Studies in health technology and informatics最新文献

Global population ageing will impact our communities. Increasing number of older adults live at home with physical, sensory, and cognitive challenges. Enhancing living solutions that support physical and social wellbeing of people with memory decline is important for their wellbeing. Various living solutions to integrate and support them in meaningful and active daily life are needed. The objective of this research was to develop diverse housing models to integrate older adults with memory decline and their families in their communities. The research question was: what kind of living environments and housing design solutions can support the wellbeing and daily life of people with memory decline? How to implement the research findings in design? The project used multiple case study and research by design methods to promote discussion and knowledge sharing with various stakeholders working with housing for older adults. The results of the project indicated that there is a need to increase the knowledge base of designers and architects about the needs of people with memory decline. Design solutions should focus on familiarity of the living environment, human scale, visual and sensory perception. Accessible solutions in the built environment that support social activity, sense of community but ensure the right to privacy will increase peoples' feeling of security and wellbeing. Through cross-sector collaboration and increasing participation of people with memory decline in the planning of housing we can provide better indoor and outdoor environments with current resources.

This study explores how children experience two different locations at Oslo University Hospital in terms of their architectural design and emotional potential. The first location includes a conventional modern hospital wing, whereas the other is a uniquely designed cabin in natural surroundings outside the hospital building, the Outdoor care retreat. The research is a psychological study of how various locations activate cognitive schemas and lead to elicitation of different emotional responses and modes of behavior for children. Participants included 17 children aged 7 to 16, whereby 11 children had no previous experience with hospitalization for a serious medical condition and 6 children were undergoing treatment or follow-ups related to a medical condition at the time of data collection. The data material consisted of walking interviews accompanied by a semi-structured interview guide. The qualitative material was analyzed by applying reflexive thematic analysis and categorized into themes. Study findings illustrate that children experience the environments differently in terms of physical and emotional restrictions. Overall, the children prefer architectural spaces with direct contact to nature or design that mimics natural environments, in addition to being exciting, friendly, and intimate. In these environments, children feel less restricted, more relaxed and more free to express themselves and a range of emotions. This study proposes that spending time in such environments will increase resilience and hospitalization satisfaction for children admitted to hospitals for longer periods of time. In turn, this could have important implications for practice if included in the design of future health care facilities.

The symbiotic relationship between healthy hospital design and infection prevention and control (IPC) is crucial to developing a safe healthcare environment. Collaborative efforts in mitigating the risk of hospital-acquired infections (HAIs) are needed and will decrease morbidity, mortality rates, and costs. HAIs not only impact patient health but also tarnish the reputation of healthcare institutions. This paper delves into the distinctions between exogenous-derived and endogenous-derived HAIs, elucidating their sources, transmission mechanisms, and preventive strategies. Exogenous-derived HAIs can be prevented by a well-designed hospital layout which minimize contamination. Endogenous-derived HAIs originate from the patient's own microbial flora, necessitating tailored infection prevention strategies such as antimicrobial prophylaxis. Standard precautions and transmission-based precautions, as outlined by the Centers for Disease Control and Prevention (CDC), form the cornerstone of infection control efforts. Hospital design should facilitate compliance with these measures, ensuring a microbial-safe environment conducive to patient recovery. Interdisciplinary collaboration between architects, healthcare professionals, and infection control experts are needed to integrate infection control principles into hospital design processes effectively. Key considerations include optimizing patient flows, separating clean and dirty materials, and implementing robust ventilation systems to mitigate airborne transmission risks. Furthermore, selecting appropriate surface materials resistant to microbial growth and enabling effective cleaning and disinfection protocols are important to maintain a microbial safe hospital environment. Most importantly, the shift towards single-occupancy rooms represents a significant stride in infection prevention, minimizing the risk of cross-contamination compared to multi-occupancy wards. Scientific evidence supports the efficacy of single-occupancy rooms in reducing microbial contamination and preventing HAIs.

Modern architecture has generated measurable requirements about users' interactions with the built environment to create user-oriented architecture through meticulous full-scale testing with subsequent standardization. These requirements have entered the legal framework as minimum threshold values for basic demands that regulate building and physical planning. In the construction of the modern welfare society, building-related requirements have been associated with fundamental ethical values for the societal construction, e.g., equity, health, inclusion, and sustainable development. The programming of architecture through building requirements can be seen as giving the users a dosage of happiness through architecture. The modern welfare state defines an architectural happiness through is legal frameworks. This study analyzed thirteen questions from a 37-question questionnaire, distributed to 122 informants, in thirteen countries. The study aimed at establishing the contemporaneous understandings and uses of the concept of accessibility. The study concluded that, currently, the concept of accessibility has turned into a technical instrument that limits the quest for an increased fit between user demands and needs with the architectural design. Furthermore, there is a loose link between accessibility and sustainability. In conclusion, architectural happiness for the upcoming sustainable society of the 2030s needs to update the concept of accessibility so that the outcome - usability for future users - becomes apparent.

The housing sector plays a crucial role in fostering innovation in response to the changing needs and desires of a growingly diverse ageing population. In recent years, collective housing concepts have gained more attention as a promising alternative option to address these changing needs. Architects are at the forefront of creating suitable, collective housing projects that enhance the subjective wellbeing of both current and future older residents. However, the challenges and constraints faced by architects when realizing these projects have remained largely unexplored. This study seeks to bridge this knowledge gap by conducting in-depth interviews with ten Belgian architects who have completed a collective project for future or current older people. The findings provide an overview of the obstacles architects encounter related to (1) architects' values and vision, (2) collaboration and communication, and (3) practical and policy barriers, offering a better understanding in the process of designing innovative, collective housing projects. As a next step, these results may be utilized by policymakers, designers, and stakeholders, to develop more effective strategies for overcoming these challenges and constraints, and to unlock the potential for innovative, collective housing solutions that cater for the wellbeing of residents.

This scientific paper examines how the Dutch architects Jacoba Froukje Pot-Keegstra (1908-1997) and her husband Johan Willem Hindrik Cornelis Pot (1909-1972) designed for older people. In the decades following World War II, with the advent of the welfare state, care for older people became a priority of new social policy in the Netherlands. In 1956, the state pensions were launched (Algemene Ouderdomswet), and in 1963, the Dutch Ministry of Housing and Spatial Planning (Volkshuisvesting en Ruimtelijke Ordening) introduced the Older People's Homes Act (Wet op de Bejaardenoorden). At the time, there was a growing demand for housing for older people, and this aimed to facilitate their large-scale production while meeting the highest possible standards. Through some of their most significant projects, this paper explores the aspects that Pot & Pot-Keegstra added to the design of collective housing to make life more convenient for old people beyond the "Regulations and Guidelines" (Voorschriften en Wenken) introduced in 1965. The methodology of this paper consists mainly of archival research in the National Collection for Dutch Architecture and Urban Planning at the Nieuwe Instituut in Rotterdam, a review of scientific and non-scientific literature, and plan analysis. It is worth noting that Pot-Keegstra was the first female architect by the Academy of Architecture in Amsterdam in 1936, and she was one of the very first women to run an office with her husband. Among the analysed projects designed by Pot & Pot-Keegstra for older people is the first high-rise nursing home, the Osdorperhof in Amsterdam (1962-1968). The General Act on Exceptional Medical Expenses adopted in 1968 (Algemene Wet Bijzondere Ziektekosten) made the proliferation of nursing homes possible. The Osdorperhof, with medically oriented care, was a forerunner of the nursing home boom that began in the late 1960s. The design of this project facilitated a new way of taking care of older people, as this collective housing enabled them to live relatively independently and to have the care they needed.

Hospitals, as institutions serving a diverse population, must address the needs of individuals with disabilities. While many nations prioritize a public health approach to hospital accessibility, this research contends that specialized strategies are vital to accommodate the complex requirements of all users. The study employs a mixed-method methodology. It encompasses an in-depth literature review on accessible design theories, cross-country comparisons of regulations in five nations (Greece, UK, USA, Australia, Sweden), and a survey evaluating existing accessibility within Greek hospitals. The review and cross-country comparisons underscore the pressing demand for specialized attention to wheelchair users and reveal a glaring absence of regulations catering to the visually and hearing impaired. The survey results illuminate a concerning trend of noncompliance with existing rules, underscoring the urgency for legislative actions and the establishment of international standards to ensure comprehensive accessibility. Although strides have been taken, strict adherence to regulations remains paramount. The research places paramount importance on social well-being and equity in healthcare access for individuals with disabilities. It is evident that individuals experience emotional difficulties when confronted with accessibility obstacles, underscoring the necessity to integrate emotional support into hospital design in conjunction with accessible design principles. The study aligns closely with the principles of equity, diversity, and inclusion, advocating for equal access to healthcare and specialized care for vulnerable populations. In conclusion, the research significantly contributes to the conference's overarching theme by delving into the intricate interplay between design, social well-being, and emotional health within healthcare facilities. The primary focus on the inclusion of individuals with disabilities serves as a driving force in the pursuit of a more equitable and accessible healthcare landscape.

Existing research on stroke in adults highlights the role of the built environment during recovery. However, this role has been greatly overlooked in the everyday lives of children with stroke. A stroke in childhood brings substantial changes for affected individuals and their families. Special care and treatments are necessary even many years after the stroke. Although many children recover after a stroke and can lead largely normal lives, cognitive and physical impairments are not uncommon. Typical consequences of childhood stroke include one-sided weakness (hemiparesis), ataxia, seizures, and visuoperceptual deficits. These conditions influence the children's everyday life. For example, home modifications are sometimes necessary to alleviate difficulties, but their implementation and effects on family life remain understudied. This study investigates the role of the built environment in the daily lives of children and families affected by this rare disease, aiming to understand how the built environment hinders and supports the daily lives of children with stroke and their families in their home environment. Using a participatory approach, children serve as experts, offering insights into their home environments. Fifteen German families participated, with guided tours documenting barriers and support measures through floor plans and photos. From an architectural perspective, it was noticeable that 1) large renovation measures were rarely implemented, instead, small aids in daily life were more common, 2) even small everyday aids can significantly improve the lives of these children and their families, 3) children are constantly developing, thus requiring adaptable solutions that can keep up with their growth and changing needs. In summary, this study illuminates the built environment's impact on paediatric stroke survivors, providing insights to inform interventions and enhance the quality of life for the children and their families.

Observation tools are increasingly important in healthcare building design research. They enable us to understand how the design of healthcare buildings affects users' health and organisational outcomes. Observations are used in case studies and pre- and post-occupancy evaluations. However, these case studies often struggle to pinpoint the specific design features responsible for observed outcomes. Additionally, harnessing collective knowledge from multiple cases can be challenging. This underscores the need for structured observations. The paper describes the lessons learnt from using three spatial observation tools as part of a study to assess a hospital ward design. Its goal is to reflect on the purpose, usability, advantages, disadvantages, and future improvements of these tools and to offer insights into their potential to support research on hospital ward design. The first tool, by the Centre for Health Design, utilizes a checklist-style matrix to evaluate the design of patient rooms, assessing 17 Evidence Based Design goals, including patient safety, worker safety and effectiveness, quality of care, patient experience, and organizational performance. The second tool is a one-time observation tool, a structured spatial inventory aimed at documenting design features throughout the entire hospital ward, covering elements such as room size, access to daylight, natural elements, furniture, safety measures, and more. It can be combined with the third tool; the recurring observation tool, which focuses on monitoring usage, users, their activities, and behaviour across various types of environments, including patient, staff, care, and supportive spaces. The last two observation tools were developed for the research project, adapting the Smart Sustainable Offices method for healthcare environments. This paper emphasizes the importance of selecting suitable observation tools for specific research objectives, providing guidance for working with observations and conducting pre-and post-studies. While not aimed at validating observation tools, it offers reflections to aid in development and use of observation tools. Finally, documenting spatial contexts enhances understanding of study findings, and reusing observation tools enables cross-study comparisons, with future potential for leveraging artificial intelligence.

The traditional architectural design of care institutions is characterised by limited privacy, autonomy, user involvement, and rigidity in scheduling. In contrast, the Person-Centred Care (PCC) model presents an alternative approach to care provision, emphasising the active participation of the care recipient, involvement of the family, flexible scheduling, as well as a close relationship between users and caregivers. This approach requires reorganising facilities into smaller, more compact, self-contained units, known as living units. In Spain, the public administration responsible for social and health care centres (Imserso) has initiated the process of adapting its buildings to enhance social integration and implement the PCC model at a national level. The aim of this study is to outline and analyse the participatory process involved in evaluating the architectural design for the transformation of two such buildings. The research design is a multicentred descriptive case study with data collected through group workshops. The results describe the findings of four workshops conducted with care providers and care recipients of both buildings. Incorporating a co-design process with building users should be a fundamental aspect throughout all project phases, as deinstitutionalisation involves empowering individuals to participate and be active agents in their environments.