Evaluating the impact of Environmental Quality Indicators on the degree of humanization in healing environments

Document Type: Original Article

Authors

1 Professor, Faculty of Architecture, Iran University of Science and Technology, Tehran, Iran

2 Associate Professor, Faculty of Architecture, Iran University of Science and Technology, Tehran, Iran

3 PhD Candidate, Faculty of Architecture, Iran University of Science and Technology, Tehran, Iran.

Abstract

During the last 2 decades, the effects of the physical and social environment on the healing process, recovery and well-being of patients, families and staff in hospitals have been proved.There is a growing recognition that healthcare architecture could do more by promoting overall wellness, and this requires expanding the focus to healing.The research on evidence-based design (EBD) has demonstrated the power of environmental design,but EDDmost links between design and outcome such as safety and efficiency, while there is a difference between efficient environment and pleasing humanized environment.Humanization is the result of user-centered concept in design. The present study aimed to evaluate the perceived environmental quality indicators thataffect the degree of humanization in hospital design. In this descriptivecross-sectional study, first, the user-centered level of the hospital environment (humanization) was determinedin three selected hospitals in the city of Tehran by two hospital designing and planning experts,and then,with the data collected from patients, staff, and visitors (n=184) the relationship between the variableshas been found. Analysis of the data was performed in SPSS V.19 software using standard tests.The results of the study showed that there was asignificant relationship between the user-centered levels of hospitals and the users’ comments on perceived environment quality of a hospital from various aspects. Out of 12 quality indicators, 10 were meaningfullyrelated with the user-centered level of hospitals, and 4 had asignificant relationship with the user type. The results indicated that the group of patients was more sensitive to the changes in environmental quality conditions than other groups of users.

Keywords


  1. Andrade C, Lima M.L, Fornara F, Bonaiuto M. (2012).Users’ views of hospital environmental quality: validation of the perceived hospital environment quality indicators (PHEQIs). Journal of Environmental Psychology; 32, 97–111.
  2. Andrade C, Lima M.L, Fornara F, Bonaiuto M. (2013). Inpatients’ and outpatients’ satisfaction: The mediating role of perceived quality of physical and social environment.  Health & Place; 21 , 122–132.
  3. Arneil A, Devlin A. (2002). Perceived quality of care: The influence of the waiting room environment. Journal of EnvironmentalPsychology; 22(4), 345–360.
  4. Arneill, B., &Frasca-Beaulieu, F. (2003). Healing environments: architecture and design conducive to health. In S. B. Frampton, L. Gilpin, & P. A. Charmel (Eds.), Putting patients first: Designing and practicing patient-centred care. San Francisco, CA: Jossey-Bass.
  5. Becker, F., Sweeney, B., Parsons, K. (2008). Ambulatory facility design and patients’ perceptions of healthcare quality. Health Environments Research & Design Journal 1 (4), 35–54.
  6. Bolger N, Amarel D. (2007).“Effects of social support visibility on adjustment to stress: Experimental evidence”, Journal of Personality and Social Psychology ;92:458–475.
  7. Bonaiuto M, Fornara F, Bonnes M. (2003). Indexes of perceived residential environment quality and neighbourhood attachment in urban environments: A confirmation study on the city of Rome. Landscape and Urban Planning; 65, 41–52.
  8. Bonnes, M., &Secchiaroli, G. (1995). Environmental psychology: A psycho-social introduction. London: Sage.
  9. Boudreaux E, Mandry C, Wood K. (2003). “Patient satisfaction data as a quality indicator: a tale of two emergency departments”, Academic Emergency Medicine ;10(3), 261e268.
  10. CABE. (2004). The role of hospital design in the recruitment, retention and performance of nurses in England. London: The Commission of Architecture and the Built Environment.
  11. Casparia, S., Erikssonb, K., &Naden, D. (2006). The aesthetic dimension in hospitals e an investigation into strategic plans. International Journal of Nursing Studies, 43, 851e859.
  12. Davidson A. W. (1994).  Banking on the environment to promote humanwell-being.  Oklahoma City, OK: EDRA.
  13. Dijkstra, K., Pieterse, M., &Pruyn, A. (2006). Physical environmental stimuli that turn healthcare facilities into healing environments through psychologically mediated effects: systematic review. Journal of Advanced Nursing, 56(2), 166e181.
  14. Dilani, A. (2001). Psychosocially supportive design e Scandinavian healthcare design. International Academy for Design and Health, 37(1), 31e38.
  15. Dubose, J., Macallister, L., Hadi, K.  (2016). Exploring the Concept of Healing Spaces. HERD; 18: 1-14.
  16. Firth, K., Smith, K., Sakallaris, B. R., Bellanti, D. M., Crawford, C., & Avant, K. C. (2015). Healing, a Concept Analysis. Global Advances In Health And Medicine, 4, 44–50. doi:10.7453/ gahmj.2015.056.
  17. Fornara F, Andrade C. (2015). Healthcare environments, In S. Clayton (Ed.), The Oxford handbook of environmental and conservation psychology; New York: Oxford University Press.
  18. FornaraF,bonaiuto M, bonnes M. (2006). Perceived hospital environment quality indicators: A study of orthopedic units. Journal of Environmental Psychology; 26, 321–334.
  19. Fornara, F., &Cerina, V. (2011). Hospitalization experience and psychological wellbeing in the elderly: a field study in Sardinia. Abstracts of the interactive poster presentations at the 25th EHPS (European health psychology society) conference. Psychology & health, 26(Suppl. 2), 125, Hersonissos (Greece), 20e24 September.
  20. Gesler, W., Bell, M., Curtis, S., Hubbard, P., & Francis, S. (2004). Therapy by design: evaluating the UK hospital building program. Health & Place, 10(2), 117e128.
  21. Gifford, R. (2003). Environmental psychology: Principles and practice. Colville, WA: Optimal Books.
  22. Gotlieb, J.B., (2002). Understanding the effects of nurses on the process by which patients develop hospital satisfaction. Holistic Nursing Practice; 16 (5), 49–60.
  23. Haltman. T, Coakley. A, Annese. C, Bouvier. S. (2012). Exploring the sleep experiences of adult patients, Creative Nursing; 18, 135-139.
  24. Harris, P., McBride, G., Ross, C., Curtis, L. (2002). A place to heal: environmental sources of satisfaction among hospital patients. Journal of Applied Social Psychology 32, 1276–1299.
  25. Horelli, L. (2006). Environmental human-friendliness as a contextual determinant for quality of life. Revue Européenne de PsychologieAppliquée, 56, 15e22.
  26. Huisman, E., Morales, E., Van Hoof, J., &Kort, H. (2012). Healing environment: A review of the impact of physical environmental factors on users. Building and Environment; 58 :70e80.
  27. Iso DIS. 9241–210:2010: ergonomics of human-system interaction—part 210: human-centred design for interactive systems (formerly known as 13407). Switzerland: International Standards Organization; 2010.
  28. Kaplan S. (1995). The restorative benefits of nature: Toward anintegrative framework. Journalof Environmental Psychology; 15,169–182.
  29. Kuniavsky M, Moed A, Goodman E. (2012). Observing the user experience. 2nd ed. Waltham, MA: Morgan Kaufmann.
  30. Lee, M. A., & Yom, Y. (2007). A comparative study of patients’ and nurses’ perceptions of the quality of nursing services, satisfaction and intent to revisit the hospital: a questionnaire survey. International Journal of Nursing Studies, 44, 545e555.
  31. Lis, C. G., Rodeghier, M., & Gupta, D. (2011). The relationship between perceived service quality and patient willingness to recommend at a national oncology hospital network. BMC Health Services Research, 11, 46.
  32. Moos R. H, Lemke S. (1984). Multiphasic environmental assessment procedure: Manual”, Palo Alto, CA: Social Ecology Laboratory; Veterans Administration and Stanford University Medical Center.
  33. Sakallaris, B. R., MacAllister, L., Voss, M., Smith, K., & Jonas, W. B. (2015). Optimal healing environments. Global Advances In Health And Medicine, 4, 40–45. doi:10.7453/gahmj.2015.043.
  34. Schweitzer, M., Gilpin, L., & Frampton, S. (2004). Healing spaces: elements of environmental design that make an impact on health. The Journal of Alternative and Complementary Medicine, 10(1), 71e83.
  35. Shumaker S. A, Pequegnat, W. (1989).Hospital design, health providers, and the delivery of effective health care, Advances in environment.behavior and design; Vol. 2 :pp. 161–199.
  36. Siddiqui Z, Zuccarelli R, Durkin N, Wu A, Brotman D. (2014), Changes in patient satisfactionrelated to hospital renovation: Experience with anew clinical building. Journal of Hospital Medicine;10, 1–7.
  37. Swan J E, Richardson, L. D, Hutton, J. D. (2003). “Do appealing hospital rooms increase patient evaluations of phycians, nurses and hospital services?”, Health Care Management Review; 28, 254.
  38. Ulrich RS, Giplin L. (2003). Healing arts: nutrition for the soul, San Francisco, CA: John Wiley & Sons.
  39. Yusoff Abbas M, Ghazali R. (2010). Healing environment of pediatric wards. journal of Procedia Social and Behavioral Sciences;vol(5),p.984-957.
  40. Zimring C, Reizenstein, CarpmanJ,Michelson W. (1987). Design for special populations: Mentally retarded persons, children, hospital visitors.  Handbook of environmental psychology; Vol. 2 (pp. 919–949). New York: Wiley.
  41. Zimring C.M, Bosch, S. (2008), Building the Evidence Base for Evidence-Based Design: Editors' Introduction. Environment and Behavior; 40(2): 147-150