The Role of Environmental Design in Cancer Prevention, Diagnosis, Treatment, and Survivorship: A Systematic Literature Review

Trust-Based Partnerships Are Essential - and Achievable - in Health Care Service

When people think about trust in the context of health care, they typically focus on whether patients trust the competence of doctors and other health professionals. But for health care to reach its full potential as a service, trust must also include the notion of partnership, whereby patients see their clinicians as reliable, caring, shared decision-makers who provide ongoing "healing" in its broadest sense. Four interrelated service-quality concepts are central to fostering trust-based partnerships in health care: empathetic creativity, discretionary effort, seamless service, and fear mitigation. Health systems and institutions that prioritize trust-based partnerships with patients have put these concepts into practice using several concrete approaches: investing in organizational culture; hiring health professionals for their values, not just their skills; promoting continuous learning; attending to the power of language in all care interactions; offering patients "go-to" sources for timely assistance; and creating systems and structures that have trust built into their very design. It is in the real-world implementation of trust-based partnership that health care can reclaim its core mission.

Assessing the Supportiveness of Healthcare Environments' Light and Color: Development and Validation of the Light and Color Questionnaire (LCQ)

Aim:

The aim of this study was to develop and evaluate a self-report instrument measuring patients’, family members’, and staff’s perceived support from light and color in the physical environment of an emergency department (ED)—the Light and Color Questionnaire (LCQ).

Background:

The physical care environment is an important part of a comprehensive caring approach in all levels of care not only for patients but also for family members and staff. However, no existing self-report questionnaire assessing the extent to which light and color are perceived as being supportive in the physical care environment from the users’ perspective was found.

Method:

The LCQ was developed as part of a pre–post study in which an ED serving 125,000 people was refurbished and remodeled using evidence-based design. The LCQ consists of six items for light and five items for color and assesses awareness/orientation, safety/security, functional abilities, privacy, personal control, and stimulation. The study was carried out in four steps: constructions of items, assessment of face validity, data collection, and data analysis.

Result/Conclusion:

Psychometric evaluation of the two versions, LCQ-Patient/Family member and LCQ-Staff, showed satisfactory content and internal validity (>90%) and high internal consistency (Cronbach’s coefficient α = .9) to support the use of the questionnaire for research and development purposes. Explorative factor analysis of a total of 600 questionnaire responses confirmed light and color as distinctive and independent dimensions creating perceptions of more or less supportiveness for respondents. The LCQ instrument may be useful for architects, administrators, and researchers of healthcare environments.

Designing connection into healthcare services

Purpose

The purpose of this article is to highlight the importance of the foundational construct of “connection” in linking design and service in performing vital functions in the healthcare sector. “Connection” facilitates patients receiving life-saving and life-improving care at the right time, in the right place, in the right way.

Design/methodology/approach

This article discusses various design-improvement initiatives making clear that healthcare, like any labor-intensive service delivered to people, is a human endeavor whose systems and features can be materially and cleverly enhanced once their intricacies are analyzed, understood and then redesigned to move closer to excellence.

Findings

By designing connection into healthcare and thinking holistically about the needs and preferences of users (patients), the functionality and the appeal of healthcare services can be enhanced.

Originality/value

The gap between the service that healthcare aims to deliver – and what it actually delivers – is unacceptably large. This article calls for incorporating connection through design into healthcare as a way to bridge this gap.

Impact of unit design on intensive care unit clinicians: a scoping review protocol

OBJECTIVE

This scoping review aims to identify the known impact of unit design on intensive care unit clinicians, and more specifically, to explore similarities and differences across critical care settings.

INTRODUCTION

Construction and infrastructure renewal represent great opportunities for designing units that enhance patient care, as well as support the work of clinicians. A growing body of evidence is showing how unit design can impact clinical staff, but no reviews have been found that focus exclusively on clinicians within intensive care units.

INCLUSION CRITERIA

The review will consider studies that include healthcare staff who offer direct patient care in adult or pediatric intensive care units. Studies that focus on the impact of design (related to physical environment features) on clinicians will be included.

METHODS

The proposed systematic review will be conducted in accordance with JBI methodology for scoping reviews. The search strategy aims to find published and unpublished studies. The databases to be searched will include Embase MEDLINE, PsycINFO, Healthstar and CINAHL. Retrieved studies will be assessed against the inclusion criteria by two independent reviewers. For the papers included in the scoping review, data will be extracted and quality assessed by two independent reviewers. The extracted data will be presented in tabular form, and a narrative summary will describe how the results relate to the review objective.

A systematic framework for understanding environmental design influences on physical activity in the elderly population

Purpose

This paper aims to synthesize the published literature regarding the impact of environmental design on the improvement of elderly residents’ physical activity.

Design/methodology/approach

To provide convergent evidence about the association between facility design/management and physical activity of elderly population, searches were conducted in the PubMed and Google Scholar databases, as well as in specific active living design journals such as Applied Gerontology, Aging and Physical Activity, Housing for the Elderly and Sports Sciences. The inclusion criteria for the final list were the articles that were qualitative, quantitative and mixed-methods studies as well as systematic reviews; written in English; related to the built environmental design; wholly or partially focused on physical activity in elderly population; and published in peer-reviewed journals between 1984 and 2019.

Findings

Overall, 30 studies were included in the final list. The results of this review demonstrate that design interventions can raise physical functioning inside and outside of long-term residential facilities. Increasing opportunities for walkable spaces and reducing physical barriers can result in higher levels of physical activity for the elderly population.

Research limitations/implications

This systematic review discloses the design strategies to enhance the level of physical activity by the elderly population based on the findings of the published literature. Overall space layout and accessibility to outdoor walkable spaces were addressed to generally promote the moderate levels of physical activity in elderly population.

Practical implications

Increasing opportunities for walkable spaces and reducing physical barriers result in higher level of activity for the elderly population. Corridor design and interior design ergonomic considerations were highlighted in the literature. Space layout and accessibility to outdoor walkable spaces promote the moderate levels of physical activity.

Social implications

Environmental design considerations are unique aspects of enhancement of activity level in the elderly population.

Originality/value

This systematic review discloses the design strategies to enhance the level of physical activity by the elderly population based on the findings of the published literature. Overall space layout and accessibility to outdoor walkable spaces were addressed to generally promote the moderate levels of physical activity in elderly population.

Using Evidence to Design Cancer Care Facilities

The nuts and bolts of planning and designing cancer care facilities—the physical space, the social systems, the clinical and nonclinical workflows, and all of the patient-facing services—directly influence the quality of clinical care and the overall patient experience. Cancer facilities should be conceived and constructed on the basis of evidence-based design thinking and implementation, complemented by input from key stakeholders such as patients, families, and clinicians. Specifically, facilities should be designed to improve the patient experience, offer options for urgent care, maximize infection control, support and streamline the work of multidisciplinary teams, integrate research and teaching, incorporate palliative care, and look beyond mere diagnosis and treatment to patient wellness—all tailored to each cancer center’s patient population and logistical and financial constraints. From conception to completion to iterative reevaluation, motivated institutions can learn to make their own facilities reflect the excellence in cancer care that they aim to deliver to patients.

Is cancer prevention influenced by the built environment? A multidisciplinary scoping review

The built environment is a significant determinant of human health. Globally, the growing prevalence of preventable cancers suggests a need to understand how features of the built environment shape exposure to cancer development and distribution within a population. This scoping review examines how researchers across disparate fields understand and discuss the built environment in primary and secondary cancer prevention. It is focused exclusively on peer-reviewed sources published from research conducted in Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States from 1990 to 2017. The review captured 9958 potential results in the academic literature, and this body of results was scoped to 268 relevant peer-reviewed journal articles indexed across 13 subject databases. Spatial proximity, transportation, land use, and housing are well-understood features of the built environment that shape cancer risk. Built-environment features predominantly influence air quality, substance use, diet, physical activity, and screening adherence, with impacts on breast cancer, lung cancer, colorectal cancer, and overall cancer risk. The majority of the evidence fails to provide direct recommendations for advancing cancer prevention policy and program objectives for municipalities. The expansion of interdisciplinary work in this area would serve to create a significant population health impact.

The Perceptions of Nurses About the Behavioral Needs for Daylighting and View to the Outside in Inpatient Facilities

Objectives:

This research aims to explore the perceptions of nursing staff regarding the effects of daylighting on behavioral factors including mood, stress, satisfaction, medical error, and efficiency.

Background:

In spite of an extensive body of literature seeking to investigate the impact of daylighting on patients, a limited number of studies have been done for the sake of nurses’ perceptions and behavioral responses.

Method:

A mixed-methods approach, comprised of qualitative explorations (structured interviews) and a validated survey, was applied and the results were compared and triangulated. Five nurses were interviewed and 156 nurses volunteered for a lighting survey from six departments of three inpatient facilities in Iran.

Results:

The findings of this study are consistent with the existing evidence that daylighting and view to the outside enhance nurses’ perceptions regarding satisfaction, mood, stress, medical error, and alertness, while reducing fatigue and stress.

Conclusion:

Patient rooms and work stations are the most crucial areas to provide daylighting from nurses’ perspectives.