Herd-Health Environments Research & Design Journal最新文献

Background: This study addresses the challenges in hospital navigation, particularly focusing on the sequence of arrival experiences through foot traffic or driving within a medical campus. While previous research has emphasized wayfinding in interiors, this study recognizes the importance of transition from outdoor to indoor spaces in the hospital arrival zone.

Objectives: Twofold research efforts include: (1) Exploring vehicular and pedestrian behaviors in a hospital arrival zone using Space Syntax Analyses (SSA), and (2) Validating the SSA results using empirical data collected from onsite observations and behavior mapping.

Methods: A series of axial map analyses were conducted on the hospital campus and building arrival zone regarding spatial connectivity and integration, depth of spaces, and wayfinding intelligibility based on vehicular and pedestrian movement paths. Systematic behavioral data collection includes vehicle shadowing (10 h) and pedestrian mapping (20 h) in the building arrival zone.

Results: Space Syntax Analyses indicates high intelligibility scores for vehicles (R = .91) and pedestrian (R = .78) circulation patterns; traffic situations were visualized via axial maps. A dataset of 219 vehicles and 2,096 pedestrian behaviors was analyzed and visualized using diagrams and heatmaps, identifying different occupancy patterns within the space. Correlational analyses indicated strong correlations between the results: connectivity and integration scores are significantly correlated with both vehicular and pedestrian traffic volumes.

Conclusion: Preliminary findings of the study validated an integrated protocol to evaluate the impacts of campus configuration and building approach design on patient arrival and spatial navigation at large hospitals, serving as a POE protocol involving SSA.

Aim: The objective of this study was to develop a comprehensive multidimensional framework by identifying the key drivers and components associated with the health of older people in healing environments, and to apply this framework in high-density city block spaces, creating opportunities for aging in place. Background: Effective theoretical and practical research frameworks are necessary to determine how to best support older adults in high-density city areas as they face aging-related challenges. Methods: The methodological approach involved bibliometric analysis (SciMAT) and systematic literature review of approximately 4446 articles related to rehabilitation settings and older adults. The review focused on literature that developed concepts and research frameworks and provided an empirical foundation. Results: The review identified four types of drivers for a healing environment for older individuals in high-density city blocks (HEOI-HCBs): self-environment, interpersonal, physical, and informational environments. These drivers were linked to eight desirable outcomes: initiative acquisition, shared vision, trust, empathy, integrity, systematicity, networking, and perceived usefulness. Conclusion: The drivers and outcomes formed the HEOI-HCBs framework, each representing a distinct dimension of the HEOI-HCBs concept. This study and the resulting framework facilitate the application and understanding of healing environments.

Objectives: This systematic review aims to explore virtual reality (VR) applications for rehabilitation purposes among people with intellectual and developmental disabilities (IDD), identify their effects on rehabilitation outcomes, explore themes to consider in VR intervention design, and provide guidance for designers and researchers in creating therapeutic environments using VR technology.

Background: VR has gained increasing attention in healthcare settings to assist in achieving rehabilitation goals for people with IDD. VR is particularly advantageous since it simulates the real world while providing controllable, safe, and versatile environments. It is necessary to expand the current body of knowledge on VR intervention's outcomes by synthesizing further information on VR application characteristics as well as identifying design considerations regarding feasibility, usability, safety, and other aspects that will benefit future VR intervention design and research.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framed the current review. Multiple databases were searched to identify studies published between 2001 and 2023. The review qualitatively organized VR environment design considerations according to three themes: feasibility, usability, and safety.

Results: This review included 27 articles and included 868 participants. The overall findings indicated that VR interventions are promising in enhancing rehabilitation outcomes among people with IDD, such as physical, cognitive, emotional, and functional independence domains.

Conclusion: This review provides design recommendations to create effective, usable, and safe VR interventions for individuals with IDD. The suggested design implications should be applied with the awareness that VR is a relatively emerging technology with rapidly evolving features.

Aim: This study aims to shift views away from negative perceptions towards aging by exploring the following research question: How are the multiple levels of the gerotranscendence theory influenced by the sustainable behavior and attitude toward the biophilic design of older adults? Background: Improving perceptions of aging is vital for positively impacting both the biological and societal aspects of the global aging phenomenon. Methods: The study utilized a mixed-method design. Initially, 300 older Turkish adults completed self-reported measures including the Gerotranscendence Scale (GS), Pro-environmental Behavior (PB), Environmental Identity Scale (EID), Biophilic Design Importance Level (BDI), and Inclusion of Nature in the Self Scale (INS). Subsequently, the second phase involved diary logs from 30 participants who volunteered during the initial phase. Results: Results indicated that a higher importance level placed on biophilic design was linked to a greater inclusion of nature in the self. Moreover, a stronger interest in nature correlated positively with the gerotranscendence experience. Conclusions: The results bring significant attention to biophilic design, especially its relevance in supporting sustainable environmental behaviors and positive aging.

Objectives: The study aimed to fill the knowledge gap about how operating room (OR) design could reduce orthopedic surgery duration and contribute to surgical care safety and efficiency.

Background: Long surgery duration may lead to delays and cancellations of surgeries, deteriorated patient experiences, postoperative complications, and waste of healthcare resources. The OR physical environment may contribute to the reduction of surgery duration by minimizing workflow disruptions and personnel movements during surgeries.

Methods: Unobtrusive observations were conducted of 70 unilateral total knee or hip replacement surgeries in two differently designed ORs at a community hospital in the United States. A set of computer-based forms adapted from recent research was used to measure the surgery duration, environment-related disruptions, and ambulatory movements involving circulators. Potential confounding factors like surgery type were controlled in statistical analyses.

Results: Significantly shorter surgery durations were recorded in the larger OR with more clearances on both sides of the operating table, a wider door located on the sidewall, more cabinets, and more clearance between the circulator workstation and the sterile field (p =.019). The better-designed OR was also associated with less frequent disruptions and fewer movements per case (p < .001). Significant correlations existed between surgery duration, the number of disruptions, and the number of movements (rs = .576-.700, ps < .001).

Conclusions: The study demonstrated the important role of OR physical environment in supporting the safe and efficient delivery of surgical care, which should be further enhanced through research and design innovations.

Background: It is proposed that patients in single-occupancy patient rooms (SPRs) carry a risk of less surveillance by nursing and medical staff and that resuscitation teams need longer to arrive in case of in-hospital cardiac arrest (IHCA). Higher incidences of IHCA and worse outcomes after cardiopulmonary resuscitation (CPR) may be the result.

Objectives: Our study examines whether there is a difference in incidence and outcomes of IHCA before and after the transition from a hospital with multibedded rooms to solely SPRs.

Methods: In this prospective observational study in a Dutch university hospital, as a part of the Resuscitation Outcomes in the Netherlands study, we reviewed all cases of IHCA on general adult wards in a period of 16.5 months before to 16.5 months after the transition to SPRs.

Results: During the study period, 102 CPR attempts were performed: 51 in the former hospital and 51 in the new hospital. Median time between last-seen-well and start basic life support did not differ significantly, nor did median time to arrival of the CPR team. Survival rates to hospital discharge were 30.0% versus 29.4% of resuscitated patients (p = 1.00), with comparable neurological outcomes: 86.7% of discharged patients in the new hospital had Cerebral Performance Category 1 (good cerebral performance) versus 46.7% in the former hospital (p = .067). When corrected for telemetry monitoring, these differences were still nonsignificant.

Conclusions: The transition to a 100% SPR hospital had no negative impact on incidence, survival rates, and neurological outcomes of IHCAs on general adult wards.

Objectives, purpose, or aim: The study aimed to decrease noise levels in the ICU, anticipated to have adverse effects on both patients and staff, by implementing enhancements in acoustic design.

Background: Recognizing ICU noise as a significant disruptor of sleep and a potential hindrance to patient recovery, this study was conducted at a 40-bed ICU in Fiona Stanley Hospital in Perth, Australia.

Methods: A comprehensive mixed-methods approach was employed, encompassing surveys, site analysis, and acoustic measurements. Survey data highlighted the importance of patient sleep quality, emphasizing the negative impact of noise on work performance, patient connection, and job satisfaction. Room acoustics analysis revealed noise levels ranging from 60 to 90 dB(A) in the presence of patients, surpassing sleep disruption criteria.

Results: Utilizing an iterative 3D design modeling process, the study simulated significant acoustic treatment upgrades. The design integrated effective acoustic treatments within patient rooms, aiming to reduce noise levels and minimize transmission to adjacent areas. Rigorous evaluation using industry-standard acoustic software highlights the design's efficacy in reducing noise transmission in particular. Additionally, cost implications were examined, comparing standard ICU construction with acoustically treated options for new construction and refurbishment projects.

Conclusions: This study provides valuable insights into design-based solutions for addressing noise-related challenges in the ICU. While the focus is on improving the acoustic environment by reducing noise levels and minimizing transmission to adjacent areas. It is important to clarify that direct measurements of patient outcomes were not conducted. The potential impact of these solutions on health outcomes, particularly sleep quality, remains a crucial aspect for consideration.

Objectives: This research aims to propose a novel methodology for analyzing and optimizing wayfinding in complex environments by examining their spatial configurations.

Background: Wayfinding difficulties often lead to disorientation and hinder users' ability to locate destinations. Although architectural design can aid in simplifying user access, existing approaches lack a specific focus on wayfinding optimization despite its significant impact on users' navigational abilities.

Methods: In this study, an agent-based model was employed to assess the efficacy of wayfinding in a multistory hospital. Subsequently, the layouts were optimized, leading to the creation of a new space distribution diagram. The simulation was then repeated to examine the potential improvement in wayfinding. Data collection encompassed user types, workflow scenarios, population distribution, and user speed.

Results: Comparative analysis of the agent-based simulation findings before and after layout optimization revealed a decrease in total distance and time spent on the modified floor plans for all users when compared to the existing layout. This suggests that the optimized layout holds significant potential for enhancing wayfinding performance. Given the positive outcomes observed for users, this approach is particularly well suited for preliminary design stages of complex environments, where designations among user groups are less crucial or flexibility is desired. Additional advantages include the ability to generate a comprehensive simulation of users' daily workflow, which is integrated into the optimization process and considers specific requirements regarding spatial adjacency.

Objective: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010-2021).

Methods: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe.

Results: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study's outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research.

Conclusion: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities.

Background: Women need a safe and comfortable environment to breastfeed their babies. The quality of breastfeeding environments in social areas is important for women's breastfeeding satisfaction.

Aim: The aim of this study was to develop a measurement tool for the evaluation of breastfeeding environments and to examine the impact of the quality of breastfeeding environments in social areas on breastfeeding satisfaction.

Method: The first phase of the study was conducted in methodological design and the second phase in cross-sectional design. The draft scale was applied to 365 women who had breastfeeding experiences in social environments during the postpartum 6 months-3 years period. In the first stage, scale development analyses were applied. In the second stage, the developed scale was applied to 255 women. Frequency, percentage, Cronbach's α coefficient, and correlation analysis were used in the analysis of the data.

Results: The Ideal Breastfeeding Environment Assessment Scale, consisting of 23 items and four subdimensions, was obtained in the study. As a result of the application of the scale in the second stage, the mean score of the breastfeeding environments evaluated by the women was 23.43 ± 8.36. A statistically significant moderate-weak correlation was found between the ideality of breastfeeding environments and the satisfaction levels of women (p < .001).

Conclusion: It was determined that the developed scale is a valid and reliable measurement tool that can be used to evaluate breastfeeding environments. As the quality of breastfeeding environments increases, women's breastfeeding satisfaction increases.