Color and newborn intensive care unit design: executive summary

Research on color in the design of healthcare settings is minimal. This paper provides an executive summary of a recent review on this topic, focusing on application to newborn intensive care units. The review focuses on the following question: Does the use of color in the design of the newborn intensive care units impact health outcomes in infants, families, and/or staff? We employed a structured review process, resulting in four studies involving the use of color in NICUs. The search was expanded to include general research on responses to color and studies in other healthcare settings. The literature clustered around preferences and psychobiological impact of color on infants and adults in NICUs, the interaction of color and light, and the impact of color on adults in general medical settings. Recommendations are made regarding the importance of modifiability and flexibility in the use of color in NICUs and colors that are associated with stress reduction and stimulation.

Color and NICU Design

PURPOSE

The appropriate use of color in healthcare settings has been a topic of interest for designers and researchers, and the need for evidence-based standards evident. The purpose of this article is to summarize recent research on color as applicable to neonatal intensive care units and to propose standards for color in these settings.

BACKGROUND

Research on this topic is limited due to difficulties associated with constructing research protocols, challenges in setting parameters for the independent variable (color), and the need to simultaneously address infants, families, and caregivers.

METHODS

For our literature review, the following research question was developed: Does the use of color in the design of the neonatal intensive care units (NICUs) impact health outcomes in newborn infants, families, and/or staff? Using Arksey and O'Malley's framework for conducting a structured literature review, we (1) identified the research question, (2) identified relevant studies, (3) selected studies, and (4) collated and summarized the results. Only four papers were found regarding NICUs, so the search was expanded to include related healthcare and authors reporting on best practice.

RESULTS

Overall, the primary research focused on behavioral or physiological outcomes including the role of wayfinding and art, the impact of lighting on color, and tools for evaluating the impact of color. Best practice recommendations sometimes reflected the primary research but occasionally provided contradictory advice.

CONCLUSIONS

Based on the reviewed literature, five topics are addressed: palette malleability; the use of the primary colors, blue, red, and yellow; and the relationship between light and color.

Evidence-Based Design for Waiting Space Environment of Pediatric Clinics-Three Hospitals in Shenzhen as Case Studies

This study explores the waiting space environment of pediatric clinics in general hospitals and the relationships between the use of space, behavioral activities and overall satisfaction. Patients often spend a lot of time waiting for doctors, and child patients waiting to be seen are particularly likely to feel bored, depressed and anxious, which negatively affects their overall experience of seeking medical attention. Since the launch of China's second-child policy, the number of children born in China has surged. As medical resources for children are in short supply and of uneven quality, it is urgently necessary to carry out research on optimizing the design of children's waiting space in Chinese hospitals to improve their medical environment and experience.

METHOD

This study identified four first-level indicators and twenty-seven second-level indicators in four dimensions: functional layout (layout and area), flow organization, supporting facilities and environmental details (physical and landscape environment). The research combined subjective and objective methods, including comprehensive observation, a questionnaire survey and interviews, taking three hospitals in Shenzhen as case studies.

RESULTS

The study found that the waiting space in pediatric clinics currently fails to meet key patient needs in areas such as mother and infant rooms, children's play areas and drinking water facilities, and there are widespread problems with the creation of natural environments, such as views of natural scenery from windows and indoor green plants. Six factors were found to significantly positively influence overall satisfaction with waiting space, describing 69.76% of the changes in the respondents' degree of satisfaction with the waiting environment. Supporting facilities and aspects of the physical environment had the greatest influence on overall satisfaction with the waiting space.

CONCLUSION

Optimizing the design of the waiting space in pediatric clinics, with a focus on functional layout, flow organization, supporting facilities and environmental details, can improve overall satisfaction with pediatric waiting rooms. The results are preliminary; they need to be further tested in practice to complete the process of evidence-based design. This will lead to suggestions for refining the design of pediatric waiting units which can be used by architects and hospital administrators.

The Cognitive-Emotional Design and Study of Architectural Space: A Scoping Review of Neuroarchitecture and Its Precursor Approaches

Humans respond cognitively and emotionally to the built environment. The modern possibility of recording the neural activity of subjects during exposure to environmental situations, using neuroscientific techniques and virtual reality, provides a promising framework for future design and studies of the built environment. The discipline derived is termed "neuroarchitecture". Given neuroarchitecture's transdisciplinary nature, it progresses needs to be reviewed in a contextualised way, together with its precursor approaches. The present article presents a scoping review, which maps out the broad areas on which the new discipline is based. The limitations, controversies, benefits, impact on the professional sectors involved, and potential of neuroarchitecture and its precursors' approaches are critically addressed.

Application of Human Factors in Neonatal Intensive Care Unit Redesign

Only recently has physical space design become more widely recognized as playing a critical role in delivery of care, with an emerging body of literature on the application of human factors approaches to design and evaluation. This chapter describes the use of human factors approaches to develop and conduct an evaluation of a proposed Neonatal Intensive Care Unit redesign in a Midwestern children's hospital. Methods included observations and knowledge elicitation from stakeholders to characterize their goals, challenges, and needs. This characterization is integral to informing the design of user-centered solutions, including physical space design. We also describe an approach to evaluating the proposed design that yielded actionable recommendations specific to hospital-driven design goals.

Ways to harness the built environment of ambulatory cancer facilities for comprehensive patient support: A review of the literature

OBJECTIVE

To review patient experiences of the architectural elements conducive to a supportive or healing-promoting environment in the context of ambulatory oncology care.

DESIGN

A comprehensive review of original peer-reviewed qualitative studies conducted to reveal the meaning and significance of patient experience in this context was undertaken.

DATA SOURCES

Studies were identified through electronic databases including Ovid MEDLINE, CINAHL, PubMed and Embase. No time limit was applied and language was restricted to English.

REVIEW METHODS

The generated records were screened at the titles and abstracts level by the first reviewer, with full text assessment conducted by both authors. Main themes were extracted in an excel file and a narrative synthesis strategy was used to systematically gather evidence and explain the findings. The guidelines of the Centre for Reviews and Dissemination have been followed in the searching and reporting of the essential matters relevant to this review.

RESULTS

Eleven original studies were selected; in addition to these, fourteen other studies that did not fully meet the selection criteria, however held important information relevant to the scope of the review, were considered to expand the discussion with relevant information to ambulatory cancer facilities. The findings of these studies were synthesized into five major themes: stimulating and homely environments; flexibility and environmental enrichment; social support; complementary support and engagement; and physical and sensory support.

CONCLUSION

The paper identified key architectural design qualities that have the potential to support treatment and empower patients, with particular reflection on patients undergoing intravenous anti-cancer treatment within ambulatory settings. It provides examples in which designing the built environment with people in mind and providing tailored solutions to meet their actual needs and preferences may help cancer patients cope with the emotional and physical challenges of the disease and its treatment and support a general experience of patient-centred care. A conceptual framework that articulates the principal constituents of a supportive environment is tentatively proposed, extending existing theoretical propositions to facilitate further investigation of this context.

Influence of Color in a Lactation Room on Users' Affective Impressions and Preferences

OBJECTIVE

The present study aims to examine the influence of environmental color hue in a lactation room at a health center on users' affective response and preference.

BACKGROUND

Hospital design plays an important role in the emotional experience of patients. In this regard, many studies have attempted to find relationships between design variables and healthcare facilities users' response. Color has been frequently examined because it is always present in the environment and can be easily changed. However, most of the studies dealing with color-emotion relationships acquire users' affective response by questionnaires developed by experts which could lead to inaccurate results since nonexperts may misunderstand concepts set by experts and use nonimmersive images to simulate the environments to assess.

METHODS

To overcome these limitations, a Kansei Engineering-based approach was proposed. In the first phase, users' specific affective factors for lactation rooms were determined using Semantic Differential. In the second phase, the influence of nine different color hues on users' affective factors was obtained. An immersive display system was used to visualize the room altering hues in an isolated and controlled way.

RESULTS

(1) Six user's affective factors connected to the lactation rooms were discovered: safety, elegance, coziness, spaciousness, simplicity, and luminosity, of which coziness has the most impact on the assessment of the room. (2) Warm colors like orange and yellow tend to score highly for coziness which puts them in leading positions when users' assess lactation rooms.

CONCLUSIONS

Results provide recommendations for designers and show the advantages of using semantic differential and immersive displays to analyze user's affective response to environments.

Psychological and physiological human responses to simulated and real environments: A comparison between Photographs, 360° Panoramas, and Virtual Reality

Psychological research into human factors frequently uses simulations to study the relationship between human behaviour and the environment. Their validity depends on their similarity with the physical environments. This paper aims to validate three environmental-simulation display formats: photographs, 360° panoramas, and virtual reality. To do this we compared the psychological and physiological responses evoked by simulated environments set-ups to those from a physical environment setup; we also assessed the users' sense of presence. Analysis show that 360° panoramas offer the closest to reality results according to the participants' psychological responses, and virtual reality according to the physiological responses. Correlations between the feeling of presence and physiological and other psychological responses were also observed. These results may be of interest to researchers using environmental-simulation technologies currently available in order to replicate the experience of physical environments.