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Pasha S, Shepley MM. A Structured Literature Review on the Research and Design of Rehabilitation Environments. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024:19375867241248604. [PMID: 38742748 DOI: 10.1177/19375867241248604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
AIM This literature review is conducted to identify knowledge gaps and shape a framework for the development of guidelines and future research on programming and design of rehabilitation environments. BACKGROUND Patients suffering from trauma, stroke, neurological or cardiopulmonary conditions, or recovering from surgery or cancer treatment require rehabilitation services. A comprehensive rehabilitation program can support continuum of care for inpatient and outpatient groups. However, within most facilities, rehabilitation environments are found to be outdated and undersized compared to other programs or lack the correct adjacencies within the facility. Unfortunately, this deficiency is echoed by limited guidelines on programming, planning, and design of these environments. General guidelines derived from healthcare environments research is not adaptable to rehabilitation environments, because the paradigm used in most healthcare environment research does not address specific needs of rehabilitation patients in regaining confidence or relearning daily life skills. METHOD We conducted a structured literature review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a basis for reporting the available body of work on evidence-based research in rehabilitation environments. RESULT AND CONCLUSION Through analysis of the limited literature, specific mediators such as patient confidence and motivation were identified. An environment that creates a balance between privacy and social interaction can promote these mediators. Creating enriched environments through elements that engage the senses and encourage more social and physical interaction is essential for recovery. Finally, accessibility and wayfinding are of great importance in these environments due to potential limited mobility or cognitive impairments of patients.
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Seale B, Davis A, Lawson J, Smith L, Watson J, Henderson-Wilson C. Nature-Based Design in Stroke Rehabilitation Environments: A Scoping Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024:19375867241251832. [PMID: 38742749 DOI: 10.1177/19375867241251832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE To identify, examine, and map the characteristics of knowledge of nature-based design in stroke rehabilitation facilities, examine how research in this field has been conducted and identify gaps in knowledge. BACKGROUND Many stroke survivors have wide ranging impacts, resulting in long hospital stays to undertake rehabilitation. The physical environment can influence brain recovery; however, there is limited evidence to support the design of effective rehabilitation environments. Conversely, the health benefits available from connection with nature are well established. A nature-based design approach may have benefits and implications for the physical environment of inpatient stroke rehabilitation facilities; however, it is unclear what evidence exists in this field. METHOD This scoping review followed the JBI methodological guidance for the conduct of scoping reviews, with systematic searches of six databases. RESULTS Twenty-eight studies were included in the review. Aims and research methods varied widely. Investigations in 19 studies related to gardens and other designed outdoor nature-based environments. Other studies explored natural analogues, nature inside, inside/outside connections, and the natural environment. Findings from the studies were spread across the fields of design, use, exposure to, and engagement in nature-based environments. CONCLUSION The characteristics of knowledge underpinning nature-based design in stroke rehabilitation environments are highly diverse, and significant gaps exist in the evidence base. A framework developed during this review for mapping knowledge on the intentions and impacts for spaces and services in this field assisted to identify these gaps and may be applied to other areas of healthcare design research.
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Affiliation(s)
- Belinda Seale
- Health Nature & Sustainability Research Group, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Aaron Davis
- UniSA Creative, University of South Australia, Adelaide, Australia
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Justin Lawson
- Health Nature & Sustainability Research Group, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Louisa Smith
- Disability and Inclusion, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Joanne Watson
- Disability and Inclusion, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Claire Henderson-Wilson
- Health Nature & Sustainability Research Group, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
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Moore H, Boisvert K, Bryan M, Hoare L, Gates M, Garnett B, Kennedy AG, Latreille M. Inspired to Garden: A Qualitative Study of Participants' Experiences in an Academic Medical Center Garden. Cureus 2023; 15:e41695. [PMID: 37575742 PMCID: PMC10413914 DOI: 10.7759/cureus.41695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Gardening is a healthy activity that promotes nutrition and satisfaction, with positive impacts on patients with chronic diseases, including patients with obesity, diabetes, and cardiovascular disease. Hospital-based gardening programs may provide opportunities to introduce patients to gardening. However, few studies have included participant experience as a metric of evaluation. The objective of this study was to explore participant experience in a hospital-based gardening intervention designed for individuals with metabolic syndrome. Methods This study was a qualitative evaluation of free text responses from four questions included in post-participation questionnaires from 59 community-dwelling adults who participated in a hospital-based garden program located at the University of Vermont Medical Center in 2020 and 2021. Eligible participants included a convenience sample of novice gardeners with self-reported hypertension, diabetes, pre-diabetes, or overweight/obesity. We used an interpretative phenomenological approach to analyze the questionnaire data. The phenomenological cycle for each of the questions included: 1) reading and re-reading participant responses, 2) exploratory noting, 3) constructing experimental statements, 4) searching for connections across statements, and 5) naming the themes. This process also involved working with individual question-level themes to develop group themes across questions. Results This dataset was one of positivity about gardening, new information gleaned, and the quality of instruction. Several themes and codes emerged: program implementation (new knowledge, new skills, new connections, instructor ability, climate), self-efficacy (confidence, vicarious experience, mastery experience, verbal persuasion), and future change (behavior change, future issues/problem-solving, passing it on). Conclusion This study supports analyzing participant experience as part of hospital-based gardening interventions. We found positivity around program implementation, increased self-efficacy, and intentions to change behavior in ways that support healthy lifestyles.
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Affiliation(s)
| | - Keelan Boisvert
- College of Arts and Sciences, University of Vermont, Burlington, USA
| | - Maria Bryan
- Medicine, University of Vermont Medical Center, Burlington, USA
| | - Lisa Hoare
- Nutrition Services, University of Vermont Medical Center, Burlington, USA
| | - Michelle Gates
- Executive Director, Vermont Garden Network, Essex Junction, USA
| | - Bernice Garnett
- College of Education and Social Services, University of Vermont, Burlington, USA
| | - Amanda G Kennedy
- Larner College of Medicine, University of Vermont, Burlington, USA
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Lee J, Kang M, Lee S, Lee S. Effects of Vegetation Structure on Psychological Restoration in an Urban Rooftop Space. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:260. [PMID: 36612582 PMCID: PMC9819547 DOI: 10.3390/ijerph20010260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/18/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Connectedness to nature has been recognized as an important factor for well-being, with rooftop green spaces being used for stress reduction in modern cities. This study aimed to examine psychological and physiological responses to three different vegetation models on an urban rooftop. An analysis of psychological parameters indicated that the existence of vegetation in rooftop spaces could have positive effects on mood states, and the size of the effect was greater in a structured vegetation design than in a monotonous one. An analysis of the physiological parameters of heart rate variability and systolic blood pressure indicated that greater restorative effects are elicited from the use of vertical elements, such as shrubs and trees, added to grassy areas than from concrete environments. However, a fully enclosed vegetation with trees was not associated with higher parasympathetic activities than a half-open vegetation model. Based on these findings, an open and structured vegetation design that includes both grass and shrubs may have more potential for stress reduction than a monotonous vegetation model. A larger volume of vegetation was not necessarily linked to higher psychological and physiological benefits.
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Affiliation(s)
- Juyoung Lee
- Department of Landscape Architecture, Hankyong National University, 327 Chungang-ro, Anseong 17579, Republic of Korea
| | - Minji Kang
- Department of Landscape Architecture, Hankyong National University, 327 Chungang-ro, Anseong 17579, Republic of Korea
| | - Sungku Lee
- Graduate School of Environmental Studies, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Seoyong Lee
- Department of Landscape Architecture, Hankyong National University, 327 Chungang-ro, Anseong 17579, Republic of Korea
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Lipson-Smith R, McLaughlan R. Mapping Healthcare Spaces: A Systematic Scoping Review of Spatial and Behavioral Observation Methods. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:351-374. [PMID: 35356828 DOI: 10.1177/19375867221089702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To provide a taxonomy of spatial observation methods that are commonly used in healthcare environments research and to describe their relative success. BACKGROUND Spatial observation is a valuable but resource intensive research method that is often used in healthcare environments research, but which frequently fails to deliver conclusive results. There is no existing catalog of the different spatial and behavioral observation methods that are used in healthcare design research and their benefits or limitations. METHODS The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ten key databases were searched, and articles were screened by both authors. RESULTS Across 67 included studies, 79 observation methods were reported. We categorized those into four, distinct methodological approaches, outlining the benefits, limitations, and suitability of each for obtaining different types of results. Common limitations included difficulty generalizing to other contexts and a lack of detailed description during data collection which led to key environment variables not being recorded. More concrete conclusions were drawn when observation methods were combined with complimentary methods such as interview. CONCLUSIONS The relative success of spatial observation studies is dependent on the fit of the method selected relative to the research question, approach, and healthcare setting; any complimentary methods delivered alongside it; and the analysis model employed. This article provides researchers with practical advice to guide the appropriate selection of spatial observation methods.
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Affiliation(s)
- Ruby Lipson-Smith
- School of Architecture and the Built Environment, University of Newcastle, Australia
| | - Rebecca McLaughlan
- School of Architecture and the Built Environment, University of Newcastle, Australia.,Sydney School of Architecture, Design & Planning, The University of Sydney, Australia
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Tseung V, Verweel L, Harvey M, Pauley T, Walker J. Hospital Outdoor Spaces: User Experience and Implications for Design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:256-267. [PMID: 34663106 DOI: 10.1177/19375867211045403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This article aims to describe users' perspectives about the impact of hospital outdoor spaces on the patient experience in a postacute setting. BACKGROUND Hospital outdoor space is an important element in healthcare facility design. There is growing evidence that access to green space within hospital outdoor spaces facilitates healing. However, limited studies have explored the users' perspective regarding how hospital outdoor spaces impact the patient experience. METHODS As part of a hospital preoccupancy evaluation, users (patients, family, and staff) were invited to participate in a semi-structured interview to describe their experiences in the hospital's outdoor spaces. Data were analyzed using inductive thematic analysis. RESULTS Seventy-four individuals participated in this study: 24 inpatients, 15 outpatients, 11 family, 23 staff, and one volunteer. Three themes were identified: (1) outdoor space benefits healing by helping patients focus on life beyond their illness, (2) design of healthcare spaces facilitates patients' access to outdoor space to benefit healing, and (3) programming in the outdoor space promotes healing and recovery. CONCLUSIONS This study describes the users' perspective regarding the value of outdoor spaces and the design elements that influence the patient experience.
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Affiliation(s)
- Victrine Tseung
- Campus Development, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Lee Verweel
- Research and Innovation, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Martha Harvey
- Campus Development, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Tim Pauley
- Research and Innovation, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Jan Walker
- West Park Healthcare Centre, Toronto, Ontario, Canada
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Cui W, Li Z, Xuan X, Lu C, Tang Q, Zhou S, Li Q. Influence of Hospital Outdoor Space on Physiological Electroencephalography (EEG) Feedback of Staff. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:239-255. [PMID: 34409863 DOI: 10.1177/19375867211030701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the differences and relationships between different outdoor spaces of hospitals on the physiological electroencephalography (EEG) feedback (PEEGF) of staff. BACKGROUND Relieving the pressure of hospital staff is essential, and several studies have revealed that even short-term exposure to outdoor space has a decompression effect. Yet, the focus is scarcely centered on the differences and influential relationships between the PEEGF from different outdoor spaces where the staff spend time, particularly in large-scale hospitals in China. METHODS EEG measurement equipment was utilized to obtain the value of β wave (vβw) that represents the stress and anxiety of staff in three different outdoor spaces: open, traffic, and rest. On the basis of EEG data, correlation analysis was conducted in accordance with the proportion of space elements. RESULTS The proportion of natural elements, such as landscape (r = -.800** p=.005) and waterscape (r = -.782* p=.013), were negatively correlated with the vβw produced by staff, while the proportion of hard paving was positive (r = .817** p=.004) with more vβw produced by staff. In other words, the percentage of landscape and waterscape can reduce stress, while hard paving has the opposite effect. Further, there was a difference in the amount of vβw generated between nurses and administrators in the open space at the entrance of the main building (p = .043). CONCLUSIONS The present study revealed the influence of different outdoor space elements of the hospital on the physiological feedback of staff, demonstrated the practical necessity of evidence-based design, and proposed relevant optimization suggestions.
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Affiliation(s)
- Weiyi Cui
- College of Architecture and Art, Hefei University of Technology, Hefei, China
| | - Zao Li
- College of Architecture and Art, Hefei University of Technology, Hefei, China
| | - Xiaodong Xuan
- College of Architecture and Art, Hefei University of Technology, Hefei, China
| | - Chao Lu
- The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qiqiang Tang
- Department of Neurology Disease, The First Affiliated Hospital of the University of Science and Technology of China, Hefei, China
| | - Shaobo Zhou
- The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qingtao Li
- Hefei Railway Engineering School, Hefei, China
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Vujcic Trkulja M, Tomicevic-Dubljevic J, Tosevski DL, Vukovic O, Toskovic O. Development of Evidence-Based Rehabilitation Practice in Botanical Garden for People With Mental Health Disorders. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:242-257. [PMID: 33858211 DOI: 10.1177/19375867211007941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM This article aims to make clearer, with supporting evidence, the clinical benefits of the nature-based rehabilitation program (NBRP) and the restorative values of visiting botanical garden for people with stress-related mental disorders. BACKGROUND Throughout the years, nature-based therapy has been acknowledged as a valuable rehabilitation practice that integrates specially designed natural environments and nature-related activities for people with mental health conditions. SUBJECT AND METHODS The comparative analyses of parallel conducted the NBRP at botanical garden and occupational therapy realised at the Day Hospital of the Institute of Mental Health in Belgrade included 27 participants divided into two groups. The data collection employed a mixed method combining a Clinical Global Impression (CGI) Scale and on-site observations. RESULTS The positive findings on the psychological recovery of the participants seem to be related to NBRP. The restorative potential of the garden was recognized through the observed interaction between participants and the natural entities employed through the various themed activities. The observed landscape elements especially solitary plant specimens or tall and single-form trees within the garden can be embraced as design guidelines for the development of an evidence-based practice that can support the recovery process of people with mental health conditions. CONCLUSION Our findings endorse that ongoing social development and progressive urbanization have broadened the interest in scientific research involving nature-based solutions that help preserve the physical and mental health of people in low- and middle-income Western Balkan countries with a high prevalence of mental disorders in the urban environment that relates to social inequalities and natural disasters.
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Affiliation(s)
- Maja Vujcic Trkulja
- Environment and Sustainable Development, 217879Singidunum University, Belgrade, Serbia
| | - Jelena Tomicevic-Dubljevic
- Department of Landscape Architecture and Horticulture, Faculty of Forestry, 54801University of Belgrade, Serbia
| | | | - Olivera Vukovic
- Department of Psychiatry, School of Medicine, 54801University of Belgrade, Serbia.,Institute of Mental Health, Belgrade, Serbia
| | - Oliver Toskovic
- Laboratory for Experimental Psychology, Faculty of Philosophy, 54801University of Belgrade, Serbia
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Martin K, Nanu L, Kwon WS, Martin D. Small Garden, Big Impact: Emotional and Behavioral Responses of Visitors to a Rooftop Atrium in a Major Hospital. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:274-287. [PMID: 33576250 DOI: 10.1177/1937586721992799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To measure hospital visitors' satisfaction with a rooftop atrium and its resultant impact on the visitors' behavioral intentions toward the healing garden, the hospital, and overall satisfaction with the hospital. BACKGROUND There is a significant lack of empirical research that links the emotional and behavioral responses toward healing gardens and the hospitals providing them. METHODS A purposeful sample of 96 visitors to the healing garden in the rooftop atrium of a surgery building in a major hospital in the Southeastern United States completed a survey based on Roger Ulrich's Theory of Supportive Gardens and the Stimulus, Organism, Response (S-O-R) paradigm. RESULTS Findings of this study suggest visitors' experience with the healing garden can lead to overall satisfaction with the hospital and behavioral intentions toward the hospital. Visitors' satisfaction with the healing garden significantly predicted their satisfaction with the hospital, their intend to revisit the hospital, and their intend to recommend it. CONCLUSIONS This study demonstrates that a small healing garden can be a powerful enough space to impact visitors' overall satisfaction with the hospital and their intentions regarding their future behavior toward the hospital, such as revisiting or recommending the hospital.
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Affiliation(s)
- Kelly Martin
- Department of Consumer and Design Sciences, 1383Auburn University, AL, USA
| | - Luana Nanu
- Department of Nutrition, Dietetics, & Hospitality Management, 1383Auburn University, AL, USA
| | - Wi-Suk Kwon
- Department of Consumer and Design Sciences, 1383Auburn University, AL, USA
| | - David Martin
- Department of Nutrition, Dietetics, & Hospitality Management, 1383Auburn University, AL, USA
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Uwajeh PC, Iyendo TO, Polay M. Therapeutic gardens as a design approach for optimising the healing environment of patients with Alzheimer's disease and other dementias: A narrative review. Explore (NY) 2019; 15:352-362. [PMID: 31230998 DOI: 10.1016/j.explore.2019.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 05/02/2019] [Accepted: 05/23/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The first half of this paper documents the role of nature in healthcare environments and its impact on wellness, with a particular focus on gardens. The second half presents a scientific evaluation of the role of gardens as a therapeutic intervention to optimise the clinical outcomes in patients with Alzheimer's disease (AD) and dementia, including a review of the innovative application of technologies alongside nature to promote cognitive rehabilitation in this particular patient population. METHODS Using search engines such as the Institute for Scientific Information (ISI) Web of Science, PubMed, ProQuest Central, MEDLINE, Scopus and Google Scholar, a relevant literature search on the positive health implications of therapeutic gardens (TG) on AD and dementia patients in the healthcare milieu was conducted. RESULTS The health implications of TG for AD and dementia patients span physical, social, psychological and cognitive effects. Virtual reality (VR) technologies that display natural environments also offer positive cognitive outcomes for AD and dementia patients. CONCLUSION TG should be used to improve the health and wellbeing of AD and dementia patients, and its application should be extended to other patient populations to promote quicker recovery. Future directions in the design of TG, with a focus on patients with AD and other dementias, is also discussed.
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Affiliation(s)
- Patrick Chukwuemeke Uwajeh
- Department of Architecture, Eastern Mediterranean University, Faculty of Architecture, Mersin 10, Gazimağusa, North Cyprus, Turkey
| | | | - Mukaddes Polay
- Department of Architecture, Eastern Mediterranean University, Faculty of Architecture, Mersin 10, Gazimağusa, North Cyprus, Turkey
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Weerasuriya R, Henderson-Wilson C, Townsend M. Accessing Green Spaces Within a Healthcare Setting: A Mixed Studies Review of Barriers and Facilitators. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 12:119-140. [PMID: 30482056 DOI: 10.1177/1937586718810859] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review describes the facilitators and barriers impacting on passive access to green spaces within healthcare settings. A systematic mixed-studies review was undertaken to review the quantitative and qualitative evidence on access to green spaces within healthcare settings, as well as to review the methodological quality of the studies eligible for inclusion. A total of 24 articles met the inclusion criteria and were included in the review. The barriers to access were grouped into three themes: "awareness," "accessibility," and "comfort." The facilitators were grouped into 13 themes: "flora and foliage," "views," "water features," "sun, rain, fresh air, wind," "animal life," "diverse textures, heights, shapes," "lawn," "natural versus artificial material," "rest areas," "shade," "private areas," "play equipment," and "safety." These findings can be explained through multiple lenses, using existing theories on contact with nature and supportive garden design. In an era of elevated stress, patient admissions, and staff turnover in hospitals, and rising costs of providing healthcare services, the creation of settings conducive to health promotion, stress reduction, and faster recovery is relevant and timely. This article, which has collated over three decades of research evidence, is invaluable in addressing this issue.
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Affiliation(s)
- Rona Weerasuriya
- 1 Faculty of Health, Health Nature and Sustainability Research Group, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
| | - Claire Henderson-Wilson
- 1 Faculty of Health, Health Nature and Sustainability Research Group, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
| | - Mardie Townsend
- 1 Faculty of Health, Health Nature and Sustainability Research Group, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
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Lygum VL, Poulsen DV, Djernis D, Djernis HG, Sidenius U, Stigsdotter UK. Post-Occupancy Evaluation of a Crisis Shelter Garden and Application of Findings Through the Use of a Participatory Design Process. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 12:153-167. [PMID: 30463449 DOI: 10.1177/1937586718812444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study concerned optimization of an evidence-based crisis shelter garden as a setting for everyday activities and nature-based therapy. The study hereby tested the design guidelines that the garden is based on. BACKGROUND Design guidelines for gardens intended to support health are becoming increasingly specialized, targeting different user groups. This study contributes to the knowledge concerning health-supporting garden design at crisis shelters for women and children who are exposed to domestic violence. METHOD The study included a post-occupancy evaluation (POE) consisting of landscape analyses, observation of physical traces, and interviews as well as a subsequent participatory design process. RESULTS The landscape analyses and the observation of physical traces indicated a minimal level of maintenance and recurrent use being limited to a few areas of the garden. The interviews added nuance and new issues to these results, resulting in the following themes: maintenance, accessibility, safety, therapeutic setting and free space, many ways to play, and social and private spheres. The participatory design process led to an optimization of the garden, including changes to its physical design related to making the garden safer, positively distractive, and more versatile in terms of activities. Improvements were also made regarding policy for use, maintenance, and informing users. CONCLUSION The design guidelines were tested, and the evidence was strengthened, adding nuance and new issues to consider during further development of the guidelines. Both the POE and the participatory design process were confirmed as crucial aspects of evidence-based health design.
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Affiliation(s)
- Victoria L Lygum
- 1 Section of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Frederiksberg C, Denmark
| | - Dorthe V Poulsen
- 1 Section of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Frederiksberg C, Denmark
| | - Dorthe Djernis
- 1 Section of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Frederiksberg C, Denmark
| | | | - Ulrik Sidenius
- 1 Section of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Frederiksberg C, Denmark
| | - Ulrika K Stigsdotter
- 1 Section of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Frederiksberg C, Denmark
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Miedema E, Lindahl G, Elf M. Conceptualizing Health Promotion in Relation to Outpatient Healthcare Building Design: A Scoping Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 12:69-86. [PMID: 30203663 DOI: 10.1177/1937586718796651] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: This review explored different conceptualizations of health promotion in the context of, and in relation to, outpatient building design. BACKGROUND: Today's healthcare organizations are implementing holistic healthcare approaches such as health promotion, while simultaneously increasing their outpatient services. These health promotion approaches, focused on empowering people to take control of their health, are expected to have implications for the outpatient healthcare building design. Yet there is limited knowledge what these may be. A review of the literature on the current state of the art is thus needed to enable and support dialog on future healthcare building design. METHOD: A scoping review of 4,506 papers, collected from four databases and three scientific journals in 2015, resulted in 14 papers relating health promotion to building design and outpatient healthcare. From the subsequent content analysis, multiple common themes and subthemes emerged. RESULTS: The review reveals diverse range of health promotion interpretations, three health promotion perspectives (health behavior, health equity, and sense of coherence), associated design approaches, design objectives, health-related outcomes, building features, and solutions. CONCLUSIONS: While diverse health promotion perspectives might merely represent variations in focus, these differences become problematic when relating to building design. To support further dialogs on development of health promotion in, and in relation to, the build environment, there is a need to strengthen the health promotion vocabulary. Further research is needed to compare different design approaches and how these can be combined to minimize contradicting implications for building design.
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Affiliation(s)
- Elke Miedema
- 1 Division of Building Design, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Göran Lindahl
- 1 Division of Building Design, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Marie Elf
- 1 Division of Building Design, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden.,2 School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
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Stichler JF. State of the Science in Healthcare Design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2017; 10:6-12. [PMID: 28335627 DOI: 10.1177/1937586716676552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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15
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Devlin AS, Andrade CC. Quality of the Hospital Experience: Impact of the Physical Environment. HANDBOOK OF ENVIRONMENTAL PSYCHOLOGY AND QUALITY OF LIFE RESEARCH 2017. [DOI: 10.1007/978-3-319-31416-7_23] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Spring JA. Design of evidence-based gardens and garden therapy for neurodisability in Scandinavia: data from 14 sites. Neurodegener Dis Manag 2016; 6:87-98. [PMID: 27033715 DOI: 10.2217/nmt.16.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM A total of 14 Scandinavian therapy gardens were visited and data collected on plantings, therapeutic activities and assessment of effectiveness in Spring 2014. METHODOLOGY Data were gathered by a questionnaire and by interviewing staff in Sweden, Denmark and Norway. The data collection structured proforma used the post-occupation assessment method. RESULTS Gardening promoted physical movement, presented cognitive challenges and provided opportunities for social participation. Half the gardens were enclosed with sensory plants and 85% were adapted for wheelchairs. A total of 57% of gardens visited had simple designs with flowers, shrubs, lawns and trees. A social center was important especially for dementia clients. Planted pots were used in 79% of gardens. The effectiveness of therapy gardens was assessed at 71% of sites.
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Sandal LF, Thorlund JB, Ulrich RS, Dieppe PA, Roos EM. Exploring the effect of space and place on response to exercise therapy for knee and hip pain--a protocol for a double-blind randomised controlled clinical trial: the CONEX trial. BMJ Open 2015; 5:e007701. [PMID: 25818278 PMCID: PMC4386269 DOI: 10.1136/bmjopen-2015-007701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Context effects are described as effects of a given treatment, not directly caused by the treatment itself, but rather caused by the context in which treatment is delivered. Exercise is a recommended core treatment in clinical guidelines for musculoskeletal disorders. Although moderately effective overall, variation is seen in size of response to exercise across randomised controlled trial (RCT) studies. Part of this variation may be related to the fact that exercise interventions are performed in different physical environments, which may affect participants differently. The study aims to investigate the effect of exercising in a contextually enhanced physical environment for 8 weeks in people with knee or hip pain. METHODS AND ANALYSIS The study is a double-blind RCT. Eligible participants are 35 years or older with persisting knee and/or hip pain for 3 months. Participants are randomised to one of three groups: (1) exercise in a contextually enhanced environment, (2) exercise in a standard environment and (3) waiting list. The contextually enhanced environment is located in a newly built facility, has large windows providing abundant daylight and overlooks a recreational park. The standard environment is in a basement, has artificial lighting and is marked by years of use; that is, resembling many clinical environments. The primary outcome is the participant's global perceived effect rated on a seven-point Likert scale after 8 weeks exercise. Patient-reported and objective secondary outcomes are included. ETHICS AND DISSEMINATION The Regional Scientific Ethical Committee for Southern Denmark has approved the study. Study findings will be disseminated in peer-reviewed publications and presented at national and international conferences. TRIAL REGISTRATION NUMBER NCT02043613.
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Affiliation(s)
- Louise Fleng Sandal
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jonas Bloch Thorlund
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | | | - Ewa M Roos
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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