Herd-Health Environments Research & Design Journal最新文献

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.

BackgroundExisting literature highlights the crucial role of Healthcare Built Environments (HBEs) in generating value and shaping service experiences. HBEs must fulfil their intended purpose during the operational phase of construction projects to generate value. Additionally, many design requirements for facilities are shaped by the needs of clinical and support services, as well as those of users. Therefore, understanding value generation requires considering the dynamic interdependence between physical space and service needs. However, previous studies have not thoroughly explored these relationships, leaving a critical research gap.ObjectiveIt aims to propose a method to understand value generation in HBEs by examining the relationships between built environment attributes and healthcare service delivery, from the perspectives of multiple user groups.MethodDesign Science Research was the methodological approach adopted in this investigation. Two empirical studies were undertaken in different hospitals.ResultsThe primary output is the i3 method, a novel approach for understanding value generation in HBEs. It integrates the laddering technique, which is based on the means-end chain conceptual model, with additional sources of data, such as design documents, interviews with stakeholders, and direct observations of the HBEs.ConclusionsFindings highlight the importance of analyzing the interactions between the HBE and services, revealing opportunities to enhance value generation. The hierarchical value maps generated through the i3 method offer a structured approach to support design decision-making. The i3 method helps identify overlooked constructs and relationships, such as the need for HBE adaptability to address service changes or respond to unforeseen service demands.

ObjectivesThis study investigates the interplay between energy efficiency, lighting control, and window design in hospital settings, emphasizing their collective impact on sustainable healthcare operations.BackgroundDespite growing attention to energy conservation in healthcare, limited research comprehensively addresses how lighting strategies, window designs, glazing solutions, and occupant behavior interact to optimize energy use while enhancing patient environments.MethodsA systematic review of 43 rigorously selected studies was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, analyzing research across architecture, engineering, environmental science, and healthcare disciplines to explore these relationships.ResultsThe findings highlight that adaptive lighting, high-performance glazing, and optimized window design play a crucial role in enhancing energy efficiency, lowering operational costs, and improving patient comfort.ConclusionThis study provides actionable insights for healthcare professionals, facility managers, and policymakers to promote sustainable hospital design by integrating energy-efficient strategies.

Aim: To assess staff satisfaction with the physical work environment (PWE) and its relationship with work engagement and turnover intention through a new hospital's postoccupancy evaluation (POE). Background: The healthcare workforce shortage has intensified globally. POE is a well-established method for collecting information on the success of the PWE. While strong work engagement is associated with lower turnover intention, research on their relationship with satisfaction in PWE in hospitals is limited. Methods: The study used a cross-sectional survey design. Data were collected at a public hospital in Finland from January to February 2024, using a POE questionnaire, the Utrecht Work Engagement Scale-3, and the Turnover Intention Scale. A total of 510 hospital staff members participated. The data were analyzed using correlations and multifactor analysis of variance. Results: Overall satisfaction with the physical work environment was relatively high. Satisfaction in security and safety, comfort, and architecture was strongly correlated with most other PWE categories. Physicians and hospital support and logistics staff were more satisfied with the PWE than nurses. A moderate relationship was found between satisfaction with the PWE and work engagement. The perception of comfort with the PWE and satisfaction with security and safety were moderately associated with work engagement. The relationship between satisfaction with the PWE and turnover intention was weak. Conclusion: The results suggest that when planning new hospitals, attention should be paid to developing the PWE, especially in terms of safety and security and comfort, since it may impact staff work engagement.

Background: Pediatric healthcare design increasingly addresses clinical and psychosocial needs, highlighting the role of spatial, technological, and environmental factors in supporting patient well-being. Emerging technologies, such as virtual reality (VR) and artificial intelligence (AI), show potential for improving patient engagement and healthcare operations, though adoption remains challenged by privacy, ethical, and implementation barriers. Objectives: This study explores current trends, barriers, and future directions in pediatric healthcare design, focusing on patient-centered care, adaptability, emerging technologies, and participatory design strategies. Methods: Fifteen experts-including architects, pediatric nurses, child life specialists, and healthcare administrators-were interviewed via Zoom using a semi-structured format. Purposive and snowball sampling facilitated recruitment, and thematic analysis was conducted to extract key themes. Results: Experts highlighted the evolution of family-centered and culturally responsive design, emphasizing the need for privacy-conscious, adaptable spaces that support neurodivergent children and behavioral health needs. Biophilic and sustainable design were seen as essential for creating calming environments and supporting long-term well-being. While VR and AI offer promise in enhancing patient experiences and operational efficiency, privacy concerns, costs, and regulatory concerns remain key barriers. Infection control measures, while critical, were seen as potentially conflicting with patient-centered and socially supportive environments. Interdisciplinary collaboration and participatory design methods were underscored as key to addressing complex design challenges. Conclusions: Future pediatric healthcare design will prioritize flexibility, inclusivity, and a public health approach, balancing clinical safety with emotional and psychological well-being. Ongoing interdisciplinary collaboration and adaptive design strategies will be critical in creating environments that enhance patient experience, caregiver support, and healthcare efficiency.

Purpose: A non-randomized exploratory and observational study evaluated the effects of high-performance four-stage air filtration systems on health and well-being of residents in skilled nursing facilities. Background: Air pollution and microorganisms are environmental hazards that can increase stress levels and are associated with increased susceptibility to heart attacks, strokes, and heart failure. Research indicates that filtration devices can lower exposure to fine particulate matter, potentially improving health. Methods: Four-stage air-filtration systems, including a pre-filter for large particulate matter, a patented molecular filtration media, chemical filtration, and a HEPA filter, were installed at two skilled nursing facilities. A facility without any intervention was also considered to provide comparative results. Data from electronic medical records were analyzed to assess changes in vital signs and instances of infection before and after filter installation. The criterion for subject selection was admission at least 6 months before the installation date of the filtration system; residents had diverse medical conditions. Surveys were used to gather staff perspectives on the air filtration systems. Results: Residents in facilities with air-filtration systems showed significant improvements in systolic blood pressure, body temperature, and pulse rate (p < 0.05). Staff reported noticeable odor reduction after filter installation. No such improvements were observed in the facility without air-filtration intervention. Conclusions: Findings suggest that the improved air quality from the four-stage air filtration systems positively impacted residents of skilled nursing care facilities, highlighting the potential benefits of implementing high-performance filtration systems in such settings. Further research is necessary to understand the long-term effects of these interventions.

Background: Europe's aging population faces resource loss, loneliness, and social isolation, making psychosocial well-being a priority. A well-designed environment can help compensate for lost resources, while poor design may harm health, highlighting environmental quality as key to successful aging. Aim: The aim of our study was to evaluate the link between psychosocial well-being, and the built environment. Method: Participants from three retirement homes in Slovenia filled in the World Health Organization Wellbeing Index, the Brief Sense of Community, the Lubben Social Network Scale, the University of California Los Angeles Loneliness Scale, and the short version of the Social Production Function Instrument with the assistance of a researcher. Additionally, the built environment was objectively assessed using the EVOLVE tool and subjectively assessed by participants using a custom scale. Structural equation modeling was used to examine paths between the environment and wellbeing. Results: The findings showed a statistically significant indirect effect of well-being on the perceived environment, while no indirect effects were found between the objective and perceived environment or well-being. However, specific objectively measured environmental factors, such as acceptability, features for sensory and dementia support, and perceived accessibility and aesthetic environmental attributes significantly affect well-being. Conclusion: These findings highlight the need to prioritize well-being in urban planning for aging populations. Beyond basic needs like safety, high-level needs like aesthetics, sensory support, and accessibility should be emphasized. Enhancing well-being through these factors may be effective when designing or modifying physical environments. Accessible, sensory-friendly, and dementia-supportive designs can further support healthy aging.

Background: Hospital environments can be distressing for pediatric patients, particularly before surgery. Preoperative anxiety is a common issue among children, potentially leading to adverse psychological and physiological effects. Child-friendly environmental modifications, such as incorporating cartoon characters and natural scenery in hospital design, may help reduce anxiety and improve patient experience. Objective: This study aimed to evaluate the effect of child-friendly environmental design interventions-specifically, painting pediatric surgery ward walls with universal cartoon images and natural scenes-on preoperative anxiety levels in children.

Methods: A mixed-methods design (comparative and descriptive) was employed. The study included 80 children aged 4 to 10 years, divided into two groups (n = 42 in the first group, n = 38 in the second group). Preoperative anxiety levels were assessed using The Children's Anxiety Meter-State and Trait scales. Additionally, children in the second group were asked, "What is your opinion about painting the walls?" to collect qualitative feedback.

Results: The mean preoperative state anxiety score was 5.40 ± 3.46 in the first group and 3.52 ± 3.50 in the second group (p < .05), indicating a significant reduction in anxiety after the environmental intervention. In group 2 (after painting), 78.5% (n = 30) of children responded to the open-ended question, with 90% expressing satisfaction with the newly designed environment.

Conclusion: Painting pediatric surgery ward walls with child-friendly imagery and natural scenes was found to be an effective nonpharmacological intervention in reducing preoperative anxiety in children. These findings support the integration of child-friendly environmental designs in pediatric healthcare settings to enhance patient wellbeing.