Herd-Health Environments Research & Design Journal最新文献

Objectives: This narrative literature review aims to develop a framework that can be used to understand, study, and design maternal care environments that support the needs of women from diverse racial and ethnic groups.

Background: Childbirth and the beginning of life hold particular significance across many cultures. People's cultural orientation and experiences influence their preferences within healthcare settings. Research suggests that culturally sensitive care can help improve the experiences and outcomes and reduce maternal health disparities for women from diverse cultures. At the same time, the physical environment of the birth setting influences the birthing experience and maternal outcomes such as the progression of labor, the use of interventions, and the type of birth.

Methods: The review synthesizes articles from three categories: (a) physical environment of birthing facilities, (b) physical environment and culturally sensitive care, and (c) physical environment and culturally sensitive birthing facilities.

Results: Fifty-five articles were identified as relevant to this review. The critical environmental design features identified in these articles were categorized into different spatial scales: community, facility, and room levels.

Conclusions: Most studies focus on maternal or culturally sensitive care settings outside the United States. Since the maternal care environment is an important aspect of their culturally sensitive care experience, further studies exploring the needs and perspectives of racially and ethnically diverse women within maternal care settings in the United States are necessary. Such research can help future healthcare designers contribute toward addressing the ongoing maternal health crisis within the country.

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.

Objective: This article aims to investigate the impact of fine-grained differences in unit layout on care staff corridor communication.

Background: Corridor design can be undertaken with greater emphasis on space and cost efficiency or with greater emphasis on affording quality knowledge workspace. Building on prior research on care team communication and inpatient unit design, this study aims to gain a better understanding of how corridor layout properties affect care team communication.

Method: This study used space syntax analysis to characterize inpatient unit design, specifically floor-plan layout. Two approaches were used to capture care team communication: behavior mapping with recording of care team member locations and whether they were communicating and the HDR CARE Scale, Inpatient Version. The two units were part of a vertical tower expansion project, and, though constructed at separate times, they maintain the same organizational culture, floor plate, and location of key vertical elements.

Results: The newer unit was found to be more visually open using three measures from space syntax. More nursing staff verbal communication was observed on this unit. Across both units, nursing staff were more likely to be observed verbally communicating in locations that were more visually connected (i.e., at locations with larger viewsheds). There were no significant differences between nursing staff self-report on work using the HDR CARE Scale, Inpatient Version.

Conclusion: We conclude that care team communication may tend to be encouraged by visual connectivity that can be promoted through floor-plan layout.

Aim: This literature review is conducted to identify knowledge gaps and shape a framework for the development of guidelines and future research on programming and design of rehabilitation environments.

Background: Patients suffering from trauma, stroke, neurological or cardiopulmonary conditions, or recovering from surgery or cancer treatment require rehabilitation services. A comprehensive rehabilitation program can support continuum of care for inpatient and outpatient groups. However, within most facilities, rehabilitation environments are found to be outdated and undersized compared to other programs or lack the correct adjacencies within the facility. Unfortunately, this deficiency is echoed by limited guidelines on programming, planning, and design of these environments. General guidelines derived from healthcare environments research is not adaptable to rehabilitation environments, because the paradigm used in most healthcare environment research does not address specific needs of rehabilitation patients in regaining confidence or relearning daily life skills.

Method: We conducted a structured literature review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a basis for reporting the available body of work on evidence-based research in rehabilitation environments.

Result and conclusion: Through analysis of the limited literature, specific mediators such as patient confidence and motivation were identified. An environment that creates a balance between privacy and social interaction can promote these mediators. Creating enriched environments through elements that engage the senses and encourage more social and physical interaction is essential for recovery. Finally, accessibility and wayfinding are of great importance in these environments due to potential limited mobility or cognitive impairments of patients.

Aim: To explore the chef's experience with a newly implemented indoor hospital-based kitchen garden designed to supplement herbs ordered for patient meals and improve staff engagement.

Background: Hospital-based therapeutic and kitchen gardens have emerged as effective health-promoting tools in hospital healthcare environments. They promote emotional, mental, and physical well-being for patients, visitors, and staff. However, formal evaluations are limited, and studies focusing on indoor hospital kitchen gardens are noticeably absent in the literature.

Methods: Qualitative evaluation of a hospital-based kitchen garden. Open-ended interviews were conducted approximately 6 months after garden implementation and explored key informants (n = 6) overall experience, engagement with the garden, perceived benefits, and opportunities for improvement. Interview data was analyzed using a thematic approach.

Results: The implementation of the kitchen gardens was met with overall acceptance among staff. However, the project's feasibility faced challenges related to local food service leadership, communication, and certain aspects of the garden setup. Despite these obstacles, the gardens contributed positively to the quality of meals by including fresh herbs and fostering greater staff engagement.

Conclusions: The chefs viewed the concept of the hospital-based kitchen garden favorably, noting that it closely aligned with their mission of providing nutritious meals to patients. However, consideration of the broader issues facing hospital food services may be required to seamlessly integrate this task into the kitchen staff's daily routine. Further research is warranted to investigate the effective implementation and feasibility of indoor kitchen gardens in hospitals and their impact on patient menus, food service staff, and the workforce.

Objectives: We empirically investigated to what extent plants in the emergency department (ED) waiting areas influence patient wait experiences (i.e., anxiety, perceived service quality, and perception of wait time) depending on individual differences in cognitive thinking styles and one's bonds with the natural world.

Background: Positive effects of nature on patient experiences in healthcare environments are well established by empirical research findings. However, evidence is scarce on the impact of nature on patient wait experiences and the roles of patient traits often related to their backgrounds.

Methods: A within-subjects study was conducted (N = 116) with two virtually built ED waiting rooms: with versus without indoor and outdoor plants.

Results: Findings confirmed that plants lower anxiety and improve perceptions of service quality and wait time. Cognitive thinking style significantly moderated how plants affected patient wait experiences. Although participants with higher connectedness to nature showed more positive responses to the nature condition, connectedness to nature did not significantly affect the association between nature and wait experiences.

Conclusions: This study contributes to the existing body of knowledge on nature's effects in healthcare environments by examining the roles of individual differences in patients' and visitors' cognitive styles and connectedness to nature. Results highlighted the impact of these differences in patient experiences for effective implications of nature in waiting areas of healthcare facilities.

Background: Studies address excessive sound levels and their adverse effects on infants in neonatal intensive care units (NICUs). However, objective measurements represent merely one aspect of the acoustic environment, and investigations into staff's perceptions of the acoustic environment remain scarce in the NICU context. A holistic approach, soundscape, is needed to explore the acoustic environment in-depth.

Aim: This study aims to (1) contribute to indoor soundscape literature and inform decision-makers of future NICU design and research by focusing on staff members' perceptions of the soundscape and (2) explore whether there is a relationship between staff members' perceptions of soundscapes and the built and acoustic environments of one NICU.

Methods: Following the ISO/TS 12913-2/3 protocols, semi-structured interviews were conducted with 10 NICU staff members and analyzed using the grounded theory to generate a conceptual framework for NICU soundscapes.

Results: The results indicated that the task-related sounds, including false alarms, were neutrally responded to as they evoked acceptance and adaptation behaviors. The sound sources perceived as irrelevant were responded to negatively. NICU staff indicated that although they expect to hear alarms clearly, specific features of alarms caused several physiological and psychological problems.

Conclusions: The findings of the study revealed the importance of conducting a soundscape approach to investigate NICU acoustic environment in detail. The study showed that staff members' perceptions and responses primarily depend on the context rather than on sound levels.

Objective: This literature review aimed to summarize the existing knowledge surrounding the role of the built environment in supporting older adults' physical and social engagement and identify opportunities for future research and design that facilitates older adults' engagement at multiple environmental scales: from interior spaces to neighborhoods.

Background: Physical environments can support or impede older adults' physical and social engagement: willful, motivated involvement in meaningful activity or occupation. Research shows that engagement is a core component of health and well-being and relates to positive health outcomes, including reduced disease risk, better mental health, and improved physical and cognitive function. Thus, designing supportive built environments for engagement can yield significant, positive health and well-being impacts.

Methods: A systematized search of five databases, a hand search, and an iterative screening process identified 55 studies for inclusion in this review. Through inductive thematic analysis, this review summarizes findings regarding the built environment's role in physical and social engagement in older age and design strategies to facilitate engagement and support health and well-being.

Results: Evidence indicates that built environment characteristics can influence older people's physical and social engagement in homes, neighborhoods, and care settings. The thematic analysis of the included studies identified three key themes concerning the relationships of built environment characteristics to older adults' engagement across multiple environmental scales: connection, access, and security.

Conclusions: Built environments influence older people's physical and social engagement, significantly affecting their health, well-being, abilities, and longevity. Numerous design strategies can support older adults' engagement, but more research is needed.