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Psychiatric Hospital: A Design for Aiding Healing in Inpatient Psychiatric Facilities (PDF)

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– Psychiatric Hospital: A Design for Aiding Healing in Inpatient Psychiatric Facilities (PDF) –

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Abstract

A systematic literature review was conducted to identify factors in the inpatient healthcare environment that support an optimal healing environment.

The PICO question for this review was what design factors in the inpatient healthcare environment support an optimal healing environment? A search of five databases and a hand search of reference lists were conducted.

The search included studies from 1980 to the present, original research conducted on inpatient units with adult patients that investigated an intervention with an outcome that promotes a healing environment.

Experimental, quasi-experimental, non-experimental, systematic literature reviews and expert opinions were sought and evaluated using a scale to analyze scientific rigor and research quality. A total of 6,874 articles were identified in the search and after screening, 27 articles were included in the final synthesis.

The search found research on eight hospital design features which may support optimal healing environments: artwork (n = 7), building configuration (n = 2), finish materials (n = 7), interior details (n = 6), lighting (n = 11), nature and view (n = 8), noise (n = 10) and room configuration (n = 6). More than 50% of the research used quasi-experimental and non-experimental designs with rare use of experimental research designs.

Evidence suggests seven design features for healing inpatient psychiatric environments. Only one of the seven design feature recommended by the literature was found to be inconsistent with industry standards and was modified to meet compliance with guidelines.

Then an evidence-based design of a psychiatric inpatient room design was formulated and illustrated incorporating all seven recommendations including (a) provide calm, naturalistic and domestic artwork or photographs; (b) provide east facing windows in the patient rooms to provide bright light;

Introduction

1.1 Background of the Study

We shape our buildings; thereafter they shape us, noted statesman and Prime Minister Winston Churchill, 1945.

This is certainly true for all kinds of buildings including hospital facilities. The “ambiance” of a space has an effect on people using the space.

In recent years, design for health care environments has begun to include esthetic enhancements in an attempt to reduce stress and anxiety, increase patient satisfaction, and promote health and healing.

Internal and external environments, as well as building design, are clearly associated with stress and the development of a range of stress-induced pathological responses affecting both psychological and physical health (Devlin and Arneill, 2003; Evans, 1987; Liberman and Yager, 1994; Rashid and Zimring, 2008).

Stressors like shape and size of room, work stress, financial difficulties and personal loss can lead to alterations in the immune response as well as greater risk for asthma, diabetes, gastrointestinal disorder, myocardial infarction, cancer and viral infections (Glaserand Kiecolt-Glaser, 2005; McEwen and Stellar, 1993).

Thus internal spaces, common stressors, and chronic stress can adversely affect health through a deleterious effect on endocrine and immune function (Glaser and Kiecolt-Glaser, 2005).

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