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Bourdon E, Havreng-Théry C, Lafuente C, Belmin J. Effect of the Physical Environment on Health and Well-Being of Nursing Homes Residents: A Scoping Review. J Am Med Dir Assoc 2022; 23:1826.e1-1826.e20. [PMID: 35787419 DOI: 10.1016/j.jamda.2022.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES In what way the physical environment of nursing homes (NHs) influences the health and well-being of nursing residents is not well codified. The authors aimed to review scientifically based knowledge on this topic. DESIGN A systematic scoping review of research into the effect that physical environment in nursing homes has on residents' health. SETTING AND PARTICIPANTS Search for relevant English-language articles in PubMed and the Cochrane database before April 15, 2022. Article selection and data extraction were performed by 2 researchers. Studies were included if conducted on nursing home residents and if they examined associations between components of the physical environment and health outcomes. MEASURES The review was performed in accordance with the PRISMA statement. RESULTS Of 1347 articles retrieved, 59 met the inclusion criteria-40 observational, 1 survey, and 18 interventional studies, of which 5 were randomized controlled trials. Certain environmental features repeatedly show significant positive effect on resident's health, such as noise reduction, tuning of lighting, natural light, easy access to garden, dining environment, and resident-centered interior renovation. Nursing home size was not found to have a direct relationship to resident health and well-being, although it is related to more than only the physical environment (eg, social environment). CONCLUSIONS AND IMPLICATIONS This review provides guidance in selective areas of the physical environment for the design of nursing homes, with potential benefits for the health and well-being of residents.
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Affiliation(s)
- Etienne Bourdon
- Laboratoire Éducation et Promotion de la Santé (LEPS UR 3412), Université Sorbonne Paris Nord, Bobigny, France; Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France
| | - Charlotte Havreng-Théry
- Laboratoire Éducation et Promotion de la Santé (LEPS UR 3412), Université Sorbonne Paris Nord, Bobigny, France; Laboratoire d'Informatique et d'Ingénierie des Connaissances en e-Santé (LIMICS, INSERM UMRS 1142), Sorbonne Université, Paris, France
| | - Carmelo Lafuente
- Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France; Clinical Epidemiology and Ageing (CePia), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Est-Créteil, Créteil, France
| | - Joël Belmin
- Service de Gériatrie, Hôpital Charles Foix, Assistance Publique-Hôpitaux de Paris and Faculté de Médecine Sorbonne, Ivry-sur-Seine, France; Laboratoire d'Informatique et d'Ingénierie des Connaissances en e-Santé (LIMICS, INSERM UMRS 1142), Sorbonne Université, Paris, France.
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Bae S, Asojo AO. Interior Environments in Long-Term Care Units From the Theory of Supportive Design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:233-247. [PMID: 34872374 DOI: 10.1177/19375867211062847] [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: 11/17/2022]
Abstract
AIM This study was designed to examine how residents in long-term care (LTC) units perceive their living environment based on the theory of supportive design. BACKGROUND Healthcare environments may cause a significant level of stress mainly due to patients' lack of familiarity with such environments and patients' poor health conditions. According to the theory, the healthcare environments providing a sense of control, social support, and positive distraction can promote wellness. This study was designed to learn how LTC residents perceive their current living environments. METHOD This study collected data through qualitative interviews. A total of 48 residents living in two LTC units were asked the three interior environments they liked and they wanted to improve. Only the residents who lived in the current space for 1 month and communicate without any cognitive disabilities were able to participate. Most residents were female and lived in a private room. RESULTS The participants' responses indicated the importance of perceived control, social support, and positive distraction in the environment. The most frequently mentioned interior environment that the residents liked was "window and view," followed by "pictures and photos" and "TV," while they wanted "bigger room and space," followed by "improved privacy" and "more options for food." In addition to the three elements, the participants considered other elements as important for them which can benefit the participants. CONCLUSION More studies must be carried out to expand the theory, so that it can be applied to future studies with inclusive perspectives.
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Affiliation(s)
- Suyeon Bae
- Department of Housing and Interior Design, Kyung Hee University, Seoul, South Korea
| | - Abimbola O Asojo
- Department of Design, Housing, and Apparel, University of Minnesota, MN, USA
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Holmes SD, Resnick B, Galik E, Kusmaul N. Developing and Testing A Model of the Assisted Living Environment. JOURNAL OF AGING AND ENVIRONMENT 2020; 35:62-76. [PMID: 34423332 PMCID: PMC8378798 DOI: 10.1080/26892618.2020.1793439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The assisted living (AL) environment plays an important role in supporting residents' satisfaction and helping them to age in place. The AL environment is multidimensional and has many interrelated components including staffing (e.g. direct care workers, nursing, activity staff), services provided (e.g. medical, mental health, pharmacy), amenities offered at the setting (e.g. beauty salon, library, exercise facilities), and the physical environment. Evidence suggests that aspects of the AL environment can enhance or detract from the physical function, well-being, social engagement, and behavioral outcomes among residents. The purpose of this study was to develop and test a multidimensional AL environment measurement model that includes indicators of staffing, services, amenities, and the physical environment. Baseline data was used from a study testing the Dissemination and Implementation of Function Focused Care in AL. A total of 54 AL facilities across three states were included in the sample. Settings ranged in size from 31 to 164 beds with an average size of 82.2 (SD=26.2) beds and the majority were for profit facilities (n=41, 74.5%). Structural equation modeling was used to test the proposed model. Results showed that the model fit the data (χ2/df=1.861, p<.05; CFI=.858, RMSEA=.126). Having a comprehensive AL environment measurement model will advance future research that explores the impact of the environment on resident outcomes. Findings from this study will inform interventions and programs designed to modify AL environments to optimize residents' satisfaction with AL.
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Affiliation(s)
- Sarah D. Holmes
- University of Maryland, Baltimore, School of Pharmacy, 220 N. Arch Street, Baltimore, Maryland 21201
| | - Barbara Resnick
- University of Maryland, Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201
| | - Elizabeth Galik
- University of Maryland, Baltimore, School of Nursing, 655 West Lombard Street, Baltimore, MD 21201
| | - Nancy Kusmaul
- University of Maryland Baltimore County, Department of Social Work, 1000 Hilltop Circle, Baltimore, MD 21250
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Money AG, Atwal A, Boyce E, Gaber S, Windeatt S, Alexandrou K. Falls Sensei: a serious 3D exploration game to enable the detection of extrinsic home fall hazards for older adults. BMC Med Inform Decis Mak 2019; 19:85. [PMID: 30992072 PMCID: PMC6469143 DOI: 10.1186/s12911-019-0808-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 04/01/2019] [Indexed: 01/20/2023] Open
Abstract
Background Falls are the main cause of death and injury for older adults in the UK. Many of these falls occur within the home as a result of extrinsic falls risk factors such as poor lighting, loose/uneven flooring, and clutter. Falls education plays an important role in self-management education about extrinsic hazards and is typically delivered via information leaflets, falls apps, and educational booklets. Serious games have the potential of delivering an engaging and informative alternative to traditional methods but almost exclusively, these are currently delivered as exergaming applications that focus solely on intrinsic falls risk factors. This study presents ‘Falls Sensei’ a first-person 3D exploration game that aims to educate older adults about extrinsic falls risk factors within the home environment. After presenting Falls Sensei, game usability and older adults’ perceptions and attitudes towards using the game in practice are explored. Methods This study involved 15 community dwelling older adults. After playing the Falls Sensei game, participants completed a Systems Usability Scale (SUS) questionnaire and post task interview, and follow-up interviews three weeks later. Inductive and deductive thematic template analysis, informed by the Unified Theory of Acceptance and Use of Technology model, was used to analyse the think-aloud, post-task and follow-up interview transcripts. Descriptive statistical analysis and one-sampled t-tests were used to analyse log-file data and SUS responses. Results Three high-level themes emerged from the analysis of transcriptions: Performance Expectancy; Effort Expectancy; Social Influence. The SUS score was 77.5/100 which indicates ‘Good’ levels of usability. Interestingly, reported usability of the game increased with participant age. Participants were positive about the usability of the game (p < = 0.05 for 9/10 items). The most memorable fall hazards were those most commonly encountered in the game or those most challenging to participants. Conclusions The results support the use of serious games as an engaging tool for educating older adults about extrinsic falls risk factors. Awareness of home hazard detection was raised by the game, and some older adults became more aware for the need to adapt their own homes after gameplay. Further research would be needed to draw comparisons with established interventions.
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Affiliation(s)
- Arthur G Money
- Department of Computer Science, Brunel University London, Uxbridge, UB8 3PH, UK.
| | - Anita Atwal
- Faculty of Health and Social Care, London South Bank University, London, SE1 0AA, UK
| | - Emily Boyce
- North London Forensic Service, Barnet, Enfield and Haringey Mental Health NHS Trust, Enfield, EN2 8JL, UK
| | - Sophie Gaber
- Department of Neurobiology, Care Sciences & Society, Division of Occupational Therapy, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Susan Windeatt
- CIS Westminster Rehabilitation Service, Gordon Hospital London, CNWL NHS Foundation Trust, SW1V 2RH, London, UK
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Teresi JA, Ramírez M, Fulmer T, Ellis J, Silver S, Kong J, Eimicke JP, Boratgis G, Meador R, Lachs MS, Pillemer K. Resident-to-Resident Mistreatment: Evaluation of a Staff Training Program in the Reduction of Falls and Injuries. J Gerontol Nurs 2018; 44:15-23. [PMID: 29677382 PMCID: PMC6668910 DOI: 10.3928/00989134-20180326-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/22/2018] [Indexed: 11/20/2022]
Abstract
Resident-to-resident elder mistreatment (R-REM) occurs frequently in long-term services and support settings. The purpose of the current study was to evaluate the effect of a R-REM training program for nursing and other frontline staff on resident falls and injuries in a cluster randomized trial of units within four nursing homes. Interview and observational data from a sample of 1,201 residents (n = 600 and n = 601 in the usual care and intervention groups, respectively) and staff were collected at baseline and 6 and 12 months. A generalized linear model was used to model the falls/injuries outcome. The net reduction in falls and injuries was 5%, translating to 10 saved events per year in an averagesized facility. Although the result did not reach statistical significance due to low power, the findings of fall prevention associated with implementing the intervention in long-term care facilities is clinically important. [Journal of Gerontological Nursing, 44(6), 15-23.].
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Kim D, Portillo M. Fall Hazards Within Senior Independent Living: A Case-Control Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 11:65-81. [DOI: 10.1177/1937586717754185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Daejin Kim
- Department of Interior Design, Iowa State University, IA, USA
| | - Margaret Portillo
- College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA
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Holmes SD, Galik E, Resnick B. Factors that Influence Physical Activity among Residents in Assisted Living. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2017; 60:120-137. [PMID: 27982744 PMCID: PMC6311414 DOI: 10.1080/01634372.2016.1269035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to examine factors that influence physical activity among residents in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from 4 assisted living facilities. Using structural equation modeling, we found that mood, satisfaction with staff and activities, and social support for exercise were directly associated with time spent in physical activity. Gender, cognition, depression, and comorbidities were indirectly associated with physical activity and accounted for 13% of the total variance in physical activity. Implications for future research and social work practice are presented.
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Affiliation(s)
- Sarah D. Holmes
- Department of Gerontology, University of Maryland, Baltimore, Maryland; USA
| | - Elizabeth Galik
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Barbara Resnick
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
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Intraindividual Changes in Ambulation Associated With Falls in a Population of Vulnerable Older Adults in Long-Term Care. Arch Phys Med Rehabil 2016; 97:1963-1968. [DOI: 10.1016/j.apmr.2016.05.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/09/2016] [Accepted: 05/14/2016] [Indexed: 11/23/2022]
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Jiang S, Verderber S. On the Planning and Design of Hospital Circulation Zones. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2016; 10:124-146. [PMID: 27742819 DOI: 10.1177/1937586716672041] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This present literature review explores current issues and research inconsistencies regarding the design of hospital circulation zones and the associated health-related outcomes. BACKGROUND Large general hospitals are immense, highly sophisticated institutions. Empirical studies have indicated excessively institutional environments in large medical centers are a cause of negative effects to occupants, including stress, anxiety, wayfinding difficulties and spatial disorientation, lack of cognitional control, and stress associated with inadequate access to nature. The rise of patient-centered and evidence-based movements in healthcare planning and design has resulted in a general rise in the quality of hospital physical environments. However, as a core component of any healthcare delivery system, hospital circulation zones have tended to remain neglected within the comparatively broad palette of research conducted and reported to date. METHOD A systematic literature review was conducted based upon combinations of key words developed vis-à-vis a literature search in 11 major databases in the realm of the health sciences and the planning and design of built environments for healthcare. RESULTS Eleven peer-reviewed articles were included in the analysis. Six research themes were identified according to associated health-related outcomes, including wayfinding difficulties and spatial disorientation, communication and socialization patterns, measures and control of excessive noise, patient fall incidents, and occupants' stress and satisfaction levels. CONCLUSIONS Several knowledge gaps as well as commonalities in the pertinent research literature were identified. Perhaps the overriding finding is that occupants' meaningful exposure to views of nature from within hospital circulation zones can potentially enhance wayfinding and spatial navigation. Future research priories on this subject are discussed.
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Affiliation(s)
- Shan Jiang
- 1 School of Design and Community Development, West Virginia University, Morgantown, WV, USA
| | - Stephen Verderber
- 2 John H. Daniels Faculty of Architecture, Landscape and Design, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Wiwanitkit V, Kaewla W. Letter to the Editors: Comments on Wood-Nartker et al. Article in HERD 7(3). HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2015; 8:228-9. [PMID: 25816191 DOI: 10.1177/193758671400800114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wood-Nartker J, Guerin DA, Beuschel E. Environmental Cues: Their Influence within Assisted Living Facilities. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2014; 7:120-43. [DOI: 10.1177/193758671400700309] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: This observational study examined the relationship between the number of environmental sensory cues within assisted living facilities (ALFs) and the number of falls by residents, using Lawton's environmental press theory as framework. BACKGROUND: A result of declining physical health is unintentional injury, for example, falling, which is one of the leading causes of death for older adults. Physical limitations increase largely due to age-related physical and sensory decline, which can increase the risk of people falling. Therefore, fall prevention becomes essential ( Willis, 2000 ). METHODS: On-site interviews were scheduled with 140 ALF directors located in the lower peninsula of Michigan. The researchers collected physical environmental data using a sensory cue checklist on a subset of rooms, for example, Lounge/Living Room, Dining Room, Corridor, Public Restroom, and Foyers in ALFs, because of the prevalence of falls within these rooms. RESULTS: Findings showed that fall rates and environmental cues sometimes have a negative correlation. A positive correlation was found between the number of residents living in an ALF and the mean number of cues included in the overall environment. Finally, there were a greater number of environmental cues incorporated when design professionals were involved. CONCLUSIONS: The need to control for facility size and for some room types when relating environmental cues to falls became clear. In addition, design professionals should have a thorough understanding of the nature of the facility and the need to control some factors in facilities, especially when including environmental cues.
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