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Norouzi N, Martinez A, Rico Z. Architectural Design Qualities of an Adolescent Psychiatric Hospital to Benefit Patients and Staff. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:103-117. [PMID: 37365801 PMCID: PMC10621023 DOI: 10.1177/19375867231180907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVES This study is focused on how architectural design of adolescent psychiatric hospitals could positively affect not only patients but also staff members working at the hospitals. BACKGROUND Adolescents between the ages of 12 and 18 are among the young population with the highest percentage of mental illness. However, there are limited number of intentionally designed psychiatric hospitals for adolescents. Staff who work in adolescent psychiatric hospitals may face workplace violence. Studies on environmental impacts suggest that the built environment affects patients' well-being and safety as well as staff's satisfaction, working condition, safety, and health. However, there are very few studies that focus on adolescent psychiatric hospitals and the impact of the built environment on both staff and patients. METHODS Data were collected through literature analysis and semi-structured interviews with staff of three psychiatric state hospitals with adolescent patient units. The triangulation of multiple data sources informed a set of environmental design conditions that captures the complexity and connectedness of architectural design and the occupants of an adolescent psychiatric hospital. RESULTS The results present architectural composition, atmosphere, lighting, natural environment, safety, and security as indispensable design conditions to create an enclosed and city-like campus that provides a serene, secure, and structured environment that benefit staff and adolescent patients. CONCLUSION The specific design strategies that need to be incorporated in the architectural design of a safe and secure adolescent psychiatric hospital include an open floor plan that respects patients' autonomy and offers privacy while always providing staff with full visibility of patients.
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Affiliation(s)
- Neda Norouzi
- Department of Architecture, University of Texas at San Antonio, TX, USA
| | - Antonio Martinez
- Department of Architecture, University of Texas at San Antonio, TX, USA
| | - Zayra Rico
- Department of Architecture, University of Texas at San Antonio, TX, USA
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Verderber S, Koyabashi U, Cruz CD, Sadat A, Anderson DC. Residential Environments for Older Persons: A Comprehensive Literature Review (2005-2022). HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:291-337. [PMID: 37078127 PMCID: PMC10328148 DOI: 10.1177/19375867231152611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Independent noninstitutional and institutional residential long-term care environments for older persons have been the subject of significant empirical and qualitative research in the 2005-2022 period. A comprehensive review of this literature is reported, summarizing recent advancements in this rapidly expanding body of knowledge. PURPOSE AND AIM This comprehensive review conceptually structures the recent literature on environment and aging to provide conceptual clarity and identify current and future trends. METHOD AND RESULT Each source reviewed was classified as one of the five types-opinion piece/essay, cross-sectional empirical investigation, nonrandomized comparative investigation, randomized study, and policy review essay-within eight content categories: community-based aging in place; residentialism; nature, landscape, and biophilia; dementia special care units; voluntary/involuntary relocation; infection control/COVID-19, safety/environmental stress; ecological and cost-effective best practices; and recent design trends and prognostications. CONCLUSIONS Among the findings embodied in the 204 literature sources reviewed, all-private room long-term care residential units are generally safer and provide greater privacy and personal autonomy to residents, the deleterious impacts of involuntary relocation continue, family engagement in policy making and daily routines has increased, multigenerational independent living alternatives are increasing, the therapeutic role of nature and landscape is increasingly well-documented, ecological sustainability has increased in priority, and infection control measures are of high priority in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review sets the stage for further research and design advancements on this subject in light of the rapid aging of societies around the globe.
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Affiliation(s)
- Stephen Verderber
- Centre for Design + Health Innovation, John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Umi Koyabashi
- Centre for Design + Health Innovation, John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Catherine Dela Cruz
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Aseel Sadat
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Diana C. Anderson
- Boston University School of Medicine, MA, USA
- Jacobs, Dallas, TX, USA
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Jingyi M, Shanshan Z, Wu Y. The Influence of Physical Environmental Factors on Older Adults in Residential Care Facilities in Northeast China. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:131-149. [PMID: 34477011 DOI: 10.1177/19375867211036705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the aspects of the objective physical environments of five residential care facilities (RCFs) for older adults and the residents' subjective perceptions of these aspects. BACKGROUND The physical environment in RCFs impacts the health and comfort of the residents. However, the design standards for RCFs lack details which can result in insufficient living conditions. METHODS Through questionnaire surveys, older adults' satisfaction on the degree of the light, acoustic, and thermal environment in the facilities was obtained. Indoor lighting condition was measured by an illuminance meter in lux, sound pressure level (SPL) with sound level meters in dBA, and temperature in °C with a temperature data logger, and an audiometer was used to test the hearing of the older adults. RESULTS A total of 480 questionnaires were obtained. Results show that (a) older adults need an appropriate light environment to avoid the negative impact of limited light, (b) poor acoustic environment could affect their mood and health, and (c) when the room temperature is within the range of 20-26 °C (68-78.8 °F), they feel most comfortable. When the appropriate temperature and humidity, balanced illumination, and SPL meet the needs of older adults, it can provide a more comfortable physical environment for them. CONCLUSION Examining the interaction between the physical environmental factors that affect older adults in RCFs is important for the design of residential housing and provides more theoretical support for research on the influence of the physical environment on the quality of life of older adults.
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Affiliation(s)
- Mu Jingyi
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, School of Architecture, 48722Harbin Institute of Technology, China
- School of Architecture, The University of Sheffield, United Kingdom
| | - Zhang Shanshan
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, School of Architecture, 48722Harbin Institute of Technology, China
| | - Yue Wu
- Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, School of Architecture, 48722Harbin Institute of Technology, China
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Roccaro I, Smirni D. Fiat Lux: The Light Became Therapy. An Overview on the Bright Light Therapy in Alzheimer's Disease Sleep Disorders. J Alzheimers Dis 2020; 77:113-125. [PMID: 32804145 DOI: 10.3233/jad-200478] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND A system of photosensitive retinal ganglion cells provides 'non-visual' information on the circadian sequences of light to the suprachiasmatic nucleus (SCN), which, as the 'master clock', synchronizes the chronobiological mechanisms of all the biological clocks. Damage to SCN structure alters circadian behavioral and hormonal rhythms and interferes with a regular sleep-wake pattern. Several studies have shown that, in aging and in Alzheimer's disease (AD), circadian rhythms change their synchronization with the environment and behavior loses sync with light. OBJECTIVE The current overview aims to examine research studies showing the effect of bright light therapy (BLT) on sleep disorders and sleep-wake patterns in AD. METHODS A literature search was conducted, taking into consideration the relevant studies over the last 20 years. Fifteen studies have been thorough: seven followed an environmental-architectural approach and eight followed a treatment devices approach. RESULTS Studies agree in considering BLT as a promising non-pharmacological intervention to compensate for circadian rhythm alterations and they support the need for standardized protocols that allow a comparison between multicenter studies. CONCLUSION Interestingly, in an attempt to contain the spread of the COVID-19 pandemic, health authorities have forced the population to stay home. Therefore, AD people are not currently able to enjoy exposure to sunlight. It is predictable that they may experience an exacerbation of circadian disturbances and that the BLT can be an effective response to prevent such exacerbation.
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Affiliation(s)
- Ilaria Roccaro
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Daniela Smirni
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Wang Z. Cross-National Comparison of Environmental Factors Important to Facility-Based Senior Living. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 13:186-199. [PMID: 31994919 DOI: 10.1177/1937586720901344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Focusing on environmental factors important to facility-based senior living, this research intends to identify cross-national similarities and differences in perspective on elderly care between senior-living professionals in the United States and China. BACKGROUND American models of senior-living facility design have been introduced in China. In social and cultural context, environmental factors important to facility-based senior living are expected to be different by nation and need to be clarified. METHOD Questionnaire data were collected from 188 staff members working in senior-living facilities in the United States and China. Seven factors summarized through literature review were investigated. The frequencies of each factor selected by the participants as one of the three most important factors were ranked. The influence of personal and social factors on environmental perception was analyzed using analysis of variance tests. RESULTS Common area and cross-facility home-like decoration were similarly valued by both groups as two of the three most important factors. Residential room was valued more in the United States whereas natural lighting was valued more in China. Chinese participants with more work experience valued building layout more. Amenities were valued less than expected in both countries. CONCLUSION Environmental factors important to facility-based senior living are different between countries. American models of senior-living facility design should be adjusted for use in China. There is much to be gained from investigating the similarities and differences in perspective on elderly care.
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Affiliation(s)
- Zhe Wang
- Department of Architecture, Henan University, Kaifeng, China
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Te Kulve M, Schlangen LJM, van Marken Lichtenbelt WD. Early evening light mitigates sleep compromising physiological and alerting responses to subsequent late evening light. Sci Rep 2019; 9:16064. [PMID: 31690740 PMCID: PMC6831674 DOI: 10.1038/s41598-019-52352-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/10/2019] [Indexed: 12/22/2022] Open
Abstract
The widespread use of electric light and electronic devices has resulted in an excessive exposure to light during the late-evening and at night. This late light exposure acutely suppresses melatonin and sleepiness and delays the circadian clock. Here we investigate whether the acute effects of late-evening light exposure on our physiology and sleepiness are reduced when this light exposure is preceded by early evening bright light. Twelve healthy young females were included in a randomised crossover study. All participants underwent three evening (18:30-00:30) sessions during which melatonin, subjective sleepiness, body temperature and skin blood flow were measured under different light conditions: (A) dim light, (B) dim light with a late-evening (22:30-23:30) light exposure of 750 lx, 4000 K, and (C) the same late-evening light exposure, but now preceded by early-evening bright light exposure (18.30-21.00; 1200 lx, 4000 K). Late-evening light exposure reduced melatonin levels and subjective sleepiness and resulted in larger skin temperature gradients as compared to dim. Interestingly, these effects were reduced when the late-evening light was preceded by an early evening 2.5-hour bright light exposure. Thus daytime and early-evening exposure to bright light can mitigate some of the sleep-disruptive consequences of light exposure in the later evening.
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Affiliation(s)
- Marije Te Kulve
- Department of Human Biology & Movement Sciences, NUTRIM, Maastricht University, Maastricht, The Netherlands. .,bba indoor environmental consultancy, The Hague, The Netherlands.
| | - Luc J M Schlangen
- Intelligent Lighting Institute, Department of Human Technology Interaction, Eindhoven University of Technology, Eindhoven, The Netherlands.,Signify, Eindhoven, The Netherlands
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Tactics to Evaluate the Evidence Base of a Nonbehavioral Intervention in an Expanded Consumer Area. Behav Anal Pract 2018; 12:677-687. [PMID: 31976278 DOI: 10.1007/s40617-018-00308-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The purpose of this article is to provide tactics for the behavior analyst to effectively evaluate the evidence base for an unfamiliar nonbehavioral intervention when expanding services. Just as behavior analysts must be aware of fad treatments in autism likely to be encountered, so, too, should practitioners become familiar with potential fad treatments in any expanded area of practice. The present article extends previous work by considering challenges surrounding contact with nonbehavioral literature in the context of an expanded consumer base. The article also considers ethical interactions with nonbehavioral professionals following appraisal of the intervention, and how adopting the strategies listed here can aid in establishing oneself as a resource. Associated barriers and solutions are presented around four tactics: (a) searching the literature, (b) recognizing and evaluating the common properties of fad treatments, (c) distinguishing quality of evidence, and (d) ascertaining behavioral mechanisms of action. Examples from gerontology will be provided to illustrate the use of the proposed tactics.
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Catt M, Giridharan R. The Reality of Well-Being-Focused Design in Dementia Care: A Case Study of Acute Dementia Wards in the United Kingdom. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 11:130-149. [PMID: 29916274 DOI: 10.1177/1937586718779172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: The study explored design for well-being within dementia care by investigating the adoption of well-being-focused design in real-world practice, through observing National Health Service (NHS) wards. BACKGROUND: Design for well-being is an approach that considers the psychological and physiological effects of architecture to improve health and well-being. The high psychological care requirement for dementia patients makes them a significant group to study in the evaluation of current hospital facilities. METHODS: A literature review was conducted to frame the current theoretical perception of the key characteristics of a good environment for dementia care. A framework was generated to summarize and used as an assessment tool in a series of observational visits to NHS wards. Interviews with clinical staff focused on care outcomes and practicalities of implementing well-being-focused design, considering the historical and economical context. Key findings from the observations and interviews were analyzed for recurring themes. RESULTS: The ward observations and interviews provided insight into the current progression of well-being-led design in NHS hospitals in England. The research highlights key areas of success and factors that inhibit further progression. CONCLUSIONS: The case studies showed a good degree of ambition to utilize well-being-focused design, with belief among staff that the physical environment has a substantial role in the health and well-being of patients. Staff also felt that this approach is most effective for those in the less advanced stages of dementia. Despite the high level of support, the current degree of implementation appears to be varied.
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Affiliation(s)
- Megan Catt
- 1 Pattern Design, London, United Kingdom
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Giménez MC, Geerdinck LM, Versteylen M, Leffers P, Meekes GJBM, Herremans H, de Ruyter B, Bikker JW, Kuijpers PMJC, Schlangen LJM. Patient room lighting influences on sleep, appraisal and mood in hospitalized people. J Sleep Res 2016; 26:236-246. [DOI: 10.1111/jsr.12470] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 09/27/2016] [Indexed: 01/25/2023]
Affiliation(s)
| | | | - Mathijs Versteylen
- Department of Cardiology; St Antonius Hospital; Nieuwegein the Netherlands
| | - Pieter Leffers
- school CAPHRI; Maastricht University Medical Center; Maastricht the Netherlands
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van Ee R, Van de Cruys S, Schlangen LJ, Vlaskamp BN. Circadian-Time Sickness: Time-of-Day Cue-Conflicts Directly Affect Health. Trends Neurosci 2016; 39:738-749. [DOI: 10.1016/j.tins.2016.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/06/2016] [Accepted: 09/13/2016] [Indexed: 10/20/2022]
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Morley JE. Sleep and the Nursing Home. J Am Med Dir Assoc 2015; 16:539-43. [DOI: 10.1016/j.jamda.2015.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/06/2015] [Indexed: 12/14/2022]
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White MD, Ancoli-Israel S, Wilson RR. Senior Living Environments: Evidence-Based Lighting Design Strategies. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2013; 7:60-78. [DOI: 10.1177/193758671300700106] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: To review from an architectural lighting perspective the effects of indoor lighting on the health and well-being of people in senior living environments. BACKGROUND: The role of circadian rhythms in people with chronic disorders continues to be a focus of laboratory research and clinical trials. Beneficial, evidence-based indoor lighting design strategies are being considered for senior living environments, particularly for residents who have limited access to natural bright light. METHODS: Articles published 2002–2012 reporting the results of prospective, randomized, controlled clinical trials (RCTs) were accessed using the U.S. National Library of Medicine PubMed site using the following search terms: “light, sleep, circadian, randomized, controlled, nursing home” and “light, sleep, circadian, randomized, controlled, elderly.” RESULTS: The search resulted in 48 citations, of which 18 meet our pre-search criteria. Data from these RCTs indicate options such as programmable, 24-hour lighting algorithms that may involve light intensity, lighting duration, spectra (wavelength) and lighting timing sequences CONCLUSIONS: Valid and actionable data are available about circadian rhythms, sleep, and human health and well-being that can inform the design of lighting for long-term care. Evidence-based architectural design of a 24-hour light/dark environment for residents may mitigate symptoms of circadian disruption; evidence-based management of darkness is as important as evidence-based management of light. Further research is needed into the long-term circadian health needs of night staff members in order to understand the effects of shift work while, at the same time providing the highest level of care.
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