Healing environment
Healing environment describes an approach that sees the physical and organizational environment in health buildings as a variable for the patient's recovery process. In addition, this approach implies that the stress experienced by patients and families can be reduced through the favorable design of the physical environment and, as a result, faster recovery from chronic or acute illnesses can occur. From a psychological point of view, the perceived stress can come from the disease itself, the recovery process itself, but also from the fact that hospitalization is inevitable. Furthermore, this approach also takes the well-being of the staff into account, as it is assumed that a stress-free work environment has a positive effect on the healing process of the patient through mediators such as empathy, patience and concentration. In addition to the human component within a health system, the healing environment approach also integrates aspects of architecture ( healing architecture ) or neuroscience and is therefore interdisciplinary in its nature.
background
The approach of creating a healing environment, or at least one that promotes healing, in order to shorten the time of suffering and recovery, is not as modern as its name suggests. First evidence can already be found from the time of ancient Greece that health structures, at that time mainly temples, were primarily built in regions that were distinguished by their proximity to nature. In these ancient sanatoriums not only medical care was guaranteed, but their proximity to thermal springs or the construction of theaters in their vicinity also ensured that physical, psychological and emotional factors interlock to optimize recovery. Even Florence Nightingale (1863) reported in mid-19th century on the positive effects of daylight and fresh air to the well-being of patients and revolutionized with these and other findings, the modern health care system.
Evidence-based design
In the 1990s, design solutions for healthcare buildings were developed for the first time on the basis of scientific findings, so that one also speaks of “evidence-based design”. This approach was largely shaped by a study by Roger Ulrich from 1984, in which it was found that patients who recovered from surgery experienced a faster recovery, needed less medication and were happier when they were out of their window could look into nature than patients who only looked at a stone wall. Based on this investigation, further studies were able to demonstrate the effect of various environmental factors (such as light, noise, space for social exchange, degree of privacy) on health indicators. The “evidence-based design” is also so important for the iterative implementation of the Healing Environment approach, since the management of health facilities is increasingly determined by economic factors. A restructuring or redesign based on scientific knowledge is thus, despite the high costs involved, commercially justifiable and can be implemented more easily. The first studies based on business administration have also already shown that an investment in healing environments can also pay off in the long term, i.e. it is quite possible to run a health care facility economically and at the same time gradually increase the quality of care perceived by the patient. The "evidence-based-design" certainly provides some interesting starting points, but has not yet been able to provide an exhaustive best practice approach. Although individual effects such. B. from light or room planning on the well-being of patients is known and has already been fundamentally proven, but the interaction effects between these have so far hardly been researched. It is also exciting that until now, examinations have mostly been carried out from the perspective of the patient, but the focus has rarely been on staff. This would be advisable, however, since the nursing staff are at least as important stakeholders in the health facility system and are of fundamental importance for the well-being and recovery of patients.
Goal of the healing environment
The main goal of creating a healing environment is to reduce stress and thus eliminate all problems that arise from it. Examples of this can be lack of concentration and incorrect assessments on the part of the staff, but also the development of behavior that hinders recovery on the part of the patient or the emergence of critical framework conditions. The relevant aspects for a healing environment from the patient's point of view can be divided into the dimensions physical, social and psychological.
Physical aspects
Room arrangement
Typical examinations:
- Effect of single and multi-bed rooms on privacy, feeling of security, social support as mediators for patient well-being
- Effect of windows in the room and the ability to look out on the development of depression
Colors used in interior design
Typical examination: effect of different colors on the mood of the patient
Light conditions
Typical examinations:
- Effect of a natural day-night rhythm controlled by artificial light on the length and quality of the patient's sleep and, associated with this, on their recovery
- Artificial light vs. daylight
Background noise
Typical examinations:
- The effect of noise, music and the possibility of shielding yourself from unpleasant noise as a patient on recovery and well-being
Proximity to nature
Typical examinations:
- The effect of the opportunities to go into nature, to see it through a window, to have pictures of nature in the room or to put plants in the room on the well-being of the patient
Typical aesthetic examinations:
- The effect of handsome furniture, functioning, modern technology and a pleasant atmosphere on the patient's well-being
Other environmental conditions
Typical investigations:
- Effect of other environmental conditions such as temperature, air quality and light on the patient's well-being
Social and Psychological Factors
Controllability of the ambient conditions
The higher the controllability of temperature, air quality, bed setting, light and noise conditions, the lower the stress perceived by the patient
Privacy
The stress of the patient can be reduced through sound-absorbing furniture and single rooms
Security
An increased sense of security can be ensured through the simple presence of nursing staff, but also through the presence of lockers and reduces the perceived stress
Social support
Social support from friends and family can be facilitated by private rooms, movable furniture or single rooms. This has positive effects on the emotions of the patients and has a positive effect on their well-being.
Individual evidence
- ↑ a b J.F. Stichler: Creating healing environments in critical care units. In: Critical Care Nursing Quarterly. No. 24, 2001, pp. 1-20.
- ↑ a b c M. Lorijn: Creating a Theoretical Framework for Healing Environment Research , 2011
- ^ J. van Nijhuis: Healing environment and patient's well-being. Finding the relationship between healing environment aspects and patient's well-being involving Dutch hosptials , 2017
- ^ R. Ulrich: View through a Window May Influence Recovery from Surgery. In: Science No. 224, 1984, pp. 420-421.
- ↑ ERCM Huisman, E. Morales, J. van Hoof, HSM Kort: Healing environment: A review of the impact of physical environmental factors on users . In: Building and Environment No. 58, 2001, pp. 70–80.