Exploring Inpatients' Experiences of Healing and Healing Spaces: A Mixed Methods Study

Research on visual comfort of color matching in space station experiment module

Considering the living environment, appropriate color adjustment has a positive effect on improving the visual comfort of astronauts, promoting their physical and mental health, and enhancing work efficiency. This article takes the Chinese space station experimental module as a prototype, and through simulation experiments, uses a method that combines physiological signals with subjective evaluation to compare the differences in the impact of 9 different color matching schemes on human visual comfort. The results showed that using 2-3 colors for pairing resulted in the highest visual comfort for people, and people were more willing to choose cool, white, or cool, warm, and white combinations. Among them, spaces using blue, green, and white combinations could help alleviate visual fatigue, while spaces using yellow, green, and white combinations could help people maintain or form a good psychological state. Finally, the experimental results were discussed, and prospects for the future development and construction of space stations were discussed.

Nurses' Perspectives on the Sleep Quality of Hospitalized Patients in Al Ahsa, Saudi Arabia

BACKGROUND

Sleep quality is crucial for patient recovery and well-being, yet hospitalized patients often suffer from poor sleep due to environmental disruptions, clinical routines, and psychosocial stressors. While these challenges are well-documented, qualitative insights into nurses' perspectives-essential frontline providers shaping the sleep environment-are scarce, especially within rapidly evolving healthcare systems like Saudi Arabia's. This study explores nurses' perceptions of factors influencing patient sleep quality in a private hospital in Al Ahsa, Saudi Arabia, and identifies strategies for improvement.

METHODS

We conducted a qualitative, cross-sectional study using semi-structured interviews with 14 registered nurses from diverse nationalities, specialties (Obstetrics/Gynecology, Medical-Surgical, Pediatrics, Intensive Care, Orthopedics, Bariatrics), and experience levels. Interviews were conducted in Arabic or English, audio-recorded, transcribed, and thematically analyzed using ATLAS.ti software. Roy's Adaptation Model guided the examination of environmental, patient-specific, and systemic factors affecting sleep.

FINDINGS

Four primary themes emerged: (1). Environmental Factors: noise from alarms, equipment, family presence, and late-night activities, along with abrupt lighting changes, consistently disrupted sleep. (2). Patient-Specific Factors: pain, emotional distress, cultural expectations, and family involvement influenced sleep experiences. (3). Systemic and Contextual Factors: language barriers, infrastructural disparities between private and governmental hospitals, and limited resources can impeded effective sleep-promoting strategies. (4). Role of Health Technology: nurses recognized the potential of innovations like smart lighting and wearable monitors to enhance sleep quality but faced challenges in implementation due to knowledge gaps and limited familiarity. Roy's Adaptation Model highlighted how effective adaptation through physiological and cognitive-emotional pathways, as observed by nurses, was facilitated or hindered by these factors.

CONCLUSIONS

Enhancing in-hospital sleep quality requires a holistic, culturally sensitive approach that integrates environmental modifications, patient-centered care, and systemic improvements. Strategic investments in staff communication training, infrastructural upgrades, language support services, and the adoption of health technologies can promote adaptive responses and optimize patient rest. By leveraging theory-driven insights and context-specific strategies, healthcare systems-particularly those undergoing rapid development-can better support nurses in fostering restorative sleep environments as a fundamental component of patient-centered care, thereby enhancing patient recovery, satisfaction, and overall well-being.

What does the word healing mean to you? Perceptions of patients with life-limiting illness

INTRODUCTION

There is a growing consensus that patient-centered care is more effective in treating patients than a strictly biomedical model, where there are known challenges to involving the patient in assessments, treatment goals, and determining preferred outcomes.

OBJECTIVES

The current study seeks to integrate patient values and perspectives by exploring how people diagnosed with a life-limiting disease define healing in their own words.

METHODS

As a part of a larger study that included cognitive interviewing, we asked the question "what does the word healing mean to you?" Data were collected during face-to-face interviews with patients from three metropolitan healthcare facilities.

RESULTS

Thirty participants responded to the question "what does healing mean to you?" Seven themes were identified through the data analysis. These themes include acceptance, feeling better, pain, social support, process, religion/spirituality, and make whole. The feeling better, pain, and process themes have subthemes.

SIGNIFICANCE OF RESULTS

Probing to understand patient perspectives and how to provide a holistic approach to care is essential to patient treatment. Patients defined healing in a broader way than how it is typically defined in literature. The patients' definitions provide greater insight into perceptions and expectations regarding the healing process.

A service-user digital intervention to collect real-time safety information on acute, adult mental health wards: the WardSonar mixed-methods study

Background

Acute inpatient mental health services report high levels of safety incidents. The application of patient safety theory has been sparse, particularly concerning interventions that proactively seek patient perspectives.

Objective(s)

Develop and evaluate a theoretically based, digital monitoring tool to collect real-time information from patients on acute adult mental health wards about their perceptions of ward safety.

Design

Theory-informed mixed-methods study. A prototype digital monitoring tool was developed from a co-design approach, implemented in hospital settings, and subjected to qualitative and quantitative evaluation.

Setting and methods

Phase 1: scoping review of the literature on patient involvement in safety interventions in acute mental health care; evidence scan of digital technology in mental health contexts; qualitative interviews with mental health patients and staff about perspectives on ward safety. This, alongside stakeholder engagement with advisory groups, service users and health professionals, informed the development processes. Most data collection was virtual. Phase 1 resulted in the technical development of a theoretically based digital monitoring tool that collected patient feedback for proactive safety monitoring. Phase 2: implementation of the tool in six adult acute mental health wards across two UK NHS trusts; evaluation via focused ethnography and qualitative interviews. Statistical analysis of WardSonar data and routine ward data involving construction of an hour-by-hour data set per ward, permitting detailed analysis of the use of the WardSonar tool.

Participants

A total of 8 patients and 13 mental health professionals participated in Phase 1 interviews; 33 staff and 34 patients participated in Phase 2 interviews.

Interventions

Patients could use a web application (the WardSonar tool) to record real-time perceptions of ward safety. Staff could access aggregated, anonymous data to inform timely interventions.

Results

Coronavirus disease 2019 restrictions greatly impacted the study. Stakeholder engagement permeated the project. Phase 1 delivered a theory-based, collaboratively designed digital tool for proactive patient safety monitoring. Phase 2 showed that the tool was user friendly and broadly acceptable to patients and staff. The aggregated safety data were infrequently used by staff. Feasibility depended on engaged staff and embedding use of the tool in ward routines. There is strong evidence that an incident leads to increased probability of further incidents within the next 4 hours. This puts a measure on the extent to which social/behavioural contagion persists. There is weak evidence to suggest that an incident leads to a greater use of the WardSonar tool in the following hour, but none to suggest that ward atmosphere predicts future incidents. Therefore, how often patients use the tool seems to send a stronger signal about potential incidents than patients' real-time reports about ward atmosphere.

Limitations

Implementation was limited to two NHS trusts. Coronavirus disease 2019 impacted design processes including stakeholder engagement; implementation; and evaluation of the monitoring tool in routine clinical practice. Higher uptake could enhance validity of the results.

Conclusions

WardSonar has the potential to provide a valuable route for patients to communicate safety concerns. The WardSonar monitoring tool has a strong patient perspective and uses proactive real-time safety monitoring rather than traditional retrospective data review.

Future work

The WardSonar tool can be refined and tested further in a post Coronavirus disease 2019 context.

Study registration

This study is registered as ISRCTN14470430.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128070) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 14. See the NIHR Funding and Awards website for further award information.

Same-day discharge after brain tumor resection: a prospective pilot study

PURPOSE

Outpatient brain surgery has many advantages for the psychological and physical wellbeing of patients, as well as reduced costs to the health care system. Compared with inpatient admissions, same day discharges reduce patient exposure to nosocomial infection, thromboembolic complications, and medical error. We aim to establish a prospectively collected quality outcomes database to examine the outcomes of patients that undergo brain tumor resection and are discharged home the same day as surgery.

METHODS

We have established a prospectively collected quality outcomes database to examine the outcomes of all patients that underwent brain tumor resection by a single neurosurgeon (R.J.K) at our institution from August 2020 to August 2021 and were discharged home the same day as surgery.

RESULTS

Over the one-year period this study was conducted, 37 of 334 patients met inclusion criteria for the outpatient protocol. Thirty-two patients were discharged on the same day as surgery. Five patients (14%) were considered eligible for outpatient surgery but were ultimately admitted to the hospital postoperatively and were discharged after an overnight observation. No postoperative complications were noted at two-week postoperative follow-up.

CONCLUSION

In select patients undergoing brain tumor surgery, same day discharge should be considered. Establishing a multidisciplinary team of physicians, nurses, radiologists, and physical therapists is critical to achieving this aim. Physicians should have a low threshold to admit a patient with concerning exam findings, complications, or complicated past medical history. Once discharged, open communication with the patient and their family is critical to detect complications that should trigger rehospitalization and intervention.

Interior Environments in Long-Term Care Units From the Theory of Supportive Design

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.

Revisiting Healing Environments: Islamic Interior Elements in Hospital Rooms in North Africa

BACKGROUND

A predominant notion among researchers is that hospital room design and decor are subject to the designer's expression of self, which is contrary to evidence-based studies showing that design and decor can impact patient health. The aim of this study was to examine whether improvement in quality of healthcare provided in hospitals could be achieved through the convergence of expertise of healthcare professionals and hospital room designers.

METHODS

This was a prospective study to identify the impact of hospital interior design features with a focus on single occupancy rooms. Volunteers were recruited through advertisements and the study was conducted at the Tripoli Medical Center. Responses were analyzed using a three-dimensional computer-aided design software to help respondents accurately map their preferences and visualize outcomes.

RESULTS

Participants preferred an aesthetically pleasing hospital room environment that included art and bright colors, window views, and the need for personalization, technology, mobility, and flexibility, all of which improved satisfaction and happiness. Of these, participants' preference for technology as a cause for satisfaction and happiness was a novel finding.

CONCLUSION

Designers of hospital room interiors should plan and create an appealing single occupancy room for increasing user satisfaction and patient wellness.

Trading company for privacy: A study of patients’ experiences

Ethical considerations

The study was conducted according to the principles of Declaration of Helsinki, and was approved by the Norwegian Social Science Data Services.

Objective

To describe patients’ experiences of staying in multiple- and single-bed rooms.

Patients and methods

This qualitative study employed a descriptive and exploratory approach, and systematic text condensation was used to analyze the material. Data were collected in a hospital trust in Norway. A total of 39 in-depth interviews were performed with patients discharged from the medical, surgical, and maternity departments.

Results

Patients had ambiguous views on whether multiple-bed rooms or single-bed rooms were to be preferred. Main results include how patients cherished “the importance of others” but at the same time valued “the importance of privacy.” Being hospitalized in multiple-bed rooms was for many patients a very positive experience in terms of social interaction. Patients in single-bed rooms reported being more dependent on nurses to maintain social contact and obtain safety.

Conclusion

This research provides new knowledge on how the need for privacy can be in contradiction with the need for socializing with other patients. When hospitalized, the physical structure of a hospital impacts with whom patients interact and to what extent they depend on the nursing staff to have their social needs met.