Herd-Health Environments Research & Design Journal最新文献

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.

ObjectiveTo clarify the influence of daylight access on patients' and their companions' stress perception and coping behavior (communication) in cancer hospital waiting areas.BackgroundIn patient care, managing stress and encouraging effective coping strategies are essential. Daylight has shown as a modulator of stress responses and coping behaviors. Limited research has been done regarding the impact of daylight access on the waiting experience of cancer patients and their companions.MethodsEmpirical data were collected through on-site observations and questionnaire surveys in 30 waiting areas across seven cancer hospitals in China. Based on responses from 419 patients and 371 family companions, we examined differences in stress and communication between groups in the areas with and without daylight access. Multivariate logistic regression models were used to assess the significance of daylight access and communication in predicting stress.ResultsPatients and families in the areas with daylight access communicated more with peers (p ≤ .05) and perceived less stress (p ≤ .10) compared to those in windowless areas. They also communicated more with nurses, though this difference was not statistically significant (p > .10). Participants who engaged in more peer communication reported less stress (p = 0.00). Daylight access and peer communication significantly contributed to stress reduction, explaining over 15% of the variance in stress, along with personal and social variables in modeling.ConclusionAccess to daylight in the waiting areas of cancer hospitals reduces stress and promotes communication among patients and family companions. Healthcare facilities should provide daylight access in their waiting areas to reduce stress and encourage communication.

Environmental design in palliative care settings receives increasing attention, yet methodologies for studying such environments often lack interdisciplinary integration. Traditional research designs may overlook the lived expertise of clinicians and designers.ObjectivesThis article describes a collaborative, cross-disciplinary communities-of-practice model developed as a methodological framework to enable effective environmental evaluation and design processes in healthcare settings. Its application is illustrated through a case study in a palliative care unit.MethodsA co-designed, multi-methods approach was developed by a team of clinicians, facility managers, and academic researchers. The methodology included a scoping review, site-specific environmental data logging (sound, temperature, lighting), and co-created survey tools for staff and patients or proxies. Data were collected over two phases, following ethically approved protocols to protect privacy and support data validity.ResultsThe communities-of-practice model successfully integrated cross-sector expertise, improved the contextual relevance of study instruments, and enabled real-time, context-sensitive data collection in a high-acuity clinical setting. The method supported context-aware adaptations that would not have emerged from conventional top-down research approaches, effectively bridging academic inquiry and practical clinical application.ConclusionThe communities-of-practice model offers a replicable, interdisciplinary method for researching complex healthcare environments. Its case study in a palliative care unit demonstrates its capacity to generate actionable insights aligned with patient-centred outcomes. As health architecture increasingly intersects with evidence-based care delivery, such methodological approaches are vital for aligning design decisions with clinical and human-centred goals.

AimThis systematic literature review, following the PRISMA statement, aims to review the knowledge of how the indoor lighting environment and color palettes impact individuals living with Autism Spectrum Disorders (ASD), particularly their behavior and lighting and/or color preferences.BackgroundA supportive built environment is crucial for persons with ASD. Lighting design (daylight and electrical lighting) and color schemes significantly impact their behavior, information processing, and overall well-being. Despite its importance, lighting design for autism has received limited attention in architecture and design research.MethodsA comprehensive search across seven electronic databases (PubMed, CINAHL, SveMed+, and four library databases including Oria, Regina, the British National Bibliography, and the Royal Danish Library), followed by a thorough review and critical appraisal, resulted in seven (7) high-quality studies with moderate to low risk of bias. Articles were assessed using three standardized checklists, for example, JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies, JBI Critical Appraisal Checklist for Qualitative Research, and Mixed Methods Appraisal Tool (MMAT).ConclusionsThe findings are consistent with previous research and confirm that light and color influence ASD individuals' behavior and sensitivity. However, there is a substantial gap in understanding practical applications, as most studies are descriptive or exploratory rather than experimental. Future research should emphasize experimental approaches to develop evidence-based guidelines for designers.