Herd-Health Environments Research & Design Journal最新文献

ObjectiveThis paper explores the role of patient-provider communication (PPC) in healthcare quality, examines how communication dynamics are influenced in telehealth settings, reviews physical environment factors affecting virtual interactions, and identifies research gaps to guide future improvements in telehealth services.BackgroundWhile PPC is a well-established determinant of healthcare quality, the telehealth context introduces new challenges due to the absence of a shared physical space. Communication dynamics are altered by the loss of nonverbal cues, technical disruptions, environmental design limitations, and changes in interaction structure. These factors collectively affect PPC in virtual settings.MethodsA scoping review was employed, focusing on peer-reviewed articles addressing PPC, telehealth communication, environmental factors, and technological influences. Thematic synthesis identified key environmental and technological variables impacting communication quality.ResultsFindings reveal that physical environment factors and technology affect communication dynamics, patient engagement, and satisfaction in telehealth settings. Despite growing recognition of issues in these domains, physical environment and technology variables are still treated as secondary considerations rather than integral parts of the communication environment. A novel conceptual framework is proposed, identifying three interconnected environments: the local user's physical environment, the remote user's physical environment, and the digital environment-which, unlike the others, is directly moderated by technology.ConclusionsPhysical environment and technology factors shape PPC in telehealth, influencing user perceptions and engagement. Greater attention to these elements is essential for optimizing telehealth service quality and improving patient outcomes. Future research should systematically investigate how physical environment and technology affect communication quality and healthcare delivery.

Objectives, Purpose, or AimThis study evaluates the effectiveness of three innovative design strategies implemented in a hospital-based maternity unit 3 years post-occupancy. It aims to identify areas for improvement and demonstrate how a perception-based Post-Occupancy Evaluation (POE) can yield actionable insights in the absence of baseline data.BackgroundAs maternity units strive to balance clinical efficiency with family-centered care, few long-term evaluations of design performance have been conducted. This study addresses this gap by using a perception-based POE to assess design outcomes over time.MethodsA convergent mixed-methods approach was employed, combining structured observations, ambient noise level measurements, focus group interviews, and an online staff survey. Participants were nursing staff, who have direct and ongoing engagement with the unit. Quantitative and qualitative data were analyzed separately and then integrated through triangulation to develop a comprehensive understanding of the facility's performance.ResultsDecentralized nursing stations improved staff responsiveness and patient proximity but reduced informal peer communication. Integrated Labor-Delivery-Recovery-Postpartum/Neonatal Intensive Care Unit rooms supported care continuity and family involvement, though some ergonomic challenges in staff workspaces were reported. Lighting design fostered a calming, residential atmosphere. Acoustic outcomes were mixed-overall noise levels decreased, but localized disturbances remained.ConclusionsThe maternity unit met key design goals in lighting, spatial efficiency, and family-centered care. Yet, improvements in communication, workspace ergonomics, and supply accessibility are needed. This study highlights the value of POE methods rooted in perception and triangulation to inform future evidence-based design improvements in healthcare environments.

PurposeThis review aimed to identify the environmental factors impacting wayfinding by people with sensory impairment (SI) and the perceived barriers and facilitators of those factors. In addition, the review explored design recommendations to improve the accessibility of built environments for this population.BackgroundWayfinding design is frequently misconceived as the implementation of signage, whereas it also involves spatial planning to facilitate intuitive navigation. Individuals with visual and hearing impairments face multiple accessibility challenges that could be tackled through user-centered design.MethodsA scoping review was conducted using standard methodology. Electronic databases were searched (Medline, Embase, APA PsycINFO, SCOPUS, Web of Science) from January 2000 to August 2023. Independent duplicate screening was performed for 10% of sources. The extracted data was analyzed using content analysis. A conceptual framework was developed to map the key environmental factors impacting the individual's wayfinding with SI.ResultsFrom the 3,716 records identified, 41 studies were included. Results were categorized into three domains of architectural, graphical, and sensory elements. Frequently cited architectural barriers included complex layouts, unclear circulation, nonstandard stairs, and the presence of obstacles. Regarding graphical elements, the nonstandard design or placement of signage was common. Key sensory challenges were related to insufficient lighting, low visual contrast, and the inappropriate selection of materials.ConclusionsThis review highlighted multiple environmental factors that influence wayfinding for people with SI. Policymakers, architects, and designers could use these results to eliminate barriers in the built environment and develop evidence-based design interventions addressing the access needs of this population.

Objective: This article provides a conceptual exploration of research and creativity within the profession of architecture, including a proposed theoretical framework exemplifying research as a catalyst in the creative process in practice. Background: There is a growing recognition among thought leaders in the profession of architecture that both intuition and research have a rightful place in the creative process. However, there remains a pervasive concern in practice that research can threaten or detract from creativity. There is an opportunity for conceptual integration of these approaches. Methodology: Inspired by Reflective Equilibrium, this work is an analysis of the potential synergies between research and creativity in architecture. The dichotomy between normative assumptions of the two concepts is reassessed. Results: A conceptual model called The Supportive Model of Research is proposed, showing how research is more likely suited as a catalyst within the creative process in the profession of architecture. This model explores three ways research can benefit the creative process: (a) fortification; (b) protection; and (c) elevation. Three narratives are presented to illustrate the three components of the model. Conclusions: The apparent dichotomy between intuition and research may be false; after all, there is rarely a one-size-fits-all approach to every problem. There is a need to construct a new paradigm with clarity around the benefits of an expansive view and an integrated approach, with research as a support for the virtues of creativity. The work in this paper is an attempt to "break ground" on this conceptual construction project.

AimTo investigate evidence for the effectiveness of physical design interventions to reduce patient and bystander violence in emergency departments.BackgroundWorkplace violence in emergency departments can cause financial, emotional and physical harm for health care staff and organizations. Violence may be impacted by the physical design of the department.MethodA scoping review was undertaken of CINAHL, Medline, Scopus, and PsycINFO. The search utilized Boolean operators with key words, major search terms and subject headings. Inclusion criteria were physical design, violence and emergency departments. Studies on mental health or pediatric emergency departments, or non-research papers were excluded. AS review was used to sort and filter. Data was extracted into Covidence. Studies were reviewed for physical design elements used to manage aggression and outcomes. Content analysis of extracted data identified four themes.ResultsTen papers were identified. The majority of studies provided staff perceptions on the effectiveness of physical design on violence. Data revealed four main areas where physical design interventions could impact on violence from patients and bystanders. These were preventing harm from weapons, controlling physical access, observation and awareness and patient comfort.ConclusionThere is little evidence for the effectiveness of physical design interventions to reduce patient and bystander violence in hospital emergency departments. Despite a lack of empirical evidence, staff perceive that the physical design of the emergency department impacts on their safety. Further research is needed to better understand the effect of physical design on violence and determine which interventions are effective in impacting on aggressive behavior.

PurposeThis study examines the impact of facility design on patient experiences in substance abuse treatment centers.BackgroundTherapeutic architecture enhances rehabilitation environments by incorporating sound, light, color, privacy, and views to promote healing. Thoughtful design can reduce stress, improve wellbeing, and support recovery and reintegration.MethodA survey was conducted between October 2022 and May 2023, comprising 25 questions focused on privacy, safety, autonomy, social interaction, and technology. The survey included 67 participants, made up of healthcare designers and individuals with substance abuse histories, with data analyzed using Qualtrics XM and NVivo 12.ResultsKey themes of privacy, safety, autonomy, social interaction, and technology emerged. Participants emphasized the need for private spaces for communication, uncluttered environments, and staff monitoring for safety. Designs allowing patients control over lighting and temperature increased autonomy. Supportive environments, including art, enhanced social interaction. While opinions on virtual reality's usefulness varied, designers viewed it as a valuable distraction tool.DiscussionThe findings highlight the significant influence of environmental design on patient engagement and healing. Essential elements include privacy, safe layouts, home-like settings, and social support areas. Both patients and designers valued autonomy over environmental controls, such as lighting and temperature. Although virtual reality showed potential benefits, concerns were raised about its effects on safety and stigma.ConclusionEffective environmental design is crucial to improving patient experiences and engagement in substance abuse treatment. Key factors include privacy, safety, autonomy, home-like environments, and supportive social spaces, with virtual reality offering additional but debated benefits.