| 1. |
- Berezecki Mårtensson, Maria, 1974, et al.
(författare)
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Den goda vårdavdelningen
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den goda vårdavdelningen Slutrapport 2011-12-31 Detta är en rapport av ett samarbetsprojekt mellan Program för Teknisk Standard (PTS) gruppen samt Chalmers Arkitektur Centrum för vårdens arkitektur. Projektet har arbetstiteln ”Den goda vårdavdelningen”. "Den goda vårdavdelningen” är ett kunskaps- och forskningsbaserat planeringsunderlag för framtidens vårdavdelningar. Materialet till rapporten har tagits fram av PTS-gruppen i samarbete med Centrum för vårdens arkitektur. Projektet redovisas på PTS hemsida samt som denna rapport. Syftet med projektet var att ta fram bättre planerings-och beslutsunderlag när vårdens lokaler planeras och byggs. Arbetet har genomförts bland annat genom tre workshops. Till dessa har vi bjudit in företrädare för vården, lokalplanerare, projektledare, arkitekter och forskare från olika discipliner. Vi har arbetat tvärprofessionellt för att i dialogform tillsamman utveckla idéer och förslag till lösningar. Målet med workshopparna var att diskutera hur tillgänglig kunskap från forskning och praktik kan ligga till grund för att utveckla konceptförslag till den optimala vårdavdelningen samtidigt som långsiktiga framtida behov och möjligheter till flexibilitet i planering och byggande är tillgodosedda. Rapporten omfattar beskrivning av arbetsprocessen, framtagen teoretiskt material samt illustrationer. Den teoretiska delen består företrädesvis av forskningssammandrag sammanställd av Professor Roger Ulrich. Forskningssammandraget belyser antal områden relevanta för vårdavdelningar. Under varje område beskrivs ett antal ”designfaktorer” och forskningsresultat genom att forskningsstudier som visar på signifikanta samband kortfattat refereras. Styrkan i relationen mellan utformning och forskningsresultat är graderat så att materialet ska vara lättare att ta ställning till. En utvald referenslista finns till varje område. Den illustrativa delen består av ritningar och visualiseringar kompletterade med förklarande texter och omfattar utformning av Vårdrum, RWC och funktionsenheter. Framtagna exempel visar konsekvenser av olika lösningar och på vilket sätt forskningsbaserad kunskap kan inarbetas. Materialet utgör stöd där vårdrum och förslag till organisation av vårdavdelningen ska ses som exempel att samverka kring snarare än som färdiga lösningar att kopiera rakt av. Rapporten behandlar inte dem delar som redan täckas av PTS – en. Dessa är: akustik, estetik, hygien, tillgänglighet, miljöledning. På hemsidan sättas dessa i direkt förbindelse till PTS. Rapporten kommenterar inte heller andra exempel från Sverige och utlandet. Dessa presenteras på PTS- hemsida.
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| 2. |
- Chalfont, Garuth, et al.
(författare)
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Designing with nature for ageing: Health-related effects in care settings
- 2020
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Ingår i: Architecture for Residential Care and Ageing Communities: Spaces for Dwelling and Healthcare. - New York, NY : Routledge, 2021. : Routledge. ; , s. 189-201
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Drawing on international research and practice, this chapter highlights how designing with nature improves care and health for ageing. We outline the benefits of nature and outdoors to care settings, architecture’s crucial role in ‘edge spaces’ and site design, plus give brief UK design examples from extra-care housing, dementia nursing care and hospice. Furthermore, we identify tools to assess and improve care settings to better support dementia green care. Scientific evidence is driving a resurgence in nature-enhanced hospital design. Gardens with pleasant views and other sensory stimulation provide psychological and physiological restoration from stress and clinically significant reduction of pain. Well-designed gardens can entice patients into movement, physical activity or rehabilitation by providing access to social support, privacy, and positive nature distraction. Families as well as patients report reduced stress, enhanced emotional well-being, and higher satisfaction with care quality, while hospital staff experience lowered work-related stress and burnout. The chapter ends with evidence-informed guidelines for designing hospitals with nature.
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| 3. |
- Cordoza, Makayla, et al.
(författare)
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Feelings of Emotional Exhaustion and Depersonalization Predict Self-Report of Trouble Sleeping for Nurses Working in Hospital Environments
- 2019
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction American nurses report sleeping an average of 6.8 hours per night on workdays, which is less than the recommended 7-9 hours. Burnout, which is comprised of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA), is common among nurses and may contribute to insufficient sleep quantity and sleep disruption. We aimed to investigate if burnout, measured using the Maslach Burnout Inventory (MBI), predicted self-report of trouble sleeping for nurses working in the hospital. Methods This is a secondary report of a prospective crossover trial of nurses assigned to either 6 weeks of daily work-breaks in an outdoor hospital garden or 6 weeks of indoor-only breaks. After a 1-week washout period, break assignments were switched for an additional 6 weeks. Nurses completed the MBI at the beginning and end of each 6-week period. Each workday, nurses completed a visual analog scale reporting no trouble sleeping to much trouble sleeping immediately following a break. For this analysis, we used initial MBI subscale score (EE, DP, PA) as a predictor of mean trouble sleeping over the subsequent 6-week period regardless of break location using generalized estimating equations. Results A total of 29 nurses (27 females, mean age 42.8 years) participated. Most (n=20) worked dayshift, and 9 worked night shift. Initial MBI subscale score, regardless of break location, was predictive of mean self-report of trouble sleeping over the subsequent 6-week period for EE (p<0.001) and DP (p=0.004), but not for PA (p=0.48). When divided by break assignment (indoor-only vs garden), results were similar for EE (indoor p<0.001; garden p<0.001), DP (indoor p<0.001; garden p<0.001), and PA (indoor p=0.20; garden p=0.49). Conclusion The MBI subscales of EE and DP were predictive of self-report of trouble sleeping for nurses in this study. Further research using objective measures of sleep are needed to confirm and extend these preliminary observations. Support (If Any) Funding for this research was provided by the TKF Foundation as part of the National Open Spaces Sacred Places Initiative.
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| 4. |
- Cordoza, Makayla, et al.
(författare)
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Impact of nurses taking daily work breaks in a hospital garden on Burnout
- 2018
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Ingår i: American Journal of Critical Care. - : AACN Publishing. - 1062-3264 .- 1937-710X. ; 27:6, s. 508-512
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Tidskriftsartikel (refereegranskat)abstract
- Background Nurses working in hospital environments are at risk for burnout. Exposure to nature has psychological benefits, but the effect of hospital gardens on nurse burnout is less understood. Objective To compare the effect on nurse burnout of taking daily work breaks in a hospital-integrated garden with the effect of indoor-only breaks. Methods A prospective crossover trial was conducted of nurses assigned to either 6 weeks of a work break in an outdoor hospital garden or 6 weeks of indoor-only breaks. After a 1-week washout period, break assignments were switched for a subsequent 6 weeks. The Maslach Burnout Inventory was administered at the beginning and end of each 6-week period, and a Present Functioning Visual Analogue Scale was completed at the start and end of each break to capture immediate psychological symptoms. Change scores were analyzed by using generalized estimating equations. Results For 29 nurses, for garden compared with indoor breaks, significant improvement was apparent in scores on the Maslach Burnout Inventory subscales for emotional exhaustion (4.5 vs -0.2; P < .001) and depersonalization (1.8 vs 0.0; P = .02) but not for personal accomplishment (-0.6 vs -0.0; P = .55). Compared with indoor breaks, total symptom scores on the Present Functioning Visual Analog Scale improved significantly when nurses took a break in the garden (garden vs indoor breaks, 4.0 vs 2.4; P = .04). Conclusions Taking daily work breaks in an outdoor garden may be beneficial in mitigating burnout for nurses working in hospital environments.
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| 5. |
- Dittrich, Christian, et al.
(författare)
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ESMO / ASCO Recommendations for a Global Curriculum in Medical Oncology Edition 2016
- 2016
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Ingår i: ESMO Open. - : Elsevier BV. - 2059-7029. ; 1:5
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Tidskriftsartikel (refereegranskat)abstract
- The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) are publishing a new edition of the ESMO/ ASCO Global Curriculum (GC) thanks to contribution of 64 ESMOappointed and 32 ASCO-appointed authors. First published in 2004 and updated in 2010, the GC edition 2016 answers to the need for updated recommendations for the training of physicians in medical oncology by defining the standard to be fulfilled to qualify as medical oncologists. At times of internationalisation of healthcare and increased mobility of patients and physicians, the GC aims to provide state-of-the-art cancer care to all patients wherever they live. Recent progress in the field of cancer research has indeed resulted in diagnostic and therapeutic innovations such as targeted therapies as a standard therapeutic approach or personalised cancer medicine specialised training for medical oncology trainees. Thus, several new chapters on technical contents such as molecular pathology, translational research or molecular imaging and on conceptual attitudes towards human principles like genetic counselling or survivorship have been integrated in the GC. The GC edition 2016 consists of 12 sections with 17 subsections, 44 chapters and 35 subchapters, respectively. Besides renewal in its contents, the GC underwent a principal formal change taking into consideration modern didactic principles. It is presented in a template-based format that subcategorises the detailed outcome requirements into learning objectives, awareness, knowledge and skills. Consecutive steps will be those of harmonising and implementing teaching and assessment strategies.
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| 6. |
- Elf, Marie, 1962, et al.
(författare)
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The built environment and its impact on health outcomes and experiences of patients, significant others and staff—A protocol for a systematic review
- 2020
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 7:3, s. 895-899
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This review will identify, evaluate and synthesize the literature related to evidence-based design of healthcare environments and to identify impacts of the built environment on the outcomes and experiences of patients, significant others and staff. Design: A mixed-method systematic review of literature 2010–2018. Methods: Database searches for evidence in peer-reviewed journals will be conducted electronically using CINAHL, Medline, SCOPUS and Web of Science. Abstract, full-text screening and data extraction will be completed independently by the reviewers. Quality assessment will follow Swedish Agency for Health Technology Assessment and Social Services Assessment. Results: This review will offer knowledge for informed decisions about the design of the healthcare environment. The review is comprehensive, includes a large volume of literature various research designs and will highlight the knowledge gap in evidence-based design and provide a breadth of knowledge about the built environments and its impact on health and well-being.
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| 7. |
- Marcheschi, Elizabeth, 1980, et al.
(författare)
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The physical environment and its effect on health outcomes: a systematic review.
- 2019
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Ingår i: ARCH19 Proceedings.
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Konferensbidrag (refereegranskat)abstract
- Objective : The study aims to identify and review the latest existing knowledge about evidence- based design (EBD) for healthcare architecture and determine the extent to which such findings pertain to the overarching goals proposed by the Institute of Medicine (IOM). Background : There is increasing knowledge regarding influences of healthcare physical environments on health and well-being outcomes. The demand for more evidence has steadily grown, and systematic literature reviews have gained increased importance in the healthcare design field. Research question : A systematic literature review was performed according to the guidelines proposed by The Swedish Agency for Health Technology Assessment and Social Services Assessment. Specific aims included evaluating the current status of research relating to evidence-based healthcare architecture and determining the extent to which such evidence corresponds to the key goals established by the IOM. Methods : A systematic literature review with a Boolean search strategy was performed using the following databases: CINAHL, Medline, SCOPUS, Cochrane library, and Web of Science. The time period covered was 2010-2018. The reference lists of articles obtained from keyword searches were then examined to identify additional relevant studies. The articles retrieved have been screened for eligibility for inclusion, and the final retained articles have been evaluated with descriptive statistics to identify which IOM quality categories are addressed, what type of healthcare settings, physical environment intervention and target groups are investigated, and what types of research design and methodology have been implemented. Furthermore, two researchers are independently assessing the quality of the material retained. This data is part of an ongoing project therefore, preliminary results are reported. Results : A total of 4546 articles were retrieved and screened for eligibility for inclusion, resulting in 688 retained articles published since 2010. Of these 92 has been analyzed until now with descriptive statistics and results suggest that the most frequently cited IOM goals are related to health (84%) and safety (46%), person-centred approach (29%) and effectiveness of care (28%). Moreover, research has been performed across acute care and overall hospital settings (22 and 21%). Conclusion : The systematic literature review indicates that the body of knowledge relating to EBD is clearly growing, and the main focus is on design interventions to improve the health and safety of patients across acute care units. Lack of evidence are instead found in regard to other IOM aspects such as, equality of care and patients’ participation.
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| 8. |
- Sandal, L. F., et al.
(författare)
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Exploring the effect of space and place on response to exercise therapy for knee and hip pain-a protocol for a double-blind randomised controlled clinical trial: the CONEX trial
- 2015
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Ingår i: BMJ Open. - : BMJ. - 2044-6055 .- 2044-6055. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Context effects are described as effects of a given treatment, not directly caused by the treatment itself, but rather caused by the context in which treatment is delivered. Exercise is a recommended core treatment in clinical guidelines for musculoskeletal disorders. Although moderately effective overall, variation is seen in size of response to exercise across randomised controlled trial (RCT) studies. Part of this variation may be related to the fact that exercise interventions are performed in different physical environments, which may affect participants differently. The study aims to investigate the effect of exercising in a contextually enhanced physical environment for 8 weeks in people with knee or hip pain. Methods and analysis: The study is a double-blind RCT. Eligible participants are 35 years or older with persisting knee and/or hip pain for 3 months. Participants are randomised to one of three groups: (1) exercise in a contextually enhanced environment, (2) exercise in a standard environment and (3) waiting list. The contextually enhanced environment is located in a newly built facility, has large windows providing abundant daylight and overlooks a recreational park. The standard environment is in a basement, has artificial lighting and is marked by years of use; that is, resembling many clinical environments. The primary outcome is the participant's global perceived effect rated on a seven-point Likert scale after 8 weeks exercise. Patient-reported and objective secondary outcomes are included. Ethics and dissemination: The Regional Scientific Ethical Committee for Southern Denmark has approved the study. Study findings will be disseminated in peer-reviewed publications and presented at national and international conferences.
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| 9. |
- Sandal, L. F., et al.
(författare)
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Room for improvement: A randomised controlled trial with nested qualitative interviews on space, place and treatment delivery
- 2019
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 53:6, s. 359-367
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Tidskriftsartikel (refereegranskat)abstract
- Objective Healthcare-oriented design in hospitals can promote better clinical outcomes. Creating optimal facilities may increase treatment effects. We investigated the influence of the treatment room on effects of exercise therapy. Methods In a mixed-method randomised controlled double-blind trial, middle-aged individuals reporting knee or hip pain performed 8 weeks of exercise therapy in (1) a newly built physically enhanced environment, (2) a standard environment or (3) were waitlisted, receiving no intervention. Participants and therapists were blind to study aim. Primary outcome was participants' Global Perceived Effect (GPE; seven-point Likert scale). Six nested focus group interviews with participants (n=25) and individual interviews with therapists (n=2) explored experiences of the environments. Results 42 people exercised in the physically enhanced environment, 40 in the standard environment, 21 were waitlisted. Contrary to our hypothesis, the treatment response seemed greater in the standard environment for GPE (0.98, 95% CI0.5 to 1.4) than for the physically enhanced environment (0.37, 95% CI -0.2 to 0.9), between-group difference (0.61, 95% CI -0.1 to 1.3) did not reach statistical significance (p=0.07). Waitlist group reported no improvement (-0.05 95% CI -0.5 to 0.4). In interviews, participants from the standard environment expressed greater social cohesion and feeling at home. Qualitative themes identified; reflection, sense of fellowship and transition. Secondary patient-reported outcomes and qualitative findings supported the primary finding, while improvements in muscle strength and aerobic capacity did not differ between exercise groups. Conclusion Results suggest that the physical environment contributes to treatment response. Matching patients' preferences to treatment rooms may improve patient-reported outcomes. Trial registration number ClinicalTrials. gov identifier: NCT02043613.
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| 10. |
- Ulrich, Roger, 1946, et al.
(författare)
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A Conceptual Framework for the Domain of Evidence-Based Design
- 2010
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Ingår i: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 4:1, s. 95-114
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Tidskriftsartikel (refereegranskat)abstract
- The physical facilities in which healthcare services are performed play an important role in the healing process. Evidence-based design in healthcare is a developing field of study that holds great promise for benefiting key stakeholders: patients, families, physicians, and nurses, as well as other healthcare staff and organizations. In this paper, the authors present and discuss a conceptual framework intended to capture the current domain of evidence-based design in healthcare. In this framework, the built environment is represented by nine design variable categories: audio environment, visual environment safety enhancement wayfinding system, sustainability, patient room, family support spaces, staff support,spaces, and physician support spaces Furthermore a series of matrices is presented that indicates knowledge gaps concerning the relationship between specific healthcare facility design variable categories and participant and organizational outcomes. From this analysis, the authors identify fertile research opportunities from the perspectives of key stakeholders.
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| 11. |
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| 12. |
- Ulrich, Roger, 1946
(författare)
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Designing for Calm
- 2013
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Ingår i: The New York times. - 0362-4331. ; 2013:January 11
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 13. |
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| 14. |
- Ulrich, Roger, 1946, et al.
(författare)
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ICU Patient Family Stress Recovery During Breaks in a Hospital Garden and Indoor Environments
- 2020
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Ingår i: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 13:2, s. 83-102
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Tidskriftsartikel (refereegranskat)abstract
- Objectives : Measure the immediate change in intensive care unit (ICU) family members’ state stress levels from the beginning to the end of a person’s visit to a hospital garden and compare the changes produced by the garden with those associated with spending time in indoor hospital environments intended for respite and relaxation. Background : No previous research has compared the efficacy of different physical environments as interventions to foster stress reduction in family members of ICU patients, a group of hospital visitors known to experience high levels of distress. Method : A convenience sample of 42 ICU patient family (from 42 different families) completed the Present Functioning Visual Analogue Scales (PFVAS) before and after each visit (128 total visits) to a garden, an atrium/café, or ICU waiting room. Results : Stress scores significantly declined (i.e., improved) from the start to the end of a break on all PFVAS subscales (p <.0001) in both the garden and indoors locations. However, it is noteworthy that garden breaks resulted in significantly greater improvement in the “sadness” scale than breaks in indoor locations (p =.03), and changes in all five other PFVAS scores showed somewhat more reduction of stress for breaks spent in the garden than indoors, although these differences were not statistically significant. Conclusion : Creating an unlocked garden with abundant nature located close to an ICU can be an effective intervention for significantly mitigating state stress in family members of ICU patients and can be somewhat more effective than indoor areas expressly designed for family respite and relaxation.
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| 15. |
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| 16. |
- Ulrich, Roger, 1946, et al.
(författare)
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Psychiatric ward design can reduce aggressive behavior
- 2018
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Ingår i: Journal of Environmental Psychology. - : Elsevier BV. - 0272-4944 .- 1522-9610. ; 57, s. 53-66
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Tidskriftsartikel (refereegranskat)abstract
- The article describes a conceptual model proposing that aggression in psychiatric facilities may be reduced by designing the physical environment with ten evidence-grounded stress-reducing features. The model was tested in a newer hospital in Sweden having wards with nine of the ten features. Data on two clinical markers of aggressive behavior, compulsory injections and physical restraints, were compared with data from an older facility (replaced by the newer hospital) that had only one stress-reducing feature. Another hospital with one feature, which did not change during the study period, served as a control. The proportion of patients requiring injections declined (p < 0.0027) in the new hospital compared to the old facility but did not change in the control hospital. Among patients who received injections, the average number of injections declined marginally in the new hospital compared to the old facility, but increased in the control hospital by 19%. The average number of physical restraints (among patients who received at least one) decreased 50% in the new hospital compared to the old. These findings suggest that designing better psychiatric buildings using reasoned theory and the best available evidence can reduce the major patient and staff safety threat posed by aggressive behavior.
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| 17. |
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| 18. |
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| 19. |
- Ulrich, Roger, 1946, et al.
(författare)
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Towards a design theory for reducing aggression in psychiatric facilities
- 2012
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Ingår i: ARCH 12: ARCHITECTURE / RESEARCH / CARE / HEALTH. 12/11/2012 → 14/11/2012. Gothenburg.. ; , s. 12-
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Konferensbidrag (refereegranskat)abstract
- The paper proposes a tentative theory for designing psychiatric environments to foster reduced aggression and violence. A basic premise underlying the design theory is that environmental and psycho-social stressors mediate and trigger aggression. The theory posits that aggression will be reduced if the facility has been designed with an evidence-based bundle of stress-reducing environmental characteristics that are identified and discussed. To make possible a tentative empirical evaluation of the theory, findings are described from a study that compared aggressive incidents in three Swedish psychiatric hospitals of different design. A newer hospital was evaluated as superior to both an old hospital it replaced and another comparison hospital (control) with respect to having nearly all the environmental features identified in the stress-reducing bundle of the design theory. Findings from restraint use data were consistent with the design theory prediction that aggression would be lower in the newer hospital having several stress-reducing environmental features than in either the old or control hospitals. The use of chemical and physical restraints decreased substantially in the new hospital compared to the old hospital it replaced. By contrast, restraint use increased in the control hospital that cared for comparable psychiatric patients according to similar treatment protocols during the same period. The design theory and preliminary findings suggest the possibility that providing better psychiatric buildings with design guided by the best available evidence and theory can play an important role in reducing the serious patient and staff safety problem of aggressive behavior.
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