Herd-Health Environments Research & Design Journal最新文献

Objective: This study examined staff perceptions of design and patterns of work locations and activities across two different designs, linear design and onstage/offstage clinic design, to inform evidence-based facility design and planning decisions. Background: Healthcare industry trends indicate an increasing focus on outpatient facilities, which currently represent 42% of healthcare construction spending, necessitating research on optimal design approaches for staff efficiency and satisfaction. Method: Three types of data collection and analysis were employed. First, surveys were conducted with nursing, medicine, physician assistants, case managers, and medical assistants/technicians from linear design (N = 48) and onstage/offstage design (N = 50) clinics. Second, focus groups of 24 staff were employed across clinics. Third, staff shadowing utilized tablet-based applications to record patterns of work activities, participants, and locations (N = 6,604 observations; 150 h). Results: Survey results showed Onstage/Offstage clinic staff had significantly more favorable perceptions of Clinic Design Features (p = .000), Design Awareness (p = .001), and Satisfaction with Design (p = .001) than Linear Design staff. Open-ended survey comments provided staff preferences and issues with clinic design. Focus group analysis revealed two themes from Linear Design staff: (1) Distance, and (2) Onstage/Offstage clinic design was superior and one theme from Onstage/Offstage staff: Proximity. Shadowing data revealed distinct workflow patterns, with Onstage/Offstage clinic staff spending significantly more time in direct patient care while Linear Design staff allocated more time to paperwork and patient reception activities. Conclusions: Key implications for clinic designers include prioritizing centralized staff work areas, implementing acoustic privacy solutions with spatial zoning; and redesigning patient interaction points for enhanced privacy compliance.

BackgroundClinical nurses are consistently exposed to high levels of occupational stress, which can undermine their professional quality of life, resulting in burnout, reduced compassion satisfaction, and psychological exhaustion. In the aftermath of the COVID-19 pandemic, resilience has emerged as a critical protective factor in helping nurses manage these stressors. Moreover, connectedness to nature has gained recognition as a potential influence on enhancing nurses' professional quality of life.PurposeDrawing on Nature-Based Biopsychosocial Resilience Theory and General Systems Theory, this research investigates how connectedness to nature influences nurses' Professional Quality of Life, exploring the mediating role of psychological resilience.MethodsA cross-sectional survey was conducted among clinical nurses during the COVID-19 pandemic. Path analysis examined direct and indirect relationships among connectedness to nature, psychological resilience, and three components of professional quality of life: compassion satisfaction, burnout, and secondary traumatic stress.ResultsConnectedness to nature was significantly associated with higher compassion satisfaction and lower burnout. Psychological resilience partially mediated these relationships, indicating that while connectedness to nature may offer immediate stress-buffering benefits, it also contributes to the development of resilience, a critical long-term protective resource. No significant effects were observed for secondary traumatic stress.ConclusionsThe findings suggest that connectedness to nature serves as a potent, nature-based avenue for strengthening nurses' psychological capital and elevating critical components of their professional quality of life. This underscores the compelling rationale for integrating nature-based strategies into healthcare environments to proactively foster the emotional well-being and long-term sustainability of frontline nurses.

BackgroundResearch has demonstrated that therapeutic architectural spaces can significantly enhance patient treatment outcomes. However, current designs underutilize therapeutic potential due to three key limitations: poor environmental comfort, suboptimal health metrics, and weak cultural immersion.PurposeThis study develops a healing-oriented spatial design framework for Traditional Chinese Medicine (TCM) clinics.MethodsForty-one requirements were identified through literature review, interviews, and WELL v2 standards, which were refined to 23 core needs based on environmental healing theory. The Kano model and Better-Worse coefficient analysis were applied to quantify their dual impacts on user satisfaction and health benefits.Results and ConclusionsThe four-layer design model comprises: (a) a Basic layer that strictly adheres to six essential requirements from TCM clinic standards; (b) an Enhanced layer that optimizes five performance-driven needs; (c) an Innovative layer that develops 11 culturally distinctive features; and (d) a Potential Optimization layer that formulates dynamic strategies for indifferent-type requirements. It provides the first quantitative tool for TCM clinic space design that integrates healing environment theory with TCM characteristics, highlights the value of the built environment as a nonpharmacological therapy, and promotes the paradigm shift of healthcare spaces from "disease treatment" to "health promotion."

ObjectiveThis study explores how experienced Chinese healthcare design professionals perceive Australian hospital environments to shed light on hospital design perspectives across cultural contexts.BackgroundWhile hospital design significantly influences patient outcomes and staff performance, limited research addresses how hospital environments are perceived across cultural and national contexts. This study fills that gap by examining Australian hospitals through the lens of Chinese professionals with extensive experience in healthcare design.MethodsUsing a mixed-methods approach, post-visit surveys were administered to twenty-three Chinese healthcare design professionals after guided tours of five large Australian tertiary hospitals. The survey captured demographic data, ranked key design priorities, and collected qualitative feedback on spatial experience and design performance.ResultsParticipants identified strengths in Australian hospitals, including child-friendly features, spatial comfort, biophilic integration, and service efficiency. However, they also point to challenges related to wayfinding clarity and public amenity distribution. Contrasts were drawn with Chinese hospitals, where design priorities emphasise functionality, administrative control, and throughput under systemic and governance constraints.ConclusionsFindings reflect differing design values shaped by cultural and institutional factors. While Australian hospitals are seen as therapeutic and inclusive, Chinese counterparts prioritise operational efficiency. The study highlights opportunities for knowledge exchange and culturally sensitive adaptation, offering practitioner-informed insights that can inform future comparative and empirical research on hospital design. (1.3).

This discussion examines the fundamental premise of the Maggie's Centre care philosophy, its success, and why North America has yet to accept this innovative, non-medicalized healthcare paradigm. This UK-based network of 26 centers, the first having opened in 1996, has garnered international attention for innovative architecture, in an orchestrated synthesis of built form with the therapeutic affordances of nature. A Maggie's Center is a distinct community-based healthcare building type for the provision of non-hospital-based counseling and related wellness treatment for women diagnosed with cancer and others coping with cancer. These centers have been built on two continents and typically designed by internationally renowned architects. Numerous peer-reviewed published studies have addressed these centers' social, behavioral, and physical environment attributes and qualities through a broad-based post-occupancy assessment lens. It is hypothesized that this research collectively has been, to date, insufficiently rigorous, methodologically. This may account, to a certain extent, for why the medical establishment in North America has not yet grasped the healing and spiritual affordances of the Maggie's concept nor the attempt to uniquely incorporate architecture as a therapeutic modality. In response, three interdependent influencing factors (determinants) are presented with respect to three core constituencies of the Maggie's Centre concept with the aim of stimulating further discourse. The evidence-based health design research community, laypersons, cancer patients, survivors, and others suffering from sickness and disease, together with the medical community, can collectively foster further acceptance of this innovative building type for health.

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.