attached to the stress of surgery significantly affects the subjective state changes surrounding the operation.
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Investigated the effects of surgery on state anxiety (A-state) and perceived pain in 59 white male surgical patients. The Melzack-Torgerson Pain Questionnaire, the State-Trait Anxiety Inventory (STAI), and the Fear of Surgery Scale (FSS) were given the day before the operation and again 10 days after surgery. Results indicate that surgery as a physical threat has an effect on A-state but not on anxiety as a personality disposition (trait anxiety; A-trait). The correlation of A-state and magnitude of reported pain postsurgery, but not presurgery, attributed to the existence of little pain variance before surgery, and to realistic concern over pain following surgery. (19 ref)
Article
: Surgical patients with similar medical problems differ greatly in their rate of postoperative recovery. This study investigated the relationship between the mode of coping with preoperative stress and recovery from surgery. Sixty-one preoperative surgical patients were interviewed and classified into three groups based on whether they showed avoidance vigilance, or both kinds of coping behavior, concerning their surgical problem. Coping dispositions referring to the same dimension, preoperative anxiety, and previous life stress were also measured. The five recovery variables included days in hospital, number of pain medications, minor medical complications, negative psychological reactions, and the sum of these. Results showed that the vigilant group had the most complicated postoperative recovery, although only two recovery variables (days in hospital and minor complications) were statistically significant. Coping dispositions, anxiety, and life stress showed no clear or consistent relationships with recovery. Ways in which mode of coping may have influenced recovery are discussed. Copyright (C) 1973 by American Psychosomatic Society
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