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Fernandes S, Brousse Y, Zendjidjian X, Cano D, Riedberger J, Llorca PM, Samalin L, Dassa D, Trichard C, Laprevote V, Sauvaget A, Abbar M, Misdrahi D, Berna F, Lancon C, Coulon N, El-Hage W, Rozier PE, Benoit M, Giordana B, Caqueo-Urízar A, Yon DK, Tran B, Auquier P, Fond G, Boyer L. Psychometric Assessment of an Item Bank for Adaptive Testing on Patient-Reported Experience of Care Environment for Severe Mental Illness: Validation Study. JMIR Ment Health 2024; 11:e49916. [PMID: 38753416 PMCID: PMC11140279 DOI: 10.2196/49916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/15/2023] [Accepted: 01/21/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The care environment significantly influences the experiences of patients with severe mental illness and the quality of their care. While a welcoming and stimulating environment enhances patient satisfaction and health outcomes, psychiatric facilities often prioritize staff workflow over patient needs. Addressing these challenges is crucial to improving patient experiences and outcomes in mental health care. OBJECTIVE This study is part of the Patient-Reported Experience Measure for Improving Quality of Care in Mental Health (PREMIUM) project and aims to establish an item bank (PREMIUM-CE) and to develop computerized adaptive tests (CATs) to measure the experience of the care environment of adult patients with schizophrenia, bipolar disorder, or major depressive disorder. METHODS We performed psychometric analyses including assessments of item response theory (IRT) model assumptions, IRT model fit, differential item functioning (DIF), item bank validity, and CAT simulations. RESULTS In this multicenter cross-sectional study, 498 patients were recruited from outpatient and inpatient settings. The final PREMIUM-CE 13-item bank was sufficiently unidimensional (root mean square error of approximation=0.082, 95% CI 0.067-0.097; comparative fit index=0.974; Tucker-Lewis index=0.968) and showed an adequate fit to the IRT model (infit mean square statistic ranging between 0.7 and 1.0). DIF analysis revealed no item biases according to gender, health care settings, diagnosis, or mode of study participation. PREMIUM-CE scores correlated strongly with satisfaction measures (r=0.69-0.78; P<.001) and weakly with quality-of-life measures (r=0.11-0.21; P<.001). CAT simulations showed a strong correlation (r=0.98) between CAT scores and those of the full item bank, and around 79.5% (396/498) of the participants obtained a reliable score with the administration of an average of 7 items. CONCLUSIONS The PREMIUM-CE item bank and its CAT version have shown excellent psychometric properties, making them reliable measures for evaluating the patient experience of the care environment among adults with severe mental illness in both outpatient and inpatient settings. These measures are a valuable addition to the existing landscape of patient experience assessment, capturing what truly matters to patients and enhancing the understanding of their care experiences. TRIAL REGISTRATION ClinicalTrials.gov NCT02491866; https://clinicaltrials.gov/study/NCT02491866.
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Affiliation(s)
- Sara Fernandes
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Yann Brousse
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Xavier Zendjidjian
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Delphine Cano
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Jérémie Riedberger
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Pierre-Michel Llorca
- Department of Psychiatry, Centre Hospitalier Universitaire de Clermont-Ferrand, University of Clermont Auvergne, Centre national de la recherche scientifique, Institut national polytechnique de Clermont Auvergne, Institut Pascal UMR 6602, Clermont-Ferrand, France
| | - Ludovic Samalin
- Department of Psychiatry, Centre Hospitalier Universitaire de Clermont-Ferrand, University of Clermont Auvergne, Centre national de la recherche scientifique, Institut national polytechnique de Clermont Auvergne, Institut Pascal UMR 6602, Clermont-Ferrand, France
| | - Daniel Dassa
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | | | - Vincent Laprevote
- Department of Addictology and Psychiatry, Centre Psychothérapique de Nancy, Laxou, France
- Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Université de Strasbourg, Institut national de la santé et de la recherche médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Anne Sauvaget
- Nantes Université, Centre Hospitalier Régional Universitaire de Nantes, Movement - Interactions - Performance - MIP UR 4334, Nantes, France
| | - Mocrane Abbar
- Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, University of Montpellier, Nîmes, France
| | - David Misdrahi
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Fabrice Berna
- Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Université de Strasbourg, Institut national de la santé et de la recherche médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Christophe Lancon
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Nathalie Coulon
- Centre Expert Schizophrénie, Centre Expert TSA-SDI et Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive - C3R, Centre Hospitalier Alpes Isère, Grenoble, France
| | - Wissam El-Hage
- Centre Hospitalier Régional Universitaire de Tours, Clinique Psychiatrique Universitaire, Tours, France
| | | | - Michel Benoit
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | - Bruno Giordana
- Department of Psychiatry, Hopital Pasteur, University Hospital of Nice, Nice, France
| | | | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Bach Tran
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
- Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Pascal Auquier
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Guillaume Fond
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
| | - Laurent Boyer
- Assistance Publique-Hopitaux de Marseille, Aix-Marseille University, UR3279: Health Service Research and Quality of Life Center - CEReSS, Marseille, France
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Huang G, Yengannagari AR, Matsumori K, Patel P, Datla A, Trindade K, Amarsanaa E, Zhao T, Köhler U, Busko D, Richards BS. Radiative cooling and indoor light management enabled by a transparent and self-cleaning polymer-based metamaterial. Nat Commun 2024; 15:3798. [PMID: 38714689 PMCID: PMC11076518 DOI: 10.1038/s41467-024-48150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/19/2024] [Indexed: 05/10/2024] Open
Abstract
Transparent roofs and walls offer a compelling solution for harnessing natural light. However, traditional glass roofs and walls face challenges such as glare, privacy concerns, and overheating issues. In this study, we present a polymer-based micro-photonic multi-functional metamaterial. The metamaterial diffuses 73% of incident sunlight, creating a more comfortable and private indoor environment. The visible spectral transmittance of the metamaterial (95%) surpasses that of traditional glass (91%). Furthermore, the metamaterial is estimated to enhance photosynthesis efficiency by ~9% compared to glass roofs. With a high emissivity (~0.98) close to that of a mid-infrared black body, the metamaterial is estimated to have a cooling capacity of ~97 W/m2 at ambient temperature. The metamaterial was about 6 °C cooler than the ambient temperature in humid Karlsruhe. The metamaterial exhibits superhydrophobic performance with a contact angle of 152°, significantly higher than that of glass (26°), thus potentially having excellent self-cleaning properties.
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Affiliation(s)
- Gan Huang
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany.
| | - Ashok R Yengannagari
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Kishin Matsumori
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Prit Patel
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Anurag Datla
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Karina Trindade
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Enkhlen Amarsanaa
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Tonghan Zhao
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Uwe Köhler
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Dmitry Busko
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - Bryce S Richards
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344, Eggenstein-Leopoldshafen, Germany.
- Light Technology Institute, Karlsruhe Institute of Technology, Engesserstrasse 1, 376131, Karlsruhe, Germany.
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Hagerup A, Wijk H, Lindahl G, Olausson S. Toward a Future Orientation: A Supportive Mental Health Facility Environment. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:38-56. [PMID: 38259241 PMCID: PMC11080379 DOI: 10.1177/19375867231221151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND The provision of supportive environments is essential in clinical and environmental psychology. Mental health disorders are a major issue, and the experience of being at a mental health facility is affected by numerous factors related to the building's design. AIM The aim of this study is to explore the expectations of a mental health facility planning group regarding the potential impact of a supportive design on patients' mental health and staff's therapeutic practices when planning and designing a new mental health facility. METHODS The new mental health facility is a case study and data were collected through qualitative in-depth interviews with nine participants and analyzed using a thematic analysis. The participants came from a mental health facility planning group in a new mental health facility in Norway. RESULTS The overall expectation of the new building was related to a future orientation to support patients' mental health and therapeutic practices. Three main themes were identified: toward a future orientation, supportive building design, and work environment. CONCLUSIONS Supportive environments are expected to influence patients' mental health and staff's therapeutic practices, including providing options for novel treatment needs in contrast to older and more outdated buildings that are perceived as hindering appropriate treatment conditions.
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Affiliation(s)
- Anne Hagerup
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Inland School of Business and Social Sciences, Inland Norway University of Applied Sciences, Inland Norway
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Quality strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Center for Healthcare Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Göran Lindahl
- Division of Construction Management/Center for Healthcare Architecture, Department of Architecture and Civil Engineering, Chalmers University of Technology, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Anesthesiology and Intensive Care/Sahlgresnka, Sahlgrenska University Hospital, Gothenburg, Sweden
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4
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Gharaveis A, Hamilton DK, Pati D, Shepley MM, Rodiek S, McCall D. How Visibility May Reduce Security Issues in Community Hospitals' Emergency Departments. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:135-147. [PMID: 37522704 DOI: 10.1177/19375867231188985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This research explored the relationship between visibility and the level of security risks as perceived by nurses and physicians in emergency departments (EDs). Security in EDs has been reported as a major global concern, and visibility has been identified as a design factor impacting behavior. However, few previous studies have rigorously investigated the role of visibility in reduction of ED security risks with evidence-based design approach. There is a lot of significant questions about how visibility impacts the reduction of security issues in EDs. METHODS How visibility may influence ED security was explored via qualitative methods in five EDs using semi-structured one-on-one interviews with 17 clinical staff and 48 hr of field observations. The coding process for both interviews and observational notes followed the principles of naturalistic inquiry. RESULTS The findings suggest security risks can be decreased by improving visibility. Medical staff (registered nurses and physicians) felt more secure in the EDs with higher visibility. DISCUSSION This study provides a framework to identify preferable levels of visibility in EDs and proposes design strategies to minimize security issues. Registered nurses and physicians can improve their team's sense of security by considering visibility throughout their daily practices.
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Affiliation(s)
| | | | | | | | | | - Denise McCall
- Emergency Department, Houston Methodist West Hospital, TX, USA
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5
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Patel V, Saxena S, Lund C, Kohrt B, Kieling C, Sunkel C, Kola L, Chang O, Charlson F, O'Neill K, Herrman H. Transforming mental health systems globally: principles and policy recommendations. Lancet 2023; 402:656-666. [PMID: 37597892 DOI: 10.1016/s0140-6736(23)00918-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/18/2023] [Accepted: 05/02/2023] [Indexed: 08/21/2023]
Abstract
A burgeoning mental health crisis is emerging globally, regardless of each country's human resources or spending. We argue that effectively responding to this crisis is impeded by the dominant framing of mental ill health through the prism of diagnostic categories, leading to an excessive reliance on interventions that are delivered by specialists; a scarcity of widespread promotive, preventive, and recovery-oriented strategies; and failure to leverage diverse resources within communities. Drawing upon a series of syntheses, we identify five principles to transform current practices; namely, address harmful social environments across the life course, particularly in the early years; ensure that care is not contingent on a categorical diagnosis but aligned with the staging model of mental illness; empower diverse front-line providers to deliver psychosocial interventions; embrace a rights-based approach that seeks to provide alternatives to violence and coercion in care; and centre people with lived experience in all aspects of care. We recommend four policy actions which can transform these principles into reality: a whole of society approach to prevention and care; a redesign of the architecture of care delivery to provide a seamless continuum of care, tailored to the severity of the mental health condition; investing more in what works to enhance the impact and value of the investments; and ensuring accountability through monitoring and acting upon a set of mental health indicators. All these actions are achievable, relying-for the most part-on resources already available to every community and country. What they do require is the acceptance that business as usual will fail and the solutions to transforming mental health-care systems are already present within existing resources.
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Affiliation(s)
- Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Shekhar Saxena
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Crick Lund
- Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Brandon Kohrt
- Center for Global Mental Health Equity, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Christian Kieling
- School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Charlene Sunkel
- Global Mental Health Peer Network, Paarl, Cape Town, South Africa
| | - Lola Kola
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Odille Chang
- College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Fiona Charlson
- School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Kathryn O'Neill
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Helen Herrman
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Arya DK. Future-proofing structural design of an acute mental health inpatient unit. Australas Psychiatry 2023; 31:466-468. [PMID: 37036410 DOI: 10.1177/10398562231169125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
OBJECTIVE The design of an acute mental health inpatient facility must enable the provision of safe and effective care in an environment that is therapeutic. To be able to do that, in addition to the fittings, light and general ambience, a future design of such a facility must consider how consumers are likely to access mental healthcare in the future, what aspects of care they are likely to find value-adding and how the inpatient aspect of their care is likely to be integrated within their care continuum. CONCLUSIONS The future design must anticipate how consumers are likely to access information, support, care and treatment, how workflows of staff are likely to change, how the diverse needs of mental health consumers will need to be accommodated and how the needs and expectations of staff will be met to enable them to provide support to mental health consumers. A future design of a mental health inpatient unit may have to be very different from the current thinking about the design of such facilities.
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Affiliation(s)
- Dinesh K Arya
- ACT's Chief Psychiatrist and Chief Medical Officer, ACT Health, Canberra, ACT, Australia
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Pereira LM, Ornstein SW. A Systematic Literature Review on Healthcare Facility Evaluation Methods. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:338-361. [PMID: 37157787 DOI: 10.1177/19375867231166094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
To present a systematic literature review on predesign evaluation (PDE), postoccupancy evaluation (POE), and evidence-based design (EBD); to delimit the concepts and relationships of these terms and place them in the building life cycle framework to guide their application and indicate a common understanding and possible gaps. The preferred reporting items for systematic reviews and meta-analyses protocol was used. Inclusion criteria cover texts that present a concept, method, procedure, or tool and use the example in healthcare services or other environments. The reports were excluded if there was no evidence of a relationship between the terms, if cited rhetorically, duplicated, or if an instrument was not related to at least one other term. The identification used Scopus and Web of Science and considered reports until December 2021 (search period). When extracting the evidence, formal quality criteria were observed and sentences and other elements were collected as evidence and tabulated to segment topics of interest. The searches identified 799 reports with 494 duplicates. In the selection, 53 records were selected from 305 obtained in 14 searches. The classification extracted concepts, relationships, and frameworks. Results indicate a consistent understanding of POE and EBD and a diffuse understanding of PDE. A summary of the three concepts including two frameworks is proposed. Situations are contextualized where these frameworks are used in specific areas of research. One of these frameworks provides a basis for classifying building assessment methods, procedures, and tools but does not detail the classification criteria. Thus, more detailed adjustments should be considered in specific studies.
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Affiliation(s)
- Lucas Melchiori Pereira
- Faculty of Architecture and Urbanism at the University of São Paulo (FAUUSP), FAU Cidade Universitária. Rua do Lago, São Paulo, Brazil
| | - Sheila Walbe Ornstein
- Faculty of Architecture and Urbanism at the University of São Paulo (FAUUSP), FAU Cidade Universitária. Rua do Lago, São Paulo, Brazil
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Hjort M, Mau M, Høj M, Roessler KK. The Importance of the Outdoor Environment for the Recovery of Psychiatric Patients: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2240. [PMID: 36767605 PMCID: PMC9915437 DOI: 10.3390/ijerph20032240] [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: 12/23/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Research has shown that patients with mental health diagnoses experience less anxiety and depressive symptoms and higher levels of 'well-being' when they spend time in natural environments as part of their treatment. It has been suggested that there is a relationship between the outdoor settings and the recovery of psychiatric patients. Recovery describes an individual process, which can vary from person to person. (2) Methods: This scoping review examined the relationship between the physical environment and the recovery of psychiatric patients. Systematic searches in three online databases, namely Medline, Embase, and PsycINFO, were performed using a selection of psychiatric, environmental, and recovery terms and included both quantitative and qualitative studies. In general, 'well-being' serves as an overarching indicator when it comes to research on how outdoor settings can affect mental health. Well-being was expressed in terms of mood, social relations, and autonomy. (3) Results: A total of 8138 records were screened, 85 studies were included for full-text reading, and five articles were included in the final analysis. The review showed in general that outdoor settings, more specifically gardening, contact with nature, and a safe environment can be related to the well-being of patients on psychiatric wards. (4) Conclusions: The five reviews allow us to conclude that outdoor settings can be seen as a comprehensive resource for mental health.
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Affiliation(s)
- Mikkel Hjort
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
| | - Martin Mau
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
- Health, Social Work and Welfare Research, UCL University College, 5230 Odense, Denmark
| | - Michaela Høj
- Mental Health Center Ballerup, Competence Center for Rehabilitation and Recovery, 2750 Ballerup, Denmark
| | - Kirsten K. Roessler
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
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Bergefurt L, Appel-Meulenbroek R, Maris C, Arentze T, Weijs-Perrée M, de Kort Y. The influence of distractions of the home-work environment on mental health during the COVID-19 pandemic. ERGONOMICS 2023; 66:16-33. [PMID: 35311483 DOI: 10.1080/00140139.2022.2053590] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
Previous research showed that office workers are mainly distracted by noise, influencing their mental health. Little investigation has been done into the influence of other workspace characteristics (i.e. temperature, amount of space, visual privacy, adjustability of furniture, wall colours, and workspace cleanliness) on distractions at the office, and even fewer while working from home (WFH). The influence of home-workspace distractions on mental health also received limited attention. This research aims to investigate relationships between home-workspace and personal characteristics, distraction, and mental health while WFH during COVID-19. A path analysis approach was used, to find that, at home, employees were distracted by noise and when having a small desk. Those with a dedicated workroom were less distracted. Distractions mediated most relationships between home-workspace characteristics and mental health, while personal characteristics influenced mental health directly. Employers can use these results to redesign policies regarding home-and-office working to stimulate a healthy work environment.Practitioner summary: The investigation of the influence of home-workspace characteristics on distractions and mental health while WFH during COVID-19 appears to be limited. This research filled this gap by performing a path analysis, using a holistic definition of mental health. Findings showed that distractions mediate relationships between home-workspace characteristics and mental health.
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Affiliation(s)
- Lisanne Bergefurt
- Faculty of the Built Environment, Eindhoven University of Technology, Eindhoven, Netherlands
| | | | - Celine Maris
- Faculty of the Built Environment, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Theo Arentze
- Faculty of the Built Environment, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Minou Weijs-Perrée
- Faculty of the Built Environment, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Yvonne de Kort
- Faculty of Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
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10
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Jiao D, Tang J, Guo R. Proactive health interventions in the workplace: The role of spatial playfulness in promoting mental health. Work 2023; 76:1203-1217. [PMID: 37212083 DOI: 10.3233/wor-220486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND The high prevalence of mental illnesses has a serious impact on productive life and there is an urgent need to intervene using a variety of active and effective measures. OBJECTIVE The concept of playfulness in space is introduced into the design of work spaces oriented towards active health interventions, creating a close interaction between the body and the space through play, thus developing a positive effect on the promotion of the physical and mental health of the staff. METHODS With the help of the spatial order theory, the analysis of the interaction between body and space is attempted to explore the form, structure and scene of space in order to optimize the body's perception, cognition and behavior in the space, thus creating an indoor workspace model with positive intervention effects on human health. RESULTS Based on the idea of spatial playful participation in active health interventions, this study explores the interaction between the body and the architectural space to enhance the perception and cognitive guidance of the space for the individual and to have a pleasant spiritual experience in the interaction to relieve work stress and enhance mental health. CONCLUSION This series of discussions on the relationship between architectural space and the human body is of great relevance in improving the public health of occupational groups.
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Affiliation(s)
- Dian Jiao
- School of Architecture and Fine Arts, Dalian University of Technology, Dalian, China
| | - Jian Tang
- School of Architecture and Fine Arts, Dalian University of Technology, Dalian, China
| | - Rui Guo
- School of Architecture and Fine Arts, Dalian University of Technology, Dalian, China
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Faerden A, Rosenqvist C, Håkansson M, Strøm-Gundersen E, Stav Å, Svartsund J, Røssæg T, Davik N, Kvarstein E, Pedersen G, Dieset I, Nyrud AQ, Weedon-Fekjær H, Kistorp KM. Environmental Transformations Enhancing Dignity in an Acute Psychiatric Ward: Outcome of a User-Driven Service Design Project. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 16:55-72. [PMID: 36567605 PMCID: PMC10133780 DOI: 10.1177/19375867221136558] [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: 12/27/2022]
Abstract
OBJECTIVES The goal of the current project was to enhance the feeling of dignity for patients in the seclusion unit in an acute psychiatric ward through environmental design changes and to evaluate the effect of the refurbishment. BACKGROUND Treating people with dignity is essential in all health-related work and important for our mental health. Hospital architecture and design signal values that can promote dignity. Patients who must spend time in seclusion are at their most vulnerable mental state and the often worn-down like environment can challenge the feeling of dignity. How environmental design can promote dignity in seclusion units have not been studied. METHODS To reach suggestions for design changes enhancing dignity, we used service design that included a broad user group. The effect of design changes was evaluated by a questionnaire answered by the nursing staff during a 4-week period pre- and post refurbishment and included a control group. RESULTS The design concepts agreed upon were a welcoming atmosphere, contact with nature, room for privacy, close contact with staff, and a designated smoking area inside the unit. The evaluation found that the environmental design changes significantly supported the patients in their situation and the staff in their work. CONCLUSION We conclude that dignity design concepts are highly applicable also in an acute psychiatric setting and improve the situation of secluded mental health patients, which is much needed. Findings align with other environmental changes in psychiatric wards that improve the patients' well-being and reduce aggression.
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Affiliation(s)
- Ann Faerden
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | - Christine Rosenqvist
- User Representative Advisory Board, Department of Acute Psychiatry, Oslo University Hospital, Norway
| | | | | | | | | | - Trude Røssæg
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | - Nils Davik
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | - Elfrida Kvarstein
- Section for Personality Psychiatry and Specialized Treatment, Oslo University Hospital, Norway
| | - Geir Pedersen
- Section for Personality Psychiatry and Specialized Treatment, Oslo University Hospital, Norway
| | - Ingrid Dieset
- Department of Acute Psychiatry, Oslo University Hospital, Norway
| | | | - Harald Weedon-Fekjær
- Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Norway
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McIntosh J, Marques B, Jenkin G. The Role of Courtyards within Acute Mental Health Wards: Designing with Recovery in Mind. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11414. [PMID: 36141687 PMCID: PMC9517498 DOI: 10.3390/ijerph191811414] [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: 07/28/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
The role of courtyards and other outdoor spaces in the recovery of acute mental healthcare users has been gaining international appreciation and recognition. However, the physical properties and conditions necessary for therapeutic and rehabilitative engagement remain to be clearly established. This paper contributes to that knowledge by triangulating evidence from the literature, exemplar case studies of good practice and first-hand accounts of the experiences of staff and service users from four acute mental health facilities. The findings are then aligned with a well-established recovery framework (CHIMES) in light of existing landscape architecture knowledge. Within the complexity of varied mental health environments, this work establishes landscape architectural design requirements and qualities essential for recovery. Rather than adopting a prescriptive quantitative approach setting out areas, numbers of elements, etc., the proposed framework recommends a performance-based model and the creation of a cohesive network of microspaces that mesh into a design of outdoor areas. In this way, design details, materials, vegetation and the variety of spaces can be modified to suit service user population demographics and site-specific needs.
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Affiliation(s)
- Jacqueline McIntosh
- Wellington School of Architecture, Victoria University of Wellington, P.O. Box 600, Wellington 6140, New Zealand
| | - Bruno Marques
- Wellington School of Architecture, Victoria University of Wellington, P.O. Box 600, Wellington 6140, New Zealand
| | - Gabrielle Jenkin
- Department of Psychological Medicine, University of Otago, Wellington 23a Mein St., Wellington 6021, New Zealand
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Zhou Y, Sun Y, Xu Y, Yuan H. Study on value-based design of healthcare facilities: Based on review of the literature in the USA and Japan. Front Public Health 2022; 10:883241. [PMID: 36159251 PMCID: PMC9500362 DOI: 10.3389/fpubh.2022.883241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/15/2022] [Indexed: 01/21/2023] Open
Abstract
With limited medical resources, it is of great significance for countries all over the world to explore architectural design methods to enhance the value of medical facilities. Therefore, it is very necessary to carry out an extensive international comparison. In order to grasp the research trend of healthcare facilities in the world, this paper conducts co-occurrence analysis, cluster analysis, and trend analysis of the keywords of 334 English articles and 153 Japanese articles related to healthcare facilities published in important academic journals in the USA and Japan in the past 15 years. We not only compare the similarities and differences in healthcare facility research between the USA and Japan, but also explore the reasons for these differences. It is found that by introducing three kinds of value variables, such as time, space, and behavior, we can not only well explain the difference in the solution of healthcare facilities in the USA and Japan to reduce medical costs but also provide new ideas for architectural design to enhance the value of hospitals. Based on the above analysis, a conceptual framework of value-based design of healthcare facilities that combines the advantages of the USA and Japan is proposed in this paper.
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Affiliation(s)
- Ying Zhou
- Department of Architecture, School of Architecture, Southeast University, Nanjing, China,*Correspondence: Ying Zhou
| | - Yaonan Sun
- Department of Civil Engineering, School of Science, Nanjing University of Science and Technology, Nanjing, China
| | - Yi Xu
- Department of Architecture, School of Architecture, Southeast University, Nanjing, China
| | - Hao Yuan
- Department of Architecture, School of Architecture, Southeast University, Nanjing, China
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Wang H, Luo P, Wu Y, Zeng X. Factors and optimizations of healthcare workers' perception in alternative care facilities. Front Public Health 2022; 10:891503. [PMID: 35968426 PMCID: PMC9364931 DOI: 10.3389/fpubh.2022.891503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background Diverse measures have been carried out worldwide to establish Alternative Care Facilities (ACFs) for different ends, such as receiving, curing or isolating patients, aiming to cope with tremendous shock in the urban medical system during the early passage of the COVID-19 epidemic. Healthcare workers always felt anxious and stressed during multiple major public health emergencies in medical facilities. Some active measures to improve healthcare workers' perceptions, such as temporary training, workflow improvement, and supplementary facilities, were proved insufficient in several past public health emergencies. Therefore, this study aims to analyze the contributing factors of the healthcare workers' perceptions of the ACFs in this pandemic, which can help find an innovative path to ensure their health, well-being and work efficiency. Method This paper conducted semi-structured in-depth interviews with the world's first batch of healthcare workers who have worked in ACFs through a qualitative study based on Grounded Theory. The healthcare workers interviewed from Heilongjiang, Shandong, Fujian, and Hubei provinces, have worked in one of the four different ACFs built in Wuhan. The results are obtained through the three-level codes and analyses of the interview recordings. Results The factors affecting the perception of healthcare workers in ACFs during the epidemic situation can be summarized into five major categories: individual characteristics, organization management, facilities and equipment, space design, and internal environment. The five major categories affecting the composition of perception can be further divided into endogenous and exogenous factors, which jointly affect the perception of healthcare workers in ACFs. Among them, individual characteristics belong to endogenous factors, which are the primary conditions, while other categories belong to exogenous factors, which are the decisive conditions. Conclusion This paper clarifies factors affecting the perception of healthcare workers in ACFs and analyzes the mechanism of each factor. It is posited that the passive strategies are a promising solution to protect healthcare workers' health, improve their work efficiency, and help reduce the operation stress of ACFs. We should train multidisciplinary professionals for future healthcare and enhance collaborations between healthcare workers and engineers. To sum up, this paper broadens new horizons for future research on the optimization of ACFs and finds new paths for alleviating healthcare workers' adverse perceptions of ACFs.
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Affiliation(s)
- Hao Wang
- School of Architecture, Harbin Institute of Technology, Harbin, China
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin Institute of Technology, Harbin, China
| | - Peng Luo
- School of Architecture, Harbin Institute of Technology, Harbin, China
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin Institute of Technology, Harbin, China
| | - Yimeng Wu
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Xianqi Zeng
- School of Architecture, Harbin Institute of Technology, Harbin, China
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin Institute of Technology, Harbin, China
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15
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Oostermeijer S, Dwyer M, Tongun P. Relational security: The impact of facility design on youth custodial staffs' practices and approaches. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:227-237. [PMID: 35411650 PMCID: PMC9546465 DOI: 10.1002/cbm.2241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Constructive relationships between staff and young people in custody are a vital component of a therapeutic youth justice approach, which extends to the maintenance of a safe and secure environment (i.e., relational security). Despite the growing recognition that the physical environment of a facility impacts the procedures within a youth justice environment, as well as the relationships between staff and young people, there is a dearth of research in this area. AIMS We investigated youth custodial staffs' views on, and approaches to, establishing relationships with young people while maintaining safety and security. The current study reports on the impacts and challenges highlighted by staff relating to the design of the facility. METHODS We interviewed a total of 26 custodial staff members working at a Youth Justice facility in Melbourne, Australia. The semi-structured interviews were audio recorded and transcribed. NVivo 12 was used for thematic analysis. Two researchers (SO and PT) coded one transcript independently, iteratively creating a coding template using a thematic analysis approach. Once the final set of broad themes was constructed, the transcripts were re-examined, and narrower themes were identified. RESULTS Thematic analysis revealed that a total of 14 staff (53.8%) identified the design of the custodial facility as impacting upon their ability to practice relational security. Identified design aspects included: unit size, quiet and private spaces, communal areas, green and outside spaces, ambience and spatial characteristics, spatial differentiation, facility and unit lay-out. CONCLUSION Youth custodial staff identified design aspects of a youth custodial facility that either promoted or impeded the ability to practice relational security approaches. The current study highlights the importance of carefully considering facility design given its impact upon staff-young people relationships, procedures and ways of working within these custodial facilities.
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Affiliation(s)
- Sanne Oostermeijer
- The Centre for Mental Health, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
| | | | - Poni Tongun
- The Centre for Mental Health, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
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16
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Corbetta M, Corso B, Camuccio CA. Rules and ward climate in acute psychiatric setting: Comparison of staff and patient perceptions. Int J Ment Health Nurs 2022; 31:611-624. [PMID: 35128772 PMCID: PMC9305954 DOI: 10.1111/inm.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022]
Abstract
The ward climate or atmosphere refers to its material, emotional and social conditions. A good ward climate in psychiatric settings can influence the mood, behaviour and self-concept of patients and staff members and improve patient outcomes. Many studies have examined the relationship between ward climate and aggression, but only a few have investigated the effect of a ward's environment, rules and activities. This multicentric observational study aimed to assess the relationship between the rules/activities and the climate of four acute psychiatric units of Northern Italy. The Essen Climate Evaluation Scheme (EssenCES) questionnaire, which was administered to patients and staff, was used to evaluate the different dimensions of ward atmosphere. There was a good response rate (79%) in patients and staff members who completed the questionnaire (114 patients and 109 staff). Safety perception appeared to be quite different in patients and staff. The patients who were authorized to have more visiting hours and more time to use their mobile phone had higher scores on Experienced Safety subscale. A negative correlation between the Therapeutic Hold and Experienced Safety subscales was found in the staff members, and this was due to their negative perception. The ward climate seemed to be affected by the unit's rules, especially with respect to visits and the smartphones use. Nurses need to be aware of the importance of ward climate and how their own perception may differ from and that of patients: this gap could lead to decisions detached from the patients' needs.
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Affiliation(s)
| | - Barbara Corso
- Neuroscience Institute, National Research Council, Padova, Italy
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17
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Engaging U.S. Adults with Serious Mental Illness in Participatory Design Research Exercises. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116743. [PMID: 35682321 PMCID: PMC9180822 DOI: 10.3390/ijerph19116743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
Clubhouses are non-clinical, community-based centers for adult members with serious mental illness. The evidence-based model assists adults with identifying employment, housing, education, and social opportunities; wellness and health-promoting activities; reducing hospitalizations and criminal justice system involvement; and improving social relationships, satisfaction, and quality of life. The model enables member participation in all Clubhouse operations, yet offers little guidance concerning facility design and member engagement in the design process. This case study explored the use of participatory design research exercises to (1) document member needs, preferences, and priorities to inform the design of a new midwestern U.S. Clubhouse facility and (2) meaningfully engage members (n = 16) in the design process. Four participatory design research exercises were developed, administered, and analyzed. Results revealed aesthetics and ambience; safety and security; ease of use and maintenance; adaptability, flexibility, and accessibility; and transportation as future priorities. Space and furnishing needs and priorities were also identified. Informal observations and participant feedback suggested that the participatory exercises meaningfully engaged members in a manner aligned with Clubhouse Model principles by centering member dignity, strengths, and work-oriented expectations. Future directions for research on Clubhouse design and member engagement in the design process are also discussed.
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18
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Occupants’ Satisfaction of Indoor Environment Quality in Non-Linear Minimum Buildings in Winter Based on the Role of Different Kinds of Perceptions. SUSTAINABILITY 2022. [DOI: 10.3390/su14094983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Non-Linear Minimum Building (NLMB) is a sort of low-carbon building designed to meet the needs of the growing urban population around the world. This study investigates the perceptions of indoor environments among students whilst staying in NLMBs. The students were asked to participate in the subjective survey in order to gather their indoor environmental satisfaction votes. The objectives of this study are to know the importance of six human sensations inside NLMBs relative to indoor environmental satisfaction. The main findings indicated the great function of the humidity sensation in NLMBs, followed by the thermal sensation, the noise sensation, the visual sensation, the air freshness sensation and the draft sensation. Although the subjects were not very satisfied with the humidity sensation, the overall indoor environmental satisfaction was quite high under the relatively cold conditions in winter. Moreover, the studies, through in-depth interviews, showed that the majority of people felt comfortable, and some of them experienced good feelings or experiences when they stayed in NLMBs.
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19
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Dhital R, Sakulwach S, Robert G, Vasilikou C, Sin J. Systematic review on the effects of the physical and social aspects of community pharmacy spaces on service users and staff. Perspect Public Health 2022; 142:77-93. [PMID: 35274562 PMCID: PMC8918882 DOI: 10.1177/17579139221080608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: This systematic review aimed to provide new insights into how pharmacy spaces, or the architecture of pharmacies, are experienced by pharmacy service users and staff. The review sought to identify environmental factors which may influence service users’ and staff participation in community-based pharmacy health services. Method: Ten databases were searched for English language publications, using a combination of search terms relating to pharmacy service users and staff; pharmacy spaces; and health and social care outcomes. Data from the final selected studies were extracted, thematically analysed using a narrative approach and the quality of each study assessed using the Integrated quality Criteria for the Review of Multiple Study designs (ICROMS). Results: 80 articles reporting 80 studies published between 1994 and 2020 were identified; they were from 28 countries, involving around 3234 community pharmacies, 13,615 pharmacy service users, 5056 pharmacists and 78 pharmacy health staff. Most studies (94%) met the ICROMS minimum score, and half did not meet the mandatory quality criteria. Four themes likely to influence service users’ and staff experiences of pharmacy health services were identified: (1) privacy; (2) experience of the physical environment; (3) professional image; and (4) risk of error. Conclusion: To optimise the delivery and experience of pharmacy health services, these spaces should be made more engaging. Future applied research could focus on optimising inclusive pharmacy design features.
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Affiliation(s)
- R Dhital
- Arts and Sciences Department, University College London, 33-35 Torrington Place, London WC1E 7LA, UK
| | | | - G Robert
- King's College London, London, UK
| | | | - J Sin
- University of London, London, UK
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20
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Simonsen T, Sturge J, Duff C. Healing Architecture in Healthcare: A Scoping Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:315-328. [PMID: 35016562 DOI: 10.1177/19375867211072513] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this scoping review is to identify evidence on how characteristics of healing architecture in clinical contexts impact clinical practice and patient experiences. Based on these insights, we advance a more practice-based approach to the study of how healing architectures work. BACKGROUND The notion of "healing architecture" has recently emerged in discussions of the spatial organization of healthcare settings, particularly in the Nordic countries. This scoping review summarizes findings from seven articles which specifically describe how patients and staff experience characteristics of healing architecture. METHODS This scoping review was conducted using the framework developed by Arksey and O'Malley. We referred to the decision tool developed by Pollock et al. to confirm that this approach was the most appropriate evidence synthesis type to identify characteristics related to healing architecture and practice. To ensure the rigor of this review, we referred to the methodological guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. RESULTS There are two main findings of the review. First, there is no common or operative definition of healing architecture used in the selected articles. Secondly, there is limited knowledge of how healing architecture shapes clinical and patient outcomes. CONCLUSIONS We conclude that further research is needed into how healing architectures make a difference in everyday clinical practices, both to better inform the development of evidence-based designs in the future and to further elaborate criteria to guide postoccupancy evaluations of purpose-built sites.
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Affiliation(s)
- Thorben Simonsen
- Department of Business IT, IT University Copenhagen, Copenhagen S, Denmark
| | - Jodi Sturge
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen Adema Architecten, Dokkum, the Netherlands
| | - Cameron Duff
- College of Business and Law, Royal Melbourne Institute of Technology, Melbourne, Australia
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21
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Weber C, Monero Flores V, Wheele TP, Miedema E, White EV. Patients' Health & Well-Being in Inpatient Mental Health-Care Facilities: A Systematic Review. Front Psychiatry 2022; 12:758039. [PMID: 35046849 PMCID: PMC8761847 DOI: 10.3389/fpsyt.2021.758039] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Previous research indicates that the physical environment of healthcare facilities plays an important role in the health, well-being, and recovery outcomes of patients. However, prior works on mental healthcare facilities have incorporated physical environment effects from general healthcare settings and patient groups, which cannot be readily transferred to mental healthcare settings or its patients. There appears to be a specific need for evidence synthesis of physical environmental effects in mental healthcare settings by psychopathology. Purpose: This review evaluates the state (in terms of extent, nature and quality) of the current empirical evidence of physical environmental on mental health, well-being, and recovery outcomes in mental healthcare inpatients by psychopathology. Method: A systematic review (PRISMA guidelines) was performed of studies published in English, German, Dutch, Swedish, and Spanish, of all available years until September 2020, searched in Cochrane, Ovid Index, PsycINFO, PubMed, and Web of Science and identified through extensive hand-picking. Inclusion criteria were: Adult patients being treated for mental ill-health (common mental health and mood disorders, Cochrane frame); inpatient mental health care facilities; specifications of the physical and socio-physical environment (e.g., design features, ambient conditions, privacy); all types of empirical study designs. Quality assessment and data synthesis were undertaken. Results: The search retrieved 1,068 titles of which 26 met the inclusion criteria. Findings suggest that there is only indicative evidence of the impact of the physical healthcare environment on patients' mental health, well-being, and recovery outcomes. There is significant lack of pathology-specific evidence. Methodological shortcomings and empirical scarcity account for the poor evidence. Conclusion: This review highlights the need for more research using advanced study designs.
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Affiliation(s)
- Clara Weber
- Institute of Facility Management, Life Sciences and Facility Management, Zurich University of Applied Sciences, Zurich, Switzerland
- Environmental Psychology Department, School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Virna Monero Flores
- Institute of Facility Management, Life Sciences and Facility Management, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Theresa Poppy Wheele
- Institute of Facility Management, Life Sciences and Facility Management, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Elke Miedema
- Architectural Theory and Methods, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Emma Victoria White
- Environmental Psychology Department, School of Psychology, University of Surrey, Guildford, United Kingdom
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22
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Ross T, Bulla J, Fontao MI. Space and Well-Being in High Security Environments. Front Psychiatry 2022; 13:894520. [PMID: 35711591 PMCID: PMC9195501 DOI: 10.3389/fpsyt.2022.894520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Research into the spatial dimensions of deprivation of liberty and psychiatric hospitalization has a long and complex tradition. In this context, the increasing numbers of prisoners and patients in forensic hospitals have impressively shown how difficult it is to ensure security, therapy and rehabilitation when space is scarce or not well-suited. In this narrative review, we present the main findings of recent lines of research on spaces in prisons and forensic psychiatric wards, with particular attention to the links between overcrowding in prisons and secure forensic psychiatric hospitals and violence, the foundations of prison and hospital architecture, and on how the design of spaces in prisons and hospitals can influence well-being. We assess and discuss these findings in the context of the current debate on how well-being in secure spaces can support the achievement of rehabilitation goals even in overcrowded institutions.
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Affiliation(s)
- Thomas Ross
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
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Mclaughlan R, Lyon C, Jaskolska D. Architecture as change-agent? Looking for innovation in contemporary forensic psychiatric hospital design. MEDICAL HUMANITIES 2021; 47:e11. [PMID: 33106241 DOI: 10.1136/medhum-2020-011887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
History suggests that departures from accepted design practice can contribute to positive change in the delivery of mental healthcare, the daily experience of hospitalised patients and public perceptions of mental illness. Yet the question of how architecture can support the therapeutic journey of patients remains a critical one. The availability of evidence-based design literature to guide architects cannot keep pace with growing global demand for new forensic psychiatric hospital facilities. This article reports a global survey of current design practice to speculate on the potential of three new hospitals to positively improve patient experience. A desktop survey was conducted of 31 psychiatric hospitals (24 forensic, 7 non-forensic) constructed or scheduled for completion between 2006 and 2022. This was supplemented by advisory panel sessions with clinical/facilities staff, alongside architectural knowledge obtained through workshops with architects from the UK and the USA, and the inclusion of Australian architects on the research team. Data analysis draws on knowledge from architectural practice, architectural history and environmental psychology, arguing that there is a responsibility to integrate knowledge from across these disciplines in respect of such a pressing and important problem.
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Affiliation(s)
- Rebecca Mclaughlan
- School of Architecture and the Built Environment, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Codey Lyon
- NTC Architects, Melbourne, Victoria, Australia
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24
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Literature Review: Evidence-Based Health Outcomes and Perceptions of the Built Environment in Pediatric Hospital Facilities. J Pediatr Nurs 2021; 61:e42-e50. [PMID: 33875322 DOI: 10.1016/j.pedn.2021.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/24/2021] [Accepted: 04/13/2021] [Indexed: 11/21/2022]
Abstract
PROBLEM The current knowledge of evidence-based design for adults is not always implemented when hospital buildings are designed. Scientific data are sparse on the effects of hospital design in pediatric settings on health outcomes in children, parents, and staff. The objective of this review is to determine the evidence-based impact of the built environment in pediatric hospital facilities on health outcomes in children, parents, and staff. ELIGIBILITY CRITERIA A systematic literature review was carried out on the electronic databases Cochrane Library, Embase, Medline and CINAHL from the period of 2008 to 2019. The review considered studies using either quantitative, qualitative, or mixed methodologies. SAMPLE Out of 1414 reviewed articles the result is based on eight included articles. RESULTS Two of these eight articles included health outcomes. The other six articles presented results on measures of perceptions and/or satisfaction for children, parents or staff with the built environment when transitioning to a new or renovated facility. These were generally higher for the new compared to the old facility. CONCLUSIONS Given the small number of studies addressing the question posed in this review, no firm conclusions can be drawn. IMPLICATIONS The review illustrates the need for more research in the pediatric setting assessing the evidence-based health outcomes of aspects of physical environmental design in pediatric hospitals or units in children, parents and staff.
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Permanent Supportive Housing Design Characteristics Associated with the Mental Health of Formerly Homeless Adults in the U.S. and Canada: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189588. [PMID: 34574513 PMCID: PMC8465794 DOI: 10.3390/ijerph18189588] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 01/05/2023]
Abstract
The built environment directly and indirectly affects mental health, especially for people transitioning from long-term homelessness to permanent supportive housing (PSH) who often experience co-occurring behavioral health challenges. Despite a rapid increase in PSH availability, little research examines influences of architecture and design within this context. This integrative review synthesized limited research on PSH design in the U.S. and Canada to identify built environment characteristics associated with PSH residents’ mental health, highlight gaps in the literature, and prioritize future research directions. A systematic search for peer-reviewed articles was conducted using nine databases drawing from multiple disciplines including architecture, environmental psychology, interior design, psychology, psychiatry, medicine, and nursing. Seventeen articles met inclusion criteria. Study design, methodology, built environment properties, place attributes, and relevant findings were extracted and iteratively analyzed. Three domains relevant to architecture and design were identified related to home, ontological security, and trauma sensitivity; dwelling unit type, privacy, control, safety, housing quality and location, and access to amenities; and shared common space. Integrative review results emphasize the potential of architecture and design to contribute to improved built environment quality and mental health outcomes among PSH residents. Methodological limitations and directions for future research are also discussed.
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Brasier C, Roennfeldt H, Hamilton B, Martel A, Hill N, Stratford A, Buchanan-Hagen S, Byrne L, Castle D, Cocks N, Davidson L, Brophy L. Peer support work for people experiencing mental distress attending the emergency department: Exploring the potential. Emerg Med Australas 2021; 34:78-84. [PMID: 34490720 DOI: 10.1111/1742-6723.13848] [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] [Received: 01/07/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study explored the benefits and limitations of employing peer support workers, who utilise their own lived experience of mental distress and recovery, to support people experiencing mental distress who are attending the ED. METHODS This co-produced qualitative study utilised four phases: (i) assemble a collaborative multi-disciplinary research team and Expert Panel, of which at least half identified as having lived experience; (ii) a site visit to an ED; (iii) focus groups with consumers, support persons and ED staff; and (iv) a learning workshop for peer workers. RESULTS Focus groups were run for consumers (n = 7), support persons (n = 5) and ED staff (n = 7). Eleven consumer peer workers participated in the learning workshop. Four themes were identified and triangulated: the individual in distress, peer support work, a 'Peers in EDs' service and the ED context. Overall, findings suggest that peer support workers contribute important skills including listening, de-escalation, relationship-building and empathy. CONCLUSIONS This study identified that peer support workers would bring important skills to an ED (e.g. empathetic support, de-escalation). However, significant workforce and organisational support would be required.
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Affiliation(s)
- Catherine Brasier
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Helena Roennfeldt
- Centre for Mental Health Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bridget Hamilton
- Centre for Mental Health Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Martel
- Faculty of Architecture, Building and Planning, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nicole Hill
- Department of Social Work, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Sally Buchanan-Hagen
- School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia
| | - Louise Byrne
- School of Management, College of Business and Law, RMIT University, Melbourne, Victoria, Australia.,School of Medicine, Yale University, New Haven, Connecticut, USA
| | - David Castle
- Centre for Complex Interventions, Centre for Addictions and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nadine Cocks
- Mind Australia Limited, Melbourne, Victoria, Australia
| | - Larry Davidson
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Lisa Brophy
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.,The Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Lipson-Smith R, Pflaumer L, Elf M, Blaschke SM, Davis A, White M, Zeeman H, Bernhardt J. Built environments for inpatient stroke rehabilitation services and care: a systematic literature review. BMJ Open 2021; 11:e050247. [PMID: 34353805 PMCID: PMC8344318 DOI: 10.1136/bmjopen-2021-050247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To identify, appraise and synthesise existing design evidence for inpatient stroke rehabilitation facilities; to identify impacts of these built environments on the outcomes and experiences of people recovering from stroke, their family/caregivers and staff. DESIGN A convergent segregated review design was used to conduct a systematic review. DATA SOURCES Ovid MEDLINE, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched for articles published between January 2000 and November 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Qualitative, quantitative and mixed-methods studies investigating the impact of the built environment of inpatient rehabilitation facilities on stroke survivors, their family/caregivers and/or staff. DATA EXTRACTION AND SYNTHESIS Two authors separately completed the title, abstract, full-text screening, data extraction and quality assessment. Extracted data were categorised according to the aspect of the built environment explored and the outcomes reported. These categories were used to structure a narrative synthesis of the results from all included studies. RESULTS Twenty-four articles were included, most qualitative and exploratory. Half of the included articles investigated a particular aspect of the built environment, including environmental enrichment and communal areas (n=8), bedroom design (n=3) and therapy spaces (n=1), while the other half considered the environment in general. Findings related to one or more of the following outcome categories: (1) clinical outcomes, (2) patient activity, (3) patient well-being, (4) patient and/or staff safety and (5) clinical practice. Heterogeneous designs and variables of interest meant results could not be compared, but some repeated findings suggest that attractive and accessible communal areas are important for patient activity and well-being. CONCLUSIONS Stroke rehabilitation is a unique healthcare context where patient activity, practice and motivation are paramount. We found many evidence gaps that with more targeted research could better inform the design of rehabilitation spaces to optimise care. PROSPERO REGISTRATION NUMBER CRD42020158006.
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Affiliation(s)
- Ruby Lipson-Smith
- Stroke, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Luis Pflaumer
- Stroke, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Marie Elf
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Sarah-May Blaschke
- Stroke, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Aaron Davis
- Stroke, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Marcus White
- Centre for Design Innovation, The Swinburne University of Technology, Hawthorne, Melbourne, Australia
| | - Heidi Zeeman
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Meadowbrook, Queensland, Australia
| | - Julie Bernhardt
- Stroke, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
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Miedema E, Lindahl G, Elf M. The Swedish Health Promoting Healthcare network and the built environment. Health Promot Int 2021; 37:6318106. [PMID: 34244726 PMCID: PMC8851404 DOI: 10.1093/heapro/daab101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Health Promoting Hospitals (HPH) networks, founded by the World Health Organisation, support the introduction of health promotion in healthcare. This development involves the creation of a health promoting built environment. However, few studies have explored the HPH in relation to the built environments, and it is unclear how HPH-networks incorporate the built environment in their work. The study therefore examined the Swedish HPH-Network in relation to the built environment. The mixed-method study included data from (i) key online material from the Swedish network, (ii) a survey with open-ended questions of representatives of the networks’ workgroups and (iii) semi-structured interviews with the built environment workgroup. The study showed that the built environment is unevenly and incoherently incorporated in the network. Moreover, there is more attention for healing and healthy rather than health-promotive strategies, indicating a knowledge gap. Descriptions of the health promoting built environment are diverse, and address design features, design strategies or indicate places for health promotion interventions. The descriptions of the built environment are combined with various HPH goals and population groups. To utilize the built environment as a resource for HPHs, the networks should consider incorporating the built environment in documents and action plans at all organizational levels.
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Affiliation(s)
- Elke Miedema
- Division of Architectural Theory and Method, Department of Architecture and Civil Engineering, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden
| | - Göran Lindahl
- Division of Building Design, Department of Architecture and Civil Engineering, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden
| | - Marie Elf
- School of Health and Welfare, Department of Nursing and Midwifery, Dalarna University, 791 88 Falun, Sweden
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Oostermeijer S, Brasier C, Harvey C, Hamilton B, Roper C, Martel A, Fletcher J, Brophy L. Design features that reduce the use of seclusion and restraint in mental health facilities: a rapid systematic review. BMJ Open 2021; 11:e046647. [PMID: 34233981 PMCID: PMC8264870 DOI: 10.1136/bmjopen-2020-046647] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
UNLABELLED Increasing efforts are being made to prevent and/or eliminate the use of seclusion and restraint in mental health facilities. Recent literature recognises the importance of the physical environment in supporting better outcomes in mental health services. This rapid review scoped the existing literature studying what physical design features of mental health facilities can reduce the use of seclusion and physical restraint. DESIGN A rapid review of peer-reviewed literature. METHODS Peer-reviewed literature was searched for studies on architectural design and the use of restraint and seclusion in mental health facilities. The following academic databases were searched: Cochrane Library, Medline, PsycINFO, Scopus and Avery for English language literature published between January 2010 and August 2019. The Joanna Briggs Institute's critical appraisal tool was used to assess the quality of included studies. RESULTS We identified 35 peer-reviewed studies. The findings revealed several overarching themes in design efforts to reduce the use of seclusion and restraint: a beneficial physical environment (eg, access to gardens or recreational facilities); sensory or comfort rooms; and private, uncrowded and calm spaces. The critical appraisal indicated that the overall quality of studies was low, as such the findings should be interpreted with caution. CONCLUSION This study found preliminary evidence that the physical environment has a role in supporting the reduction in the use of seclusion and restraint. This is likely to be achieved through a multilayered approach, founded on good design features and building towards specific design features which may reduce occurrences of seclusion and restraint. Future designs should include consumers in a codesign process to maximise the potential for change and innovation that is genuinely guided by the insights of lived experience expertise.
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Affiliation(s)
- Sanne Oostermeijer
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine Brasier
- Social Work and Social Policy, La Trobe University, Melbourne, Victoria, Australia
| | - Carol Harvey
- Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bridget Hamilton
- Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Cath Roper
- Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Martel
- Melbourne School of Design, The University of Melbourne, Melbourne, Victoria, Australia
| | - Justine Fletcher
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Brophy
- Social Work and Social Policy, La Trobe University, Melbourne, Victoria, Australia
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Hutton A, Wilson R, Foureur M. Comfort Equals Nurturing: Young People Talk About Mental Health Ward Design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:258-269. [PMID: 34128422 DOI: 10.1177/19375867211022684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM The aim of this research was to obtain user perspectives of adolescent patients to inform the redesign of an adolescent mental health inpatient facility ward unit in regional Australia. BACKGROUND It is well established that the consumer will use and understand unit space differently than the health professional, because of their unique positioning and depth of experience. The participation of young people in the design of ward environments and programs is essential. METHODS A combination of focus groups and interviews was undertaken with eight participants. RESULTS This study found that, in its current form, the unit revolves around routines, tasks, and patient safety, which in turn are driven by secure spaces and surveillance of the patients. Due to these routines and tasks, the aspects of individualized patient care and personal impetus and comfort are lost. Adolescent patients are able to identify solutions to enhance their hospital stay in the mental health context without being excessive and unrealistic in their suggestions. CONCLUSIONS When designing an adolescent unit, there needs to be some consideration as to how the group using the unit understands space. Through their role and depth of hospital experience, the adolescent patient will use and understand unit space differently from that of the health professional whose role is a worker. Therefore, it is necessary to gain the perspectives of adolescent patients for efficient and effective functioning of such an environment and to suit the needs of those it is "built for," the adolescent patient.
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Affiliation(s)
| | - Rhonda Wilson
- University of Newcastle, Callaghan, Australia.,Massey University, Palmerston North, New Zealand
| | - Maralyn Foureur
- Hunter New England Local Health, University of Newcastle, Callaghan, Australia
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Abstract
COVID-19 deeply affects many spheres of life. Lockdown measures implemented worldwide have accentuated mental wellbeing changes in the population from the perspectives of space and social relations. These changes leave lasting imprints on individuals and communities. This article draws upon solidarity and care ethics in exploring their role in rebuilding mental wellbeing in the light of constraints arising from lockdown. The diversity of responses to physical and social isolation during the pandemic illuminates the distinctly relational nature of human beings, offering the opportunity for care and solidarity to respond to mental wellbeing challenges in an inclusive and context-sensitive way.
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Affiliation(s)
- Hui Yun Chan
- Department of Law, University of Huddersfield, Huddersfield, HD1 3DH UK
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Aljunaidy MM, Adi MN. Architecture and Mental Disorders: A Systematic Study of Peer-Reviewed Literature. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 14:320-330. [PMID: 33356588 DOI: 10.1177/1937586720973767] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To perform a systematic study about the contribution of architecture and interior design researchers in studying the effect of physical environment on mental disorders. BACKGROUND Mental disorders are a major health problem worldwide and related to severe distress, functional disabilities, and heavy economical burdens. Studies propose that physical environment design can trigger or reduce mental disorder symptoms. However, there is a lack of knowledge about the extent of architectural design research contribution to all types of mental disorder prevention or intervention. METHODS A team of cross-disciplinary researchers gathered information from peer-reviewed manuscripts about the effect of architectural design on enhancing or reducing mental disorder symptoms. Data were collected from manuscripts published between 2008 and 2020 (research related to the topic became clearer in quality and quantity then). Keywords including architecture, interior design, physical environment, and mental disorders were used in the systematic search. Databases were collected using online resources. Numerical data collected from quantitative studies were organized in tables. RESULTS Our data showed that there were a lot of studies about dementia and autism; few studies about schizophrenia, anxiety, stress-related disorders, and depressive disorders; and no studies about the rest of the mental disorders. General environment followed by housing facility design were the most assessed physical environments for mental disorders. CONCLUSIONS As all mental disorders can have a significant impact on the society, we conclude that architectural studies should focus more on improving or preventing the symptoms of all types of mental disorders through the design of physical environments.
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Affiliation(s)
- Mais M Aljunaidy
- Psychology Department, Interdisciplinary Program in Neuroscience, Faculty of Economics, Administrative, and Social Sciences, 52948Bilkent University, Ankara, Turkey
| | - Mohamad Nadim Adi
- Department of Interior Architecture and Environmental Design, Faculty of Art, Design and Architecture, 52948Bilkent University, Ankara, Turkey
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Brambilla A, Lindahl G, Dell'Ovo M, Capolongo S. Validation of a multiple criteria tool for healthcare facilities quality evaluation. FACILITIES 2020. [DOI: 10.1108/f-06-2020-0070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Several healthcare quality assessment tools measure the processes and outcomes of the care system. The actual physical infrastructure (buildings and organizational) aspects are, however, rarely considered. The purpose of this paper is to describe the process of validation and weighting of an evidence-informed framework for the quality assessment of hospital facilities from social, environmental and organizational perspectives to complement other assessments.
Design/methodology/approach
Sustainable High-quality Healthcare version 2 (SustHealth v2) is the updated version of an existing framework composed of three domains (social, environmental and organizational quality). To validate and establish a relevant weighting, interviews were conducted with 15 professionals within the field of healthcare planning, design, research and management. The study has been conducted through semi-structured interviews and the application of the Simon Roy Figueras (SRF) procedure for the elicitation of weights criteria. The data collected have been processed through the DecSpace web platform.
Findings
Among the three domains, the organizational qualities appear to be the most important (W = 49%), followed by the environmental (W = 29%) and social aspects (W = 22%). Relevant indicators such as future-proofing, wayfinding and users’ space control emerged as the most important within each macro-area. Those results are confirmed by the outcome of the interviews that highlight user/patient-centeredness, wayfinding strategies and space functionality as the most important concepts to foster in existing healthcare facilities improvement.
Practical implications
The study highlights important structural and organizational aspects that hospital managers and planners can consider when dealing with healthcare facilities’ quality improvement.
Originality/value
The use of the SRF multicriteria method is novel in this context when used to weight an assessment tool with a focus on hospital built environment.
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Mutual visibility and interaction: staff reactions to the ‘healing architecture’ of psychiatric inpatient wards in Denmark. BIOSOCIETIES 2020. [DOI: 10.1057/s41292-020-00195-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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COVID-19 Lockdown: Housing Built Environment's Effects on Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165973. [PMID: 32824594 PMCID: PMC7459481 DOI: 10.3390/ijerph17165973] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 01/03/2023]
Abstract
Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on 11 March, severe lockdown measures have been adopted by the Italian Government. For over two months of stay-at-home orders, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures have had on mental health and well-being. We conducted a large web-based survey on 8177 students from a university institute in Milan, Northern Italy, one of the regions most heavily hit by the pandemic in Europe. As emerged from our analysis, poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments <60 m2 with poor views and scarce indoor quality is associated with, respectively, 1.31 (95% CI: 1046–1637), 1.368 (95% CI: 1166–1605), and 2.253 (95% CI: 1918–2647) times the risk of moderate–severe and severe depressive symptoms. Subjects reporting worsened working performance from home were over four times more likely to also report depression (OR = 4.28, 95% CI: 3713–4924). Housing design strategies should focus on larger and more livable living spaces facing green areas. We argue that a strengthened multi-interdisciplinary approach, involving urban planning, public mental health, environmental health, epidemiology, and sociology, is needed to investigate the effects of the built environment on mental health, so as to inform welfare and housing policies centered on population well-being.
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Queen NJ, Hassan QN, Cao L. Improvements to Healthspan Through Environmental Enrichment and Lifestyle Interventions: Where Are We Now? Front Neurosci 2020; 14:605. [PMID: 32655354 PMCID: PMC7325954 DOI: 10.3389/fnins.2020.00605] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/18/2020] [Indexed: 12/11/2022] Open
Abstract
Environmental enrichment (EE) is an experimental paradigm that is used to explore how a complex, stimulating environment can impact overall health. In laboratory animal experiments, EE housing conditions typically include larger-than-standard cages, abundant bedding, running wheels, mazes, toys, and shelters which are rearranged regularly to further increase stimulation. EE has been shown to improve multiple aspects of health, including but not limited to metabolism, learning and cognition, anxiety and depression, and immunocompetence. Recent advances in lifespan have led some researchers to consider aging as a risk factor for disease. As such, there is a pressing need to understand the processes by which healthspan can be increased. The natural and predictable changes during aging can be reversed or decreased through EE and its underlying mechanisms. Here, we review the use of EE in laboratory animals to understand mechanisms involved in aging, and comment on relative areas of strength and weakness in the current literature. We additionally address current efforts toward applying EE-like lifestyle interventions to human health to extend healthspan. Although increasing lifespan is a clear goal of medical research, improving the quality of this added time also deserves significant attention. Despite hurdles in translating experimental results toward clinical application, we argue there is great potential in using features of EE toward improving human healthy life expectancy or healthspan, especially in the context of increased global longevity.
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Affiliation(s)
- Nicholas J. Queen
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University, Columbus, OH, United States
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States
| | - Quais N. Hassan
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University, Columbus, OH, United States
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States
- Medical Scientist Training Program, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Lei Cao
- Department of Cancer Biology and Genetics, College of Medicine, The Ohio State University, Columbus, OH, United States
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States
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Nuamah J, Rodriguez-Paras C, Sasangohar F. Veteran-Centered Investigation of Architectural and Space Design Considerations for Post-Traumatic Stress Disorder (PTSD). HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 14:164-173. [PMID: 32441151 DOI: 10.1177/1937586720925554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM This study sought to investigate architectural and space design considerations for veterans with post-traumatic stress disorder (PTSD). BACKGROUND Anecdotal evidence suggests that urban design features could have a positive impact on the mental well-being of individuals suffering from PTSD. However, evidence-based architectural and space design guidelines for PTSD are largely absent. METHODS Semi-structured interviews were conducted with 17 veterans diagnosed with PTSD to gain insights into their personal experiences with physical indoor and outdoor spaces, and to inquire about their needs and expectations for future architectural design. Transcripts were analyzed thematically. RESULTS Architectural design features including windows, entrances and exits, walkways and hallways, open space, defensible space, and green space; interior design features including furnishings and color; and ambient features including light, air quality, and noise levels were identified as most influential design features. CONCLUSIONS Our results underscore the first important step to developing comprehensive architectural and space design guidelines for veterans with PTSD. Work is in progress to solicit more feedback from veterans.
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Affiliation(s)
- Joseph Nuamah
- Department of Industrial & Systems Engineering, 14736Texas A&M University, College Station, TX, USA
| | - Carolina Rodriguez-Paras
- Department of Industrial & Systems Engineering, 14736Texas A&M University, College Station, TX, USA
| | - Farzan Sasangohar
- Department of Industrial & Systems Engineering, 14736Texas A&M University, College Station, TX, USA
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Sumartojo S, Pink S, Duque M, Vaughan L. Atmospheres of care in a psychiatric inpatient unit. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/24735132.2020.1730068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Shanti Sumartojo
- Emerging Technologies Research Lab, Monash University, Melbourne, Australia
| | - Sarah Pink
- Emerging Technologies Research Lab, Monash University, Melbourne, Australia
| | - Melisa Duque
- Emerging Technologies Research Lab, Monash University, Melbourne, Australia
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Simonsen TP, Duff C. Healing architecture and psychiatric practice: (re)ordering work and space in an in-patient ward in Denmark. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:379-392. [PMID: 31657031 DOI: 10.1111/1467-9566.13011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Healing architecture is a defining feature of contemporary hospital design in many parts of the world, with psychiatric in-patient facilities in Denmark at the forefront of this innovation. The approach rests on the contention that designed clinical spaces and the particular dispositions they express may promote patient recovery. Although the idea that health may be spatially mediated is well-established, the means of this mediation are far from settled. This article contributes to this debate by analysing medical encounters in the context of a new purpose-built psychiatric hospital opened in Slagelse, Denmark in late 2015 as an example of healing architecture for the region. Grounded in qualitative research conducted in two wards between 2016 and 2017, we explore the key material and social effects of the hospital's healing architecture, and the spaces and practices it enacts. Following the work of Michael Lynch, we consider both the designed 'spatial order' of the in-patient wards and the 'spatial orderings' unfolding therein with a particular interest in how order is accomplished in psychiatric work. With much of the existing discussion of healing architectures focusing on their impacts on patient wellbeing, we consider how healing architectures may also be transforming psychiatric work.
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Affiliation(s)
- Thorben P Simonsen
- Department of Organization, Copenhagen Business School, Frederiksberg, Denmark
| | - Cameron Duff
- Centre for People, Organisation and Work, RMIT University, Melbourne, VIC, Australia
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Kylén M, Von Koch L, Pessah-Rasmussen H, Marcheschi E, Ytterberg C, Heylighen A, Elf M. The Importance of the Built Environment in Person-Centred Rehabilitation at Home: Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2409. [PMID: 31284620 PMCID: PMC6651011 DOI: 10.3390/ijerph16132409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 11/17/2022]
Abstract
Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced acute care will be performed in hospitals. This-along with the increased healthcare needs of people with long-term conditions such as stroke and the rising demand for services to be more person-centred-will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient's recovery process remain unexplored. This paper presents a protocol with the purpose to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. The project uses a convergent parallel mixed-methods design, with ICF (International Classification of Functioning, Disability and Health) and person-environment theories as conceptual frameworks. Data will be collected during home visits 3 months after stroke onset. Medical records, questionnaires, interviews and observations will be used. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Data will be used to synthesise the contexts, mechanisms and outcomes that are important to support the rehabilitation process at home.
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Affiliation(s)
- Maya Kylén
- School of Education, Health and Social Studies, Dalarna University, SE-791 88 Falun, Sweden.
| | - Lena Von Koch
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, SE-141 83 Huddinge, Sweden
- Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Hélène Pessah-Rasmussen
- Skåne University Hospital, Department of Neurology and Rehabilitation Medicine, 221 85 Lund, Sweden
- Lund University, Department of Clinical Sciences Lund, Neurology, 221 84 Lund, Sweden
| | - Elizabeth Marcheschi
- Arkitektur och samhällsbyggnadsteknik, Byggnadsdesign, ACE, Chalmers University, SE-412 96 Gothenburg, Sweden
| | - Charlotte Ytterberg
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, SE-141 83 Huddinge, Sweden
- Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Ann Heylighen
- KU Leuven, Department of Architecture, Research[x]Design, 3001 Leuven, Belgium
| | - Marie Elf
- School of Education, Health and Social Studies, Dalarna University, SE-791 88 Falun, Sweden
- Arkitektur och samhällsbyggnadsteknik, Byggnadsdesign, ACE, Chalmers University, SE-412 96 Gothenburg, Sweden
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Harvey C, Brophy L, Tibble H, Killaspy H, Spittal MJ, Hamilton B, Ennals P, Newton R, Cruickshank P, Hall T, Fletcher J. Prevention and Recovery Care Services in Australia: Developing a State-Wide Typology of a Subacute Residential Mental Health Service Model. Front Psychiatry 2019; 10:383. [PMID: 31244691 PMCID: PMC6580196 DOI: 10.3389/fpsyt.2019.00383] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/15/2019] [Indexed: 01/15/2023] Open
Abstract
Aims: Community-based residential alternatives to hospitalization are an emerging service model. Evidence for their acceptability and effectiveness is promising but limited. Prevention and Recovery Care (PARC) services are one such residential model, offering short-term subacute treatment and care (usually between 7 and 28 days). PARC services in Victoria, Australia, are designed to support consumers with severe mental illness to either avoid a psychiatric hospital admission (step-up care) or transition from hospital back into the community (step-down care). As a precursor to a series of studies investigating the appropriateness, effectiveness and efficiency of PARC services, we aimed to investigate whether a typology of PARC services can be developed. Methods: A manager or other appropriately knowledgeable staff member from each of the 19 adult PARC services included in the study completed a tool based on PARC operational guidelines (the Victorian PARC service mapping questionnaire) and a validated instrument measuring the quality of care in residential mental health settings (the Quality Indicator for Rehabilitative Care, QuIRC). Thirty (of 42) stakeholders participated in a modified Delphi study to select 23 from the available 230 variables for entry into a hierarchical cluster analysis. Results: Cluster analysis produced three clusters of equal dissimilarity. At the 90% confidence level, there were four variables which were significantly different between clusters. These were the year the PARC was opened, the QuIRC Living Environment domain score, the proportion of all admissions that were a step-down admission from an inpatient unit, and how often families were invited to care meetings. Sensitivity analyses suggested the findings were robust to the method used to identify clusters. Conclusions: Although PARC services were broadly similar, their identified differences suggest there is variable model implementation across Victoria sufficient to generate a PARC service typology. This typology may prove important for interpreting differences in outcomes experienced by consumers and carers using PARC services, when applied in our analyses of service effectiveness. The value of conducting service mapping and typology studies is underscored. Further research to characterize subacute residential services, including recovery-promoting features of the built environment, is warranted.
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Affiliation(s)
- Carol Harvey
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
- Psychosocial Research Centre, NorthWestern Mental Health, Coburg, VIC, Australia
| | - Lisa Brophy
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
- Mind Australia Ltd, Heidelberg, VIC, Australia
- La Trobe University School of Allied Health, Human Services and Sport, Bundoora, VIC, Australia
| | - Holly Tibble
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Helen Killaspy
- Division of Psychiatry, University College London, London, United Kingdom
| | - Matthew J. Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Bridget Hamilton
- School of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
| | | | - Richard Newton
- Peninsula Mental Health Service, Frankston, VIC, Australia
| | | | - Teresa Hall
- Nossal Institute for Global Health, and Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Justine Fletcher
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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Camuccio CA, Sanavia M, Cutrone F, Marella I, Gregio M, Cabbia C, Cocchio S, Baldo V. Noise Levels in an Acute Psychiatric Unit: An Exploratory Observational Study. Issues Ment Health Nurs 2019; 40:493-502. [PMID: 30946621 DOI: 10.1080/01612840.2018.1557301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Noise is an important aspect of the ward atmosphere climate - the combination of the architectural solutions, organizational features, the psychological traits of the operators and their interactions, and the patients' characteristics. Despite its importance noise levels have been less analyzed than other aspects of the ward atmosphere climate. Aim: In this study the aim is to identify the sources of noise and the sound pressure level in an acute psychiatric ward, and secondly to ascertain whether this is perceived by inpatients as disturbing. Method: The sound pressure levels were measured during three nonconsecutive mornings, three afternoons, and three nights. A questionnaire was administered to ascertain patients' opinions about the noise in the ward. Results: The average noise level in the ward was 62.5 dB(A)eq in the morning, 55.8 in the afternoon, and 51.5 at night. A total of 23 patients took part in the study: 65.2% of this sample did not perceive the noise in the ward as disturbing. Conclusion: In a psychiatric ward, the main source of noise is the verbal communication, and acoustic pressure also derived from care activities based around relationships. Other sources of noise perceived as disturbing came from the opening and closing of doors and the entry doorbell. Adopting relational and architectural-structural measures could reduce the sound pressure, with a view to further improving the ambience in the ward.
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Affiliation(s)
- C A Camuccio
- a Nursing School of Venice/Mestre , School of Medicine, University of Padua , Venezia/Mestre , Italy
| | - M Sanavia
- b Medical Department , Casa di Cura "Policlinico San Marco" , Venezia/Mestre , Italy
| | - F Cutrone
- c Department of Mental Health of Venice , Azienda Unità Locale Socio Sanitaria 3 Serenissima , Venezia , Italy
| | - I Marella
- d Department of Epidemiology and Environmental Hygiene , Azienda Unità Locale Socio Sanitaria 3 Serenissima , Venezia/Mestre , Italy
| | - M Gregio
- d Department of Epidemiology and Environmental Hygiene , Azienda Unità Locale Socio Sanitaria 3 Serenissima , Venezia/Mestre , Italy
| | - C Cabbia
- e Department of Cardiac, Thoracic and Vascular Sciences , School of Medicine, University of Padua , Padova , Italy
| | - S Cocchio
- e Department of Cardiac, Thoracic and Vascular Sciences , School of Medicine, University of Padua , Padova , Italy
| | - V Baldo
- e Department of Cardiac, Thoracic and Vascular Sciences , School of Medicine, University of Padua , Padova , Italy
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Friesinger JG, Topor A, Bøe TD, Larsen IB. Studies regarding supported housing and the built environment for people with mental health problems: A mixed-methods literature review. Health Place 2019; 57:44-53. [PMID: 30959400 DOI: 10.1016/j.healthplace.2019.03.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 03/19/2019] [Accepted: 03/25/2019] [Indexed: 12/12/2022]
Abstract
Places where people live are important for their personal and social lives. This is also the case for people with mental health problems living in supported housing. To summarise the existing knowledge, we conducted a systematic review of 13 studies with different methodologies regarding the built environment in supported housing and examined their findings in a thematic analysis. The built environment of supported housing involves three important and interrelated themes: well-being, social identity and privacy. If overregulated by professionals or located in problematic neighbourhoods or buildings, the settings could be an obstacle to recovery. If understood as meaningful places with scope for control by the tenants or with amenities nearby, the settings could aid recovery.
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Affiliation(s)
| | - Alain Topor
- University of Agder, Department of Psychosocial Health, Grimstad, Norway; Stockholm University, Department of Social Work, Stockholm, Sweden
| | - Tore Dag Bøe
- University of Agder, Department of Psychosocial Health, Grimstad, Norway
| | - Inger Beate Larsen
- University of Agder, Department of Psychosocial Health, Grimstad, Norway
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Healthy and Sustainable Hospital Evaluation—A Review of POE Tools for Hospital Assessment in an Evidence-Based Design Framework. BUILDINGS 2019. [DOI: 10.3390/buildings9040076] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hospitals are complex, high-performance systems that demand continuous quality improvement. Several instruments evaluate the organizational or clinical qualities but very few focus on the built environment. The purpose of this paper is to compare and review the recent tools able to assess the hospital built environment and test how they measure health, sustainability, or both through Post Occupancy Evaluation (POE). A literature review has been conducted in the field of hospital quality assessment and 13 POE instruments have been included and analyzed through Ulrich’s Evidence-Based Design (EBD) framework. The percentage and the content of health or sustainability-related criteria have been compared and further discussed. Health related criteria the most recent tools are used three times more than in the tools developed in the nineties. The most used EBD criteria are safety enhancement (n = 131; 14%) and visual environment (n = 119; 13%). Although sustainability remains a relevant issue, today, growing attention is dedicated to the impact of built environment on occupant’s health. Further investigation is needed to understand the effectiveness of those instruments in practice.
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Setola N, Naldi E, Cocina GG, Eide LB, Iannuzzi L, Daly D. The Impact of the Physical Environment on Intrapartum Maternity Care: Identification of Eight Crucial Building Spaces. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2019; 12:67-98. [DOI: 10.1177/1937586719826058] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives, Purpose, or Aim: This article investigates whether the physical environment in which childbirth occurs impacts the intrapartum intervention rates and how this might happen. The study explores the spatial physical characteristics that can support the design of spaces to promote the health and well-being of women, their supporters, and maternity care professionals. Background: Medical interventions during childbirth have consequences for the health of women and babies in the immediate and long term. The increase in interventions is multifactorial and may be influenced by the model of care adopted, the relationships between caregivers and the organizational culture, which is made up of many factors, including the built environment. In the field of birth architecture research, there is a gap in the description of the physical characteristics of birth environments that impact users’ health. Method: A scoping review on the topic was performed to understand the direct and indirect impacts of the physical environment on birth intervention rates. Results and Discussion: The findings are organized into three tables reporting the influence that the physical characteristics of a space might have on people’s behaviors, experiences, practices and birth health outcomes. Eight building spaces that require further investigation and research were highlighted: unit layout configuration, midwives’ hub/desk, social room, birth philosophy vectors, configuration of the birth room, size and shape of the birth room, filter, and sensory elements. Conclusions: The findings show the importance of considering the physical environment in maternity care and that further interdisciplinary studies focused on architectural design are needed to enrich the knowledge and evidence on this topic and to develop accurate recommendations for designers.
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Affiliation(s)
- Nicoletta Setola
- Department of Architecture, Università di Firenze, Firenze, Italy
| | - Eletta Naldi
- Department of Architecture, Università di Firenze, Firenze, Italy
| | | | - Liv Bodil Eide
- Department of Child Welfare and Social Work, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laura Iannuzzi
- Department of Health Care Professions, Careggi University Hospital, Firenze, Italy
| | - Deirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Reavey P, Brown S, Kanyeredzi A, McGrath L, Tucker I. Agents and spectres: Life-space on a medium secure forensic psychiatric unit. Soc Sci Med 2019; 220:273-282. [DOI: 10.1016/j.socscimed.2018.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/25/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
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Lindgren BM, Molin J, Lundström M, Strömbäck M, Salander Renberg E, Ringnér A. Does a new spatial design in psychiatric inpatient care influence patients' and staff's perception of their care/working environment? A study protocol of a pilot study using a single-system experimental design. Pilot Feasibility Stud 2018; 4:191. [PMID: 30607254 PMCID: PMC6307228 DOI: 10.1186/s40814-018-0383-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022] Open
Abstract
Background Research shows that worn-out physical environments are obstacles to psychiatric inpatient care. Patients want better relationships with staff and things to do; staff want an environment that offers hope, a calm atmosphere, and joint activities. A county council in northern Sweden and Philips Healthcare partnered to create solutions to the environmental challenges of psychiatric inpatient care. One ward at a county psychiatric clinic was selected for a pilot project to test solutions that could improve the care environment for patients, staff, and relatives. The aim of the overall project is to evaluate the effects of a newly designed psychiatric inpatient ward on patients and staff in terms of quality of care and stress. In this study, we focus on the feasibility through testing questionnaires and exploring barriers to recruiting staff and patients. Methods This study had a single-system experimental design, comparing a psychiatric unit pre- and post-implementation of the novel spatial design, using repeated measures with the same questionnaires twice a week during baseline and intervention phases. Primary outcomes were quality interactions (patients) and perceived stress (staff). Secondary outcomes were levels of anxiety and depression (patients), and stress of conscience (staff). A process evaluation was aimed to describe contextual factors and participant experiences of the new design. Data was collected using questionnaires and semi-structured individual interviews with patients and focus group discussions with staff. Both visual and statistical methods were used to analyse the quantitative data and content analysis for the qualitative data. Discussion The findings will contribute insights into whether and how a new spatial design might contribute to quality interactions and reduced stress. This is relevant both nationally and internationally, as similar interventions are needed but sparse. The findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration ClinicalTrials.gov, NCT03140618, registered 4 May 2017
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Affiliation(s)
- Britt-Marie Lindgren
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
| | - Jenny Molin
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
| | - Mats Lundström
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
| | - Maria Strömbäck
- 2Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden.,3Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | | | - Anders Ringnér
- 1Department of Nursing, The Caring Science Building, Umeå University, 901 87 Umeå, SE Sweden
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Van Hecke L, Van Steenwinkel I, Heylighen A. How Enclosure and Spatial Organization Affect Residents' Use and Experience of a Dementia Special Care Unit: A Case Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 12:145-159. [PMID: 30209969 DOI: 10.1177/1937586718796614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM: We aim to gain insight into how a dementia special care unit is used and experienced by its residents and what design aspects are important therein. BACKGROUND: In Flanders, housing for people with dementia evolves toward small-scale, homelike environments. As population aging challenges the affordability of this evolution, architects and other designers are asked to design dementia special care units that offer the advantages of small scaleness within the context of large-scale residential care facilities. How these units are used and experienced is not systematically evaluated. METHOD: A case study was conducted in a recently built residential care facility where a dementia special care unit was foreseen on the ground floor, yet after a few months was moved to the top floor. The case study combined architectural analysis, participant observation, and qualitative interviews with residents and care staff. RESULTS: Comparing the original situation on the ground floor with the new situation on the top floor highlights how enclosure (physical and visual access to outside and the rest of the facility) and spatial organization affect how residents use and experience a dementia special care unit. CONCLUSIONS: Depending on the type and stage of dementia, residents may have different needs for space to move, sensory stimuli, and social contact. In order to meet these different needs, confining residents to a dementia special care unit to the top floor should be avoided unless it is carefully designed, providing sufficient freedom of movement and connection with the outside world.
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Affiliation(s)
- Liesl Van Hecke
- 1 Research[x]Design, Department of Architecture, KU Leuven, Leuven, Belgium
| | | | - Ann Heylighen
- 1 Research[x]Design, Department of Architecture, KU Leuven, Leuven, Belgium
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Shannon MM, Elf M, Churilov L, Olver J, Pert A, Bernhardt J. Can the physical environment itself influence neurological patient activity? Disabil Rehabil 2018; 41:1177-1189. [PMID: 29343110 DOI: 10.1080/09638288.2017.1423520] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate if a changed physical environment following redesign of a hospital ward influenced neurological patient physical and social activity. METHODS A "before and after" observational design was used that included 17 acute neurological patients pre-move (median age 77 (IQR 69-85) years Ward A and 20 post-move (median age 70 (IQR 57-81) years Ward B. Observations occurred for 1 day from 08.00-17.00 using Behavioral Mapping of patient physical and social activity, and location of that activity. Staff and ward policies remained unchanged throughout. An Environmental Description Checklist of each ward was also completed. RESULTS Behavioral Mapping was conducted pre-/post-move with a total of 801 Ward A and 918 Ward B observations. Environmental Description Checklists showed similarities in design features in both neurological wards with similar numbers of de-centralized nursing stations, however there were more single rooms and varied locations to congregate in Ward B (30% more single-patient rooms and separate allied health therapy room). Patients were alone >60% of time in both wards, although there was more in bed social activity in Ward A and more out of bed social activity in Ward B. There were low amounts of physical activity outside of patient rooms in both wards. Significantly more physical activity occurred in Ward B patient rooms (median = 47%, IQR 14-74%) compared to Ward A (median = 2% IQR 0-14%), Wilcoxon Rank Sum test z = -3.28, p = 0.001. CONCLUSIONS Overall, patient social and physical activity was low, with little to no use of communal spaces. However we found more physical activity in patient rooms in the Ward B environment. Given the potential for patient activity to drive brain reorganization and repair, the physical environment should be considered an active factor in neurological rehabilitation and recovery. Implications for Rehabilitation Clinicians should include consideration of the impact of physical environment on physical and social activity of neurological patients when designing therapeutic rehabilitation environments. Despite architectural design intentions patient and social activity opportunities can be limited. Optimal neurological patient neuroplasticity and recovery requires sufficient environmental challenge, however current hospital environments for rehabilitation do not provide this.
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Affiliation(s)
- Michelle M Shannon
- a The Florey Institute of Neuroscience & Mental Health, NHMRC Centre of Research Excellence in Stroke Rehabilitation and Recovery , Melbourne , Australia
| | - Marie Elf
- b School of Education, Health and Social Studies , Dalarna University , Falun , Sweden.,c Department of Architecture , Chalmers University of Technology , Göteborg , Sweden
| | - Leonid Churilov
- a The Florey Institute of Neuroscience & Mental Health, NHMRC Centre of Research Excellence in Stroke Rehabilitation and Recovery , Melbourne , Australia
| | - John Olver
- d Rehabilitation Division of Epworth Hospital, Clinical Sciences School of Monash University , Melbourne , Australia
| | - Alan Pert
- e Melbourne School of Design , University of Melbourne , Melbourne , Australia
| | - Julie Bernhardt
- a The Florey Institute of Neuroscience & Mental Health, NHMRC Centre of Research Excellence in Stroke Rehabilitation and Recovery , Melbourne , Australia
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A systematic review of research on psychiatric mother-baby units. Arch Womens Ment Health 2017; 20:373-388. [PMID: 28332002 DOI: 10.1007/s00737-017-0718-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 03/06/2017] [Indexed: 10/19/2022]
Abstract
Psychiatric mother-baby units (MBUs) are currently viewed as best practice, particularly in the UK, Australia and France, for improving outcomes for mothers and babies when the former are experiencing severe forms of mental illness. A growing number of publications have examined MBUs, but to date, there has not been a comprehensive review of these studies. As such, the systematic review reported in this paper sought to address this gap. A systematic search was conducted for peer-reviewed research and grey literature published in English between 2000 and 2015. A final sample of 44 publications were identified that reported on empirical findings with regard to MBUs. Three quarters of the studies focused on individual MBUs and most studies were quantitative. A thematic analysis of the studies identified three major themes: (1) admissions data, (2) outcomes for mothers, and (3) programmes and interventions. The analysis also identified four secondary themes: (i) follow-up after discharge, (ii) separation of mothers and babies after discharge, (iii) client satisfaction with MBUs, and (iv) partners of women admitted to MBUs. The findings of the review highlight gaps in knowledge about MBUs and provide suggestions for future research.
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