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View Through a Window May Influence Recovery from Surgery

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Roger S Ulrich at Chalmers University of Technology
Roger S Ulrich
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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.
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... Ulrich's stress recovery theory (SRT) underscores measurable outcomes and evidencebased design and suggests that natural settings elicit positive emotional responses, hold attention modestly, and inhibit negative thoughts, aiding in stress recovery. Ulrich's findings have significantly impacted environmental design, particularly in healthcare settings, where the integration of natural elements has been shown to contribute to faster recovery rates and improved patient well-being [23][24][25][26]. ...
... It has emerged as a critical consideration across various built environments, with particular relevance to mental health and well-being. Research suggests that view access may contribute to reduced stress and improved mood in workplace settings, enhanced cognitive function and emotional regulation in educational environments, and potentially accelerated recovery processes in healthcare facilities [24,[47][48][49][50]. Research on view access has prompted the development of view access metrics and daylight access standards, such as EN 17037 [51] and LEED quality views [52]; however, there is not yet an established consensus on how those standards should operationalize the metric [53,54]. ...
... These findings corroborate existing literature on the positive effects of view access on well-being and restoration [24]. The results underscore the importance of incorporating ample window space in interior design, particularly in settings where restoration is a priority, such as healthcare facilities. ...
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Given the increasing prevalence of anxiety and depression, this research aims to identify design features that enhance the sense of restoration, with the goal of supporting mental and behavioral healthcare facility design. This study employed both screen-based and virtual reality (VR) stimuli to evaluate the perceived restorativeness of different interior settings. The key variables analyzed included window view access, view content, materiality, and room geometry. Thirty-five undergraduate and graduate students assessed 16 distinct interior environments. Findings indicate that the VR presentations generally produced higher restorativeness scores compared with screen-based presentations, though this effect varied across stimuli. Repeated-measures ANOVA revealed that larger windows consistently correlated with higher restorativeness scores in both presentation modes. Views of water were rated as most restorative, followed by wooded areas. Natural materials were perceived as significantly more restorative than other materials, particularly in VR presentations. Varied ceiling designs, especially vaulted ceilings, were associated with evaluations of higher restorativeness compared with flat ceiling designs, with this effect more pronounced in VR. This research underscores the potential of VR technology to simulate and assess interior design interventions, offering insights into creating more effective and personalized restorative environments in mental health treatment facilities. The findings can inform evidence-based design strategies for healthcare spaces, supporting treatment processes and patient well-being.
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  • May 2024
Contemporary hospitals may be recognized by a large variety of activities, not only delivery of care but also some concerns, such as the satisfaction level of users. This research investigates the relationship between outpatient department (OPD) design elements and medical staff satisfaction and performance, especially in light of the pandemic since 2020. A mixed-method approach was used to gather doctors' and nurses' perspectives at two hospitals in Sulaimani City. This involved an EBD questionnaire and a modified AEDET checklist where respondents filled out a 39-item questionnaire at the hospitals' OPD. The results highlight the importance of the interior environment's quality in promoting the satisfaction of medical staff. The results from the medical staff surveys showed that most medical staff expressed satisfaction with the indoor design elements, and three factors, infection control, interior appearance, and comfort and control, were essential to creating a satisfactory indoor environment. A negative correlation of some demographic information, such as practical experience and educational attainment, with medical staff satisfaction was revealed. The findings suggest that investigating the views of the medical staff can indicate the level of significance of various elements that increase their satisfaction and performance, contribute to the general body of knowledge, and inform design decisions.
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The seven colours of the rainbow are much more than visually appealing; they possess significant scientific, medical, and psychological importance. These colours appear in the natural world and also resonate within our bodies through the chakra system. In nature, these colours are prominently seen in fruits, vegetables, flowers, animals, and various landscapes. Each colour of the rainbow provides distinct health benefits, and collectively these colours form white light and sunlight. Thus, the diverse benefits associated with each colour are delivered to us by Nature, primarily from the Sun, foods, and the environment. Let us journey through the rainbow to uncover the meanings behind each colour and how they can enhance our well-being. LET'S NOT FORGET THAT THE SUN PROVIDES ALL THESE COLOURS! Red: Energy and Vitality (Base Chakra) The colour red is associated with energy, passion, and life. Psychologically, it may stir the senses, quicken the heartbeat, increase motivation, and evoke feelings of excitement and intensity. Scientifically, red light has also been proven to stimulate the production of adrenaline, enhance energy levels and alertness and therefore improve physical alertness. In medical treatments, red light therapy promotes wound healing and reduces inflammation. Foods coloured red include tomatoes, strawberries, and cherries, all of which contain lycopene and anthocyanins. These are antioxidants that can help reduce inflammation and support the cardiovascular system. Beets, a reddish vegetable, are also a source of nitrates. Nitrates can enhance blood flow and lower blood pressure. In architecture and business decor, red is used in restaurants and retail to stimulate appetite and encourage impulsive buying, creating urgency and excitement.
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The Positive impact of Greenery on the Mental and Physical Health of the Elderly: A Case Study in the Design of a Hospital Garden
Article
Full-text available
  • Dec 2024
The positive effects of greenery on human health have been studied for centuries. Knowledge and application of these benefits can be used in hospitals and retirement homes. Residents of these facilities are often mentally or physically disabled; hence creating a suitable exterior area in accordance with the scientific findings of the health benefits of greenery could improve the mental and physical states of the elderly and improve overall living conditions. Nature has calming effects and soothes our minds by driving away attention from the stressful problems of everyday life. Green colour, sounds of birds, water, and leaves decrease levels of stress and contribute to mental well-being. Free access to nature or gardens decreases the bad tempers of the elderly and improves memory and the overall state of patients with dementia. It reduces anxiety and stress, which are precursors for cardiovascular diseases. It helps prevent fall-related injuries and improves mobility and cognitive function. Consequently, contact with nature improves the quality of life, decreases the need for taking medicine, and could prolong life expectancy. As a case study, we present a design of the revitalisation of a hospital garden for the elderly in Bratislava city district of Podunajské Biskupice. It puts the knowledge of these benefits and the needs of various types of patients to practice, so that the garden could be used as an effective healing tool and as a calming area for patients as well as the staff and visitors.
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The evidence for stress recovery in forest therapy programs: investigating whether forest walking and guided forest therapy activities have the same potential?
Article
  • Dec 2024
  • J Forest Res
In recent years, forest therapy has become a popular method for improving human health. However, guided forest therapy is not always easily accessible, and forest walking is a more convenient and feasible alternative. Therefore, it is important to determine whether forest walking has the same effect as guided forest therapy. To investigate this, we conducted a campus forest-based study in which 247 university students were randomly assigned to participate in either forest walking or guided forest therapy activities. The study measured physical and psychological interventions in participants, while controlling for the intensity of physical activity. The findings indicated that both approaches were effective in promoting stress relief and physical and mental recovery among university students. No significant difference in effectiveness was observed between the two approaches. Furthermore, we constructed a mediation model that combines the biophilia hypothesis, stress reduction theory, and attention restoration theory to investigate the psychological mechanisms underlying the restorative effects of forest activities. Our findings indicate that an increase in nature connectedness significantly predicts a reduction in state anxiety. This effect is mediated by perceived restorativeness and a combination chain of mediators from perceived restorativeness to mood. This study presents a justification for selecting forest walking as a means of stress relief when guided forest therapy is unavailable. Additionally, it enhances our comprehension of how forests contribute to the restorative effects experienced by individuals.
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Natural Versus Urban Scenes: Some Psychophysiological Effects
Article
Full-text available
  • Sep 1981
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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Anxiety and pain in surgical patients
Article
Full-text available
  • Aug 1975
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)
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Visual landscapes and psychological well-being( National Parks).
Article
  • Jan 1979
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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Reduction of psychological stress in surgical patients
Article
  • Dec 1975
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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Windows and People: A Literature Survey. Psychological Reaction to Environments with and Without Windows
Article
  • Jun 1975
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, pain, and depression surrounding elective surgery: A multivariate comparison of abdominal surgery patients with kidney donors and recipients
Article
  • Feb 1977
  • J PSYCHOSOM RES
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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Active Coping Processes, Coping Dispositions, and Recovery from Surgery
Article
  • Sep 1973
: 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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