Herd-Health Environments Research & Design Journal最新文献

AimThis study explores how future-proofing is understood and applied in hospital building design, focusing on the perspectives of experienced architects. It aims to examine the practical implications of future-proofing and to identify key barriers to its implementation within contemporary healthcare infrastructure projects.BackgroundExisting literature often focuses on the general benefits, such as cost savings and sustainability, but lacks detailed analysis of the multifaceted implications and obstacles encountered in real-world projects. This study addresses this gap by directly examining architects' perspectives, offering critical insights into the practical realities and complexities of future-proofing hospital buildings, thereby contributing to a more nuanced understanding and informed decision-making in this field.MethodsSixteen semistructured interviews were conducted with experienced hospital architects based in Australia. Data were analyzed using a combination of deductive and inductive thematic analysis.ResultsThe results of thematic analysis have been categorized under three overarching categories: perceived benefits, perceived drawbacks, and implementation challenges. The findings highlight that future-proofing is neither inherently beneficial nor burdensome, but rather a context-sensitive strategy that must be tailored to each project's evolving operational, economic, and policy.ConclusionsThe study underscores the need for more systematic, longitudinal evaluation of future-proofing strategies, as well as greater integration of advanced futures methodologies into healthcare planning and design processes. A more structured and evidence-based approach to future-proofing can support the development of hospital infrastructure that is both resilient and responsive to the long-term evolution of healthcare systems.

ObjectivesChildren scheduled for surgery and anesthesia often experience fear and anxiety before the procedure, as well as pain afterward. While medical treatments are essential for managing these challenges, design strategies that positively influence environmental and psychological factors can significantly improve children's experiences and their overall subjective well-being. This narrative literature review examines "design for well-being" strategies that support the subjective well-being of children undergoing surgical procedures.BackgroundAccording to the World Health Organization, health is defined not merely as the absence of disease but as a state of complete physical and mental well-being. Achieving such well-being requires not only medical care but also the optimization of environmental and psychological conditions that impact emotional states. Today, evidence-based, multidisciplinary approaches are recommended to promote well-being. In health-related design, one focus is on improving the quality of medical care, while another addresses non-medical factors that influence subjective well-being.MethodsThis research employs a non-systematic literature review methodology, utilizing existing literature and evidence-based approaches to synthesize relevant strategies.ResultsEnhancing subjective well-being-through evidence-based design strategies such as age-appropriate environmental modifications, sensory-friendly elements, and interactive distraction tools-alongside optimized medical practices in pediatric surgeries contributes to improved clinical outcomes and reduced perioperative stress. The review highlights "design for well-being" strategies, which effectively support the subjective well-being of children undergoing surgical procedures.ConclusionsEmphasizing "design for well-being" strategies is crucial for enhancing the overall experiences and well-being of children undergoing surgery. Future research should focus on the implementation and long-term impact of these design interventions to further validate their effectiveness and scalability.

Objectives, Purpose, or AimThis study investigates how physical environmental features influence balance loss and falls among women in their third trimester of pregnancy. It aims to identify environmental affordances that contribute to or mitigate fall risks.BackgroundFalls during pregnancy pose significant risks to maternal and fetal health. Understanding interactions between pregnant women and home environments is essential for effective fall prevention. This study employs ecological and dynamic systems theories to explore these interactions.MethodsWeekly interviews were conducted with 13 pregnant women in their third trimester. Participants documented real-world incidents of falls and near-falls within home environments. Data were analyzed to identify patterns in environmental affordances and behaviors linked to balance loss and fall prevention.ResultsFindings identified three types of affordances: Functional affordances supporting behavior (e.g., sufficient lighting levels to navigate spaces). Dysfunctional affordances increasing risks, such as low furniture, slippery surfaces, and inadequate supports. Preventive affordances used to avoid falls. Behaviors linked to falls included rising from low furniture, descending stairs, navigating cluttered spaces, and entering bathtubs. Environmental factors like slippery surfaces and open furniture layouts were key contributors.ConclusionsFalls during late pregnancy result from complex interactions between environmental and behavioral constraints. This study offers insights into designing safer environments tailored to pregnant women's needs. Limitations include recall bias and limited generalizability due to the small sample size. Despite these, the study provides a strong foundation for future research and fall prevention strategies.

ObjectiveThe purpose of this study was to investigate how environmental affordances in the behavioral health inpatient milieu affect a patient's sense of autonomy.BackgroundPatients who feel empowered are more likely to participate in their care, which can, in turn, improve the quality of care (Ippolito et al. 2020). However, the lack of patient empowerment can have negative consequences in behavioral health facilities such as intensified physical violence, aggression, and loneliness in the milieu (Bellman et al., 2022; Dell et al., 2019; Hickmann et al. 2022). Research has also demonstrated that patient empowerment is closely linked to patient autonomy (Gagné, 2003; Hodgins et al., 2006). However, there is little insight as to how milieu spaces can foster patient autonomy.MethodsThis study utilizes a triangulated methodology to conduct a post occupancy evaluation through an on-site environmental assessment and behavioral observations within key milieu spaces.ResultsThe results demonstrated that access to scenic views, tactile features, patient's ability to move freely throughout the unit, and access to immediate provider care were significant indicators that differentiated patient autonomy between facilities. The behavioral observations showed that negative behaviors occurred around the edges of the milieu as well as when external stressors were involved. The autonomy score findings encapsulated by the designer evaluation were also closely associated with the frequency of positive behaviors observed by staff.ConclusionOutcomes include responsive design recommendations for design implementation.

BackgroundThe delivery of preventive and primary care has evolved through various physical environments, from early twentieth-century house calls to centralized settings like physician offices and hospitals, and more recently, through rapid adoption of telehealth. This shift occurred amidst an increasing emphasis on patient/person-centered care models.AimThis article conceptually examines the role of the physical environment in optimizing patient/person-centered care within telehealth, focusing on preventive and primary care in the pre-acute stages.MethodA rapid scoping review was conducted to identify key underlying dimensions of patient/person-centered care. Each dimension was further examined to identify theoretical background and measurement instruments used in the field, to obtain a detailed comprehension of the concepts. A series of brainstorming sessions among contributing authors, in association with logical theory-supported arguments, were conducted to articulate conceptual associations and detect the potential role of the physical environment.ResultAn articulation of the relationships between six underlying dimensions of patient/person-centered care is proposed: Shared Decision-Making, Autonomy, Communication, Empathy, Trust, and Privacy. Furthermore, the potential role of the physical environment in the pathway to patient outcomes is posited. Conclusions: Physical separation of providers and patients may present challenges to achieving optimal performance in key dimensions of patient/person-centered care. The physical environment of telehealth care has a potential role to play in care optimization.

Purpose and AimsThis study identifies and analyzes spatial adaptive measures taken by emergency departments (EDs) during the COVID-19 surge to emphasize the surge capacity in ED design. The design recommendations are also proposed to enhance ED surge capacity for further pandemics.BackgroundThe COVID-19 pandemic imposed unprecedented demands on EDs worldwide, compelling EDs to adopt spatial adaptive measures to accommodate overflow patients and mitigate the risk of nosocomial infections.Method15 EDs in 3A-Grade general hospitals in the central city area of Shanghai are selected as research objects. Data are collected during the peak surge period (December 2022-January 2023) using a web crawling program and field research to extract patient volume statistics, patient spatial distribution, and spatial adaptive measures from the text and image clusters.ResultsDuring the surge, the EDs had to accommodate patients with peak volume 2 to 3 times higher than normal patient volume, resulting in ED overcrowding and public space occupation including hallways and corridors. Spatial adaptive measures, including existing space requisition, existing patient flow improvement, and the construction of the "Second ED" were adopted to maintain ED's normal operation.ConclusionsThe COVID-19 surge overwhelmed EDs in Shanghai, prompting the implementation of relevant spatial adaptive measures. Design recommendations include establishing integrated related medical spaces with surge capacity planning, incorporating flexible public spaces by predesign, and designing isolated treatment areas for infectious patients.

BackgroundWith the growing demand for dementia-friendly care environments, existing smart room designs often lack systematic methods to translate user needs into functional solutions.ObjectiveThis study proposes an integrated Kano Model, Analytic Hierarchy Process, and Quality Function Deployment (Kano-AHP-QFD) framework to optimize the design of smart living rooms for dementia patients in nursing homes.MethodThrough literature reviews and user interviews, 22 user requirements were identified and categorized using the Kano model. The AHP was then employed to prioritize these requirements, with "behavior recognition (e.g., falls, wandering)" emerging as the top priority, assigned a weight of 0.3622. Subsequently, the QFD method translated these weighted requirements into design functions via the House of Quality, resulting in a set of optimized smart living room designs.ResultsThe study demonstrates that the integration of Kano-AHP-QFD provides a structured and data-driven approach to systematically address the complex needs of dementia patients, enhancing the scientific rigor and practicality of smart room design. User satisfaction scores improved from 61.655 to 80.663 after implementing the optimized smart living room designs.ConclusionsThe proposed framework offers valuable insights for designers, care providers, and policymakers aiming to improve the quality of life for elderly individuals with dementia. It is also applicable to various cognitive impairment care scenarios such as rehabilitation centers and assisted living facilities, and can provide scientific references for the environmental design of other special user groups.

ObjectivesThis study aims to explore how architects perceive their role in designing Extra Care Housing (ECH) environments in the UK, focusing on the impact of architectural design on the quality of life (QoL) for older residents.BackgroundECH represents a housing model for older adults that emphasizes independence, community integration, and access to care services. While existing literature examines ECH from healthcare and policy perspectives, little is known about how architects approach its design. This study addresses that gap by investigating architects' perspectives on designing ECH to enhance residents' autonomy, safety, and social inclusion.MethodsSemi-structured interviews were conducted with 12 architects across seven UK locations who specialize in ECH projects. Data were analyzed using thematic analysis, supported by qualitative software tools (Atlas.ti and NVivo), applying a primarily deductive coding approach based on six QoL domains. Code concurrence was assessed through cross-tabulations to explore interconnections between sub-themes.ResultsFindings reveal three overarching themes-Sense of Community, Health and Safety, and Choice and Control-each encompassing subthemes that illustrate how design supports autonomy, social interaction, and spatial orientation. Additionally, the study identifies a cross-cutting theme, Mobility, Sensory, and Cognitive Stimulation, as a critical yet often overlooked dimension in ECH design. Participants also highlighted persistent challenges, including regulatory constraints and limited financial resources.ConclusionsArchitects view ECH design as a balance between promoting independence and accommodating care needs. Their insights underline the importance of community-connected design, flexible spaces, and unobtrusive safety features. These findings inform future ECH practices and underscore the need for interdisciplinary collaboration in housing design for older adults.