Measuring the Impact of Bedroom Privacy on Social Networks in a Long-Term Care Facility for Hong Kong Older Adults: A Spatio-Social Network Analysis Approach

This study aims to measure the impact of bedroom privacy on residents' social networks in a long-term care (LTC) facility for older adults. Little is known about how the architectural design of bedrooms affects residents' social networks in compact LTC facilities. Five design factors affecting privacy were examined: bedroom occupancy, visual privacy, visibility, bedroom adjacency, and transitional space. We present a spatio-social network analysis approach to analyse the social network structures of 48 residents. Results show that residents with the highest bedroom privacy had comparatively smaller yet stronger groups of network partners in their own bedrooms. Further, residents who lived along short corridors interacted frequently with non-roommates in one another's bedrooms. In contrast, residents who had the least privacy had relatively diverse network partners, however, with weak social ties. Clustering analyses also identified five distinct social clusters among residents of different bedrooms, ranging from diverse to restricted. Multiple regressions showed that these architectural factors are significantly associated with residents' network structures. The findings have methodological implications for the study of physical environment and social networks which are useful for LTC service providers. We argue that our findings could inform current policies to develop LTC facilities aimed at improving residents' well-being.

Analyzing the Layout of Long-Term Care Facilities: A Psycho-Spatial Approach

When planning long-term care facilities (LTCFs), architects strive to design buildings that support high well-being (WB) levels for those who live and work in them. To achieve this goal, architects must understand what defines WB in old age and how these qualities can be achieved through the designed physical layout. This task must be achieved while tackling additional challenges, such as considering the official planning guidelines, codes, and additional requests given by the client. During the planning process, architects use their subjective impressions by visiting similar institutions, their personal experience as architects, and their subjective assumptions on what residents and caregivers may consider desirable. Once built, there are a lack of methodological ways to evaluate an existing LTCF unit's plan as a supportive tool for higher levels of WB. The current study aims to create a methodological tool to analyze LTCF units' layout, giving scores to each plan based on five aspects of WB that they support. In our article, we demonstrate this methodology's application on 40 plans of LTCFs, demonstrating its effectiveness. We believe that the approach presented in this article will contribute to furthering the quality of planning of LTCFs benefiting residents and caregivers alike.

Influences of Physical Layout and Space on Patient Safety and Communication in Ambulatory Oncology Practices: A Multisite, Mixed Method Investigation

OBJECTIVE

To examine how physical layouts and space in ambulatory oncology practices influence patient safety and clinician communication.

BACKGROUND

Ambulatory oncology practices face unique challenges in delivering safe care. With increasing patient volumes, these settings require additional attention to support patient safety and efficient clinical work processes.

METHODS

This study used a mixed methods design with sequential data collection. Eight ambulatory oncology practices (of 29 participating practices) participated in both the quantitative and qualitative phases. In surveys, clinicians (n = 56) reported on safety organizing and communication satisfaction measures. Qualitative data included observations and semistructured interviews (n = 46) with insight into how physical layout influenced care delivery. Quantitative analysis of survey data included descriptive and correlational statistics. Qualitative analysis used inductive and thematic content analysis. Quantitative and qualitative data were integrated using side-by-side comparison tables for thematic analysis.

RESULTS

Safety organizing performance was positively correlated with clinician communication satisfaction, r(54 df) = .414, p = .002. Qualitative analyses affirmed that the physical layout affected communication around chemotherapy infusion and ultimately patient safety. After data integration, safety organizing and clinician communication were represented by two themes: visibility of patients during infusion and the proximity of clinicians in the infusion center to clinicians in the clinic where providers see patients.

CONCLUSIONS

Physical layouts of ambulatory oncology practices are an important factor to promote patient safety. Our findings inform efforts to construct new and modify existing infusion centers to enhance patient safety and clinician communication.

Construction and validation of an instrument for the structural assessment of wards for urinary continence in older adults

OBJECTIVE

to build and validate an instrument for structural assessment of wards for the preservation of urinary continence in hospitalized older adults.

METHOD

this is a methodological study divided into two stages. The first corresponded to an integrative literature review that guided the construction of the instrument. The second consisted of the content validation stage of the instrument, by means of expert consensus, using the Delphi technique. The selected experts were recognized in the field and authors of the articles included in the integrative review.

RESULTS

six experts participated in the content validation, which resulted in the "Instrument for Structural Assessment of Wards for the Preservation of Urinary Continence in Older Adults", composed of 27 items, distributed in three dimensions: "physical structure", "human resources", and "material resources". Two Delphi rounds were carried out for validation, resulting in a final version with 83% agreement among the experts.

CONCLUSION

the instrument reached content validity, requiring application for clinical validation. However, it can be used by researchers and health staff in hospital settings, in order to identify structural weaknesses and guide the priority of interventions for the quality and safety of this care.

Impacts of Nursing Unit Design on Visibility and Proximity and Its Influences on Communication, Privacy, and Efficiency

OBJECTIVES

This study examines the role of visibility and proximity on nurse communication patterns, perception of privacy, and efficiency in double-corridor nursing units.

BACKGROUND

Nurses are extremely important for the quality of healthcare. The literature suggests that visibility and proximity have a substantial impact on the delivery of care and staff experience. However, few studies have empirically examined nursing units in China.

METHOD

Questionnaire surveys, observations, and simulations of medication administration tasks were employed.

RESULTS

Visibility and proximity influenced communication patterns, perceptions of privacy, and efficiency. The type of wall in the medication room could impact nurses' perception of privacy and efficiency. A partial glass wall in the medication room could achieve balance between privacy and visibility. A medication room that is adjacent to and is easily accessed from the nurse station (NS) could provide efficient communication and efficient work. The partition type between the NS and the doctor's office and the layout of the medication room could impact communication patterns. The relative position of the NS, medication room, and disposal room could influence the flow of medication administration tasks, and a geographically contiguous spatial layout could enhance work efficiency.

CONCLUSIONS

The findings contribute to the body of knowledge on the impact of visibility and proximity on nurses' communication patterns, perception of privacy, and efficiency. Recommendations to improve the design of double-corridor nursing units are also provided.

Privacy and Well-Being in Aged Care Facilities with a Crowded Living Environment: Case Study of Hong Kong Care and Attention Homes

This study aims to understand the relationship between bedroom privacy and well-being of the elderly in aged care facilities with a compact living situation. A majority of studies on this topic were carried out in a low-density population context. The crowded living situation might compromise the well-being of residents. This study proposed five architectural parameters to measure bedroom privacy in aged care facilities: total open surface per unit, openness/solid ratio per bed, height of partition wall, number of people per unit, and personal control over bedroom privacy. SF-12 v.2 Health Survey was used to collect information on physical and mental health status. The study surveyed nine Care & Attention homes and their 213 residents in Hong Kong. The total open surface per unit and the openness/solid ratio per bed were positively associated with the physical health of residents. The height of partition walls was associated negatively with their physical and mental health conditions, and the number of people per unit was negatively associated with their physical health. More than half of respondents preferred a single unit with high partition walls; however, 40% of respondents preferred low partition walls. The provision of privacy for the elderly should be balanced with their needs for social interactions; total open surface per unit, openness/solid ratio per bed and height of partition wall should be taken into consideration. The study provides evidence and design guidelines for improving privacy in aged care facilities with a compact living environment.

Legibility of floor plans and wayfinding satisfaction of residents in Care and Attention homes in Hong Kong

OBJECTIVE

Focusing on Hong Kong Care and Attention homes which provide residential care, meals, personal care and limited nursing care for older people, this study aimed to understand the impact of floor plans' legibility (layout and complexity) on residents' wayfinding satisfaction and self-reported health status.

METHODS

A questionnaire survey was conducted in nine Care and Attention homes. Space syntax, a well-established method, was used to evaluate the legibility of their floor plans via calculating the integration value.

RESULTS

Familiarity with Care and Attention homes did not influence the residents' satisfaction with wayfinding. The integration value had a significant impact on residents' satisfaction with wayfinding. No relationship was observed between integration value and self-reported health status.

CONCLUSION

Increasing complexity in floor plans appears to negatively affect residents' wayfinding satisfaction. These data suggest that circulation patterns should be improved for better wayfinding.