Herd-Health Environments Research & Design Journal最新文献

Objectives: To explore factors affecting the quality of child-nature interaction (CNI) based on the views and desires of children themselves and to offer solutions and strategies to provide this kind of spaces.

Background: CNI is one of the most important needs of children which causes very profound effects on the psyche of children from different aspects. Space and context that have the ability and characteristics to provide opportunities to establish this interaction have an important role in the cognitive and social development of children.

Methods: The qualitative data were collected by draw-and-write technique from a study of 119 children aged 2-6 years from five nursery schools located in the city of Hamedan, Iran. Then, the qualitative data were coded based on the grounded theory using three main steps of open, axial, and selective coding and a conceptual model of CNI is provided by the MAXQDA software.

Results: The conceptual model developed from CNI consisted of seven core categories: "intertwining with nature," "objective natural elements," "nature conservation," "colors," "exaggerated plant perceptions," "path perceptions," and "nature-home similarity."

Conclusions: To reach an optimal CNI within architectural spaces, thus children should have a sense of belonging to nature, be engaged in it, and protect surrounding natural elements. It is of utmost importance to reflect on some points, such as colors, familiar signs, scales, natural elements, the boundary between natural environments and interior spaces, and natural element circulation and placement in designing and planning spaces made specifically for children.

Aim: To summarize the existing literature surrounding the influence of natural elements on course in hospital and to introduce clinicians to the concept of biophilic design and the potential for incorporation of nature into the hospital environment as a component of a therapeutic hospitalization.

Background: For decades, architects and designers have espoused the benefits of incorporating natural elements into the healthcare environment for therapeutic purposes. The benefits of this "biophilic" design philosophy has been investigated predominantly in long-term care or rehabilitation settings; however, some of the most appealing opportunities lie in the acute care setting.

Methods: This scoping review surveyed the literature surrounding the influence of exposure to nature on course in acute hospitalizations. After screening 12,979 citations, 41 articles were included. Exposures were divided into seven categories, the most common of which were the presence of a window/natural light, a natural scene through a window, and nature soundscapes. These articles were reviewed in a narrative fashion and thematic analysis was conducted.

Results: Studies were extremely heterogeneous in their design, research questions, and reported outcomes. Types of exposure to nature studied were exposure to a real natural scene through a window, presence of a window/nature light, nature in the healthcare environment, art depicting nature, direct contact with nature, nature soundscapes, and nature experienced through virtual reality (VR).

Conclusions: Exposure to nature during an acute hospital admission appears to have a real but small therapeutic effect, predominantly on psychological metrics like anxiety/depression, pain, and patient satisfaction. Greater beneficial effects are seen with greater durations of exposure to nature and greater degrees of immersion into nature (e.g., creating multisensory experiences using emerging technology like VR).

Objective: This study aims (1) to understand the needs and challenges of the current intensive care unit (ICU) environments in supporting patient well-being from the perspective of healthcare professionals (HCPs) and (2) to explore the new potential of ICU environments enabled by technology.

Background: Evidence-based design has yielded how the design of environments can advocate for patient well-being, and digital technology offers new possibilities for indoor environments. However, the role of technology in facilitating ICU patient well-being has been unexplored.

Method: This study was conducted in two phases. First, a mixed-method study was conducted with ICU HCPs from four Dutch hospitals. The study investigated the current environmental support for care activities, as well as the factors that positively and negatively contribute to patient experience. Next, a co-creation session was held involving HCPs and health technology experts to explore opportunities for technology to support ICU patient well-being.

Results: The mixed-method study revealed nine negative and eight positive patient experience factors. HCPs perceived patient emotional care as most challenging due to the ICU workload and a lack of environmental support in fulfilling patient emotional needs. The co-creation session yielded nine technology-enabled solutions to address identified challenges. Finally, drawing from insights from both studies, four strategies were introduced that guide toward creating technology to provide holistic and personalized care for patients.

Conclusion: Patient experience factors are intertwined, necessitating a multifactorial approach to support patient well-being. Viewing the ICU environment as a holistic unit, our findings provide guidance on creating healing environments using technology.

Objective: In this study, we aim to develop and propose an evaluation method for analyzing the design of operating rooms (ORs) from the perspective of surgical teams' reported experiences and stress levels.

Background: Stress and burnout of surgical team members can lead to diminished performance and medical errors, which endangers the safety of both the patients and team members. The design and layout of the OR play a critical role in managing such stress.

Methods: To understand surgical teams' spatial needs related to their experiences and stress, we administered a survey and in-depth focus group discussions to three surgical teams from the same organization. The identified spatial needs were translated into functional scenarios and spatial metrics, essentially viewing the OR through the perspective of users.

Results: Our analysis revealed four integral sections-patient flow, room organization, access to facilities/medical equipment/support staff/team members, and staff well-being-identified as critical design factors associated with the experiences and stress levels of the surgical teams in the ORs.

Conclusions: We expect this method to serve as a tool for evaluating the effect of the design of OR layouts on stress, thereby supporting the well-being and resiliency of surgical teams.

Objectives: A working group conducted a survey on the use of the principle of buffer space (BS), which in case of emergencies, could benefit healthcare settings. The aim of the preliminary investigation is to define new research lines in hospitals' functional design.

Background: The global experience of the COVID-19 pandemic highlighted challenges faced by hospitals when responding promptly to emergencies, including spatial reorganization and suspension of ordinary medical activities for ensuring adequate management of the emergency surge of patients.

Methods: The group designed questionnaires to be administered to healthcare staff and healthcare designers aimed at understanding varied conceptions and features of BSs. Content across the two surveys overlapped significantly, allowing for direct comparisons of responses, while also including tailored questions in relation to the respective experience and skills of the two groups of respondents.

Results: 102 healthcare professionals and 56 designers took part to the survey. Analysis of the responses permitted for initial recommendations regarding BS typology including (a) proximity to the emergency department (ED), intensive care units (ICUs), and inpatient wards (IWs); (b) location within hospitals but separate from other medical areas; (c) need for independent access; (d) organizational and spatial features similar to ED, ICUs, and IWs; (e) existing as a fully flexible operational space; and (f) BS bed capacity to be approximately 12% of ED beds.

Conclusions: Although the analysis is related to the Italian context, the expansion of this preliminary research to alternate healthcare facilities and geographic areas is necessary for reaching a wide consensus by different professionals on this field. It serves as a starting point for future investigations regarding the implementation of BS in hospital settings.

Objective: This study investigated issues related to noise, lighting, and temperature in trauma rooms that impact patient care and staff performance.

Background: Uncontrolled sensory stimuli can hinder healthcare delivery quality in trauma rooms. High noise and temperature levels can increase staff stress and discomfort as well as patient discomfort. Conversely, proper lighting can decrease staff stress levels and reduce burnout. Sensory overload in trauma rooms is a crucial concern, but no studies have been conducted on this issue.

Method: Using a convenience sampling method, 65 trauma team members (e.g., surgeons, physicians, nurses) from six Level I trauma centers in the United States were recruited to participate in 20 focus groups. Focus groups were semi-structured and 1 hr long.

Results: Staff covered issues related to communications and disruption from noise sources (e.g., equipment, conversations). Having control over lighting allows staff to change light intensity and facilitate their work during the resuscitation. A well-maintained temperature can provide patient comfort or reduce risk of hypothermia, given that patients can lose body heat rapidly due to loss of blood.

Conclusion: Excessive sensory stimuli can result in disrupted communication, fatigue, and stress, making staff susceptible to errors. Staffs' control over environmental conditions may lead to a more efficient, comfortable, and safer environment. Technology should be reliable and flexible to facilitate this.

Objectives: The objective of this inquiry was to identify (a) rural health challenges in the United States, especially in the context of the COVID-19 pandemic and (b) to identify opportunities within the disruptions caused by the pandemic.

Background: Rural healthcare challenges in the United States are not the same as those faced in urban and suburban communities. Nor are rural hospitals a miniature version of larger urban hospitals. Urban healthcare and hospital-centric policies and solutions, hence, do not help address or optimize the unique health challenges of rural communities. Furthermore, the challenges previously faced by rural hospitals were further exacerbated by COVID-19.

Methods: Key points from public deliberations among experts in a 1-day symposium on rural health, attended by 65 professionals representing 18 west Texas institutions, were captured by the authors. The data were subsequently analyzed to identify common areas of information.

Findings: Four clusters of challenges and opportunities were identified: healthcare delivery, healthcare infrastructure/building, community health, and public administration.

Conclusions: Symposium data suggest that rural health faced numerous unique challenges, which were further compounded by the COVID-19 pandemic. However, the pandemic also helped discover the resiliency of clinicians working in rural areas. For rural health optimization, rural health buildings also need to be flexible. While funds are not easily available, some innovative community collaborations with healthcare institutions may generate novel solutions. In the meantime, telemedicine promises a radical change in rural community health services in the future.

Objective: To understand parent and child perception of spaces experienced during outpatient procedures and to measure their anxiety in these spaces.

Background: Same-day procedures are becoming prevalent among children in the United States. While studies conducted in different types of healthcare settings show that the physical environment influences healthcare experiences of patients, there is a lack of research on patient and family perceptions of the physical environment of the outpatient centers where such procedures are conducted.

Methods: This study used ecological momentary assessment to collect patient experience and anxiety data at different points during the patient's journey through an ambulatory surgical center where pediatric gastrointestinal (GI) procedures were performed. Objective and subjective measures of anxiety were collected. A Qualtrics survey asked participants' perceptions about four spaces-waiting, preprocedure, procedure, and recovery.

Results: Child participants reported liking murals, double chairs, patient beds, wall color, and access to a television. They disliked medical equipment and lack of child-friendly furniture. Most parents liked the murals, access to a television, and nature photos, while disliking the lack of privacy, lack of toys in waiting areas, and lack of child-friendly furniture. On average, both children and parents experienced the highest anxiety levels before and during the procedure and the lowest during recovery. Between the four spaces, no significant differences were observed in the heart rate variability and skin conductance responses for both groups.

Conclusions: Despite the outpatient nature of the procedures, participants experienced anxiety before the GI procedure. Comfortable design features that provide distractions are preferred by children and their parents.

Background: The absence of a cure for dementia, combined with the increased longevity of the baby boom generation, is resulting in a dramatic increase in the number of people living with dementia. Aging-related changes coupled with dementia-related behavioral symptoms pose unique challenges for those living with dementia as well as those who provide care. There is evidence that improved sleep can improve health and well-being. Research also supports using auditory interventions as a form of nonpharmacological therapy.

Objective: This study evaluated the effects of a customized auditory (sonic) treatment during sleep on the mood, behavior, quality of life, functional ability, and health condition of individuals living with the symptoms of dementia. Workforce outcomes were evaluated as a secondary outcome.

Methods: A controlled before-after design with a mixed-method approach was used to evaluate the impact of the sonic sleep treatment during baseline, intervention, and discontinuation time frames.

Results: Statistically significant improvements were observed in participants' cooperation with care (p = .0249) and daytime drowsiness (p = .0104). Other nonstatistically significant improvements included bed mobility, appetite, bathing self-performance, toilet use, incidence of falls, following requests and instructions, and nighttime insomnia. While workforce outcomes remained unchanged, staff were supportive of resuming the sonic sleep treatment after the discontinuation time frame.

Conclusions: The sonic sleep treatment demonstrated improved outcomes for individuals living with dementia. This supports using an appropriate auditory stimulus as a fundamental component of care for individuals living in memory care settings.