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Joanna Jurga, PhD
Lecturer School of Form SWPS University
Researcher at the Institute of Industrial Design in Warsaw
Justyna Puchalska, MA
independent research
Isolation, solitude, and unpleasant interiors of hospital rooms – this is the reality of
patients, who suffer from illnesses during the pandemic. After the recovery, they are
discharged from the hospital feeling depressed and exhausted. A solution can be found
in synesthetic design, which involves not only addressing patients’ senses, but also a
holistic approach towards the healing process.
According to a study conducted in San Raffaele hospital in Milan, over a half of patients
suffering from COVID-19 struggled with depression, PTSD, anxiety, or insomnia after they
left the hospital. It was not a direct effect of the disease itself, but rather of the treatment.
When patients are locked up in isolation wards, they are denied any contact with their family
and friends. They experience physical isolation along with the feeling of separation. If there
is a suspected infection with COVID-19, the patient is treated like a leper. Not only is his
physical freedom restricted, but also the mental one. Instead of receiving a treatment plan or
soothing news, he or she has to face an overwhelming sense of loneliness. There is no clear
diagnosis or solution that one can rely on.
Touch hunger
Months of lockdowns, Zoom calls, and elbow dabs have left us in a touch crisis. Skin hunger,
known as touch starvation, was already diagnosed as a disease in the 80s amongst prisoners.
Nowadays, it has been more and more common due to social distancing. Research on the role
of physical touch on our mental health has significantly accelerated. The acts of hugging,
kissing, hand-holding, or back-patting are proven to increase our oxytocin levels and sleep
quality. Research conducted at the University of North Carolina at Chapel Hill points to
possible immunity enhancing properties of touching, as well as decreased risk of
inflammation. As a result of regular touching, researchers observe decreased risk of heart
attack, stroke, as well as viral infections. Touch is undoubtedly a great way for stress
management. It has been shown that only 20 seconds of hugging and hand-holding lowers
our cortisol levels and blood pressure. The paradox of the COVID-19 pandemic is that, on the
one hand, social distancing protects us from contracting the virus, which can have lethal
consequences. On the other, lack of physical touch inevitably leads to mental health issues,
such as chronic loneliness, depression, and anxiety. We are faced with a dilemma: Which of
them poses greater long-term health risks, the virus, or the touch starvation?
Sensual experience
There exist a lot of sensual factors that affect the patient’s healing process. Firstly, it matters
whether the hospital room is visually appealing and the fabrics pleasant to the sense of touch.
Empty walls and artificial lighting contribute to the increased feeling of anxiety. Sterile
hospital interiors are supposed to provide some sort of security. Patients are closely
monitored, disinfected, and warned about all sorts of dangers. However, the increased
supervision deprives the patients of the much-needed fragility and privacy that is connected
to the sensory stimulation. According to the psychotherapist Virginia Satir, humans need four
hugs a day to survive, eight to maintain their health, and twelve to grow. An average human
being is relaxed by the smell of forest, warm and open spaces with natural fabrics, and nature.
Hospitals, on the other hand, are designed in a way that is contrary to those qualities. Instead,
patients are put into cold and restrictive rooms, with strip lighting and a sharp smell of the
disinfectant.
During the study conducted in 1972-1981 at one of the suburban hospitals in Pennsylvania,
patients after a cholecystectomy procedure were assigned to two types of rooms. The first
group had a view of trees through the window, while the other could only see a brick wall.
Twenty-three patients with a tree window view were discharged earlier, had a more pleasant
attitude towards hospital staff, and took fewer painkillers than those, who were assigned to a
brick wall room. Apparently, a mere act of watching nature can significantly lower one’s
stress levels. That is why designing hospital gardens can directly influence patients’ healing
processes and improve their health, by providing more sunlight and opportunity to focus on
nature instead of stressful clinical conditions. Architect Dr. Anna Malicka believes that
“designing hospitals is an art of searching and creating hidden potentials, it is a way in which
architecture gets involved in the healing process”. The concept of so-called “healing
environment” involves designing spaces, which do not evoke fear, but rather aid the
therapeutic processes. By acting on the sense of sight, smell, touch, hearing, and taste,
designers can significantly improve the patient’s healing process.
English psychiatrist, Humphry Osmond, was once asked to direct a large health and research
center in Saskatchewan. He noticed a relationship between semifixed-feature space and
patients’ behaviour. Waiting rooms, which he called sociofugal spaces, kept people apart,
whilst some booths and tables brought them together (these were sociopetal). The hospital
lacked the latter ones, prompting the feeling of isolation. It has been shown that distances and
orientations of the bodies in relation to one another influenced the frequency of
conversations. The results suggested a solution that could easily be implemented in today’s
hospitals. By arranging the furniture properly, designers can encourage more engagement
between patients, supporting their mental health.
Hospital diet
Hospital diet in Poland, where health care is vastly underinvested, is known for poor quality
of products, lack of taste, and repetitiveness. White bread served with a slice of cheese or
ham does not amount to culinary art. It makes no sense since serotonin, the happiness
hormone, is mostly found in the gut – often called the second brain. No wonder that food has
such a great impact on mental health. The gut and human brain are directly connected by the
vagus nerve. If the digestive system is not working properly and the gut microbiome is poor,
then a bad mood is guaranteed. The hospital diet should include produce that is rich in
tryptophan and omega-3 acids. The more variety of produce on one’s plate, the healthier the
gut microbiome. As a result, patients can observe increased concentration, better mood, and
improved sleep. The variety of texture, colour, and way of serving the dish also plays a
significant role. The cutlery should encourage the patients to eat on their own, instead of
being fed. Eating is a necessary part of social life, which is why the possibility of sharing
meals with other patients can strengthen their sense of community and introduce a necessary
element of laughter and social interaction.
Sleep, light, and circadian rhythm
The sensory deprivation that occurs at hospitals, instead of soothing patients’ nervous
systems, deregulates their circadian rhythms and leads to sleeping disorders. Artificial
lighting during evening hours does not aid our natural circadian cycle. Prolonged exposure to
light at night can lead to increased body weight and risk of cancer, which has been proven in
studies conducted on shift workers. It is not the light itself, but rather its quality and use that
is at stake. Restricting blue light exposure at least 1 hour before going to bed is crucial in
maintaining good quality sleep. Spending time outside and absorbing natural daylight is
equally important in regulating our circadian rhythm. Research shows that it aids vitamin D
and E synthesis, as well as other micronutrients which influence our energy levels,
metabolism, and blood pressure. Lack of daylight, on the other hand, forces our bodies to
block serotonin synthesis, which leads to the feeling of exhaustion, apathy, aggression and
increased pain sensitivity. Those symptoms can easily trigger the first signs of depression.
Taking into account the role of light and sleep on one’s well-being, it is worth considering
using light and colour therapy in patients’ treatment. A 2005 meta-analysis shows that by
using dawn simulation, we can effectively treat seasonal affective disorder (SAD), whereas
using bright light aids the treatment of nonseasonal depression. The results are comparable to
the majority of studies, which used traditional pharmacology, such as antidepressants. This
provides hope, by proving that light can significantly influence patients’ recovery.
Holistic approach
The hospital design and patient’s healing process are undeniably intertwined. It is crucial to
provide patients with an environment that is appealing to their senses. Introducing
aromatherapy, colour therapy, light therapy and music therapy can successfully decrease the
stress caused by the hospital stay. What patients need is being around nature and kindness
from one another. Warm spaces with daylight and the soothing smell of forest affect their
sense of comfort, sleep quality and overall well-being. Complemented with a diverse diet,
based on vegetables, fruit, healthy fats and complex carbohydrates. As a result, it is not only
the body that is being healed, but more importantly – the soul.
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