The Environmental Factors Associated With Fatigue of Frontline Nurses in the Infection Disease Nursing Unit.

The workload in the Infection Disease Nursing Unit (IDNU) is increasing dramatically due to COVID-19, and leads to the prevalence of fatigue among the frontline nurses, threatening their health, and safety. The built environment and design could fundamentally affect the fatigue of nurses for a long-term perspective. This article aims to extract the environmental factors of IDNU and explore nurses' perceptions of these factors on the work-related fatigue. It would produce evidences for mitigating the fatigue by environmental interferons. A cross-sectional design was employed by combination of focus group interview and written survey. Environmental factors of IDNU were collected from healthcare design experts (n = 8). Nurses (n = 64) with frontline COVID-19 experiences in IDNU were recruited to assess these factors individually. Four environmental factors were identified as: Nursing Distance (ND), Spatial Crowdness (SC), Natural Ventilation, and Light (NVL), and Spatial Privacy (SP). Among them, ND was considered as the most influential factor on the physical fatigue, while SP was on the psychological fatigue. Generally, these environmental factors were found to be more influential on the physical fatigue than the psychological fatigue. Technical titles were found to be associated with the nurses' perceptions of fatigue by these environmental factors. Nurse assistant and practical nurse were more likely to suffer from the physical fatigue by these factors than senior nurse. The result indicated that environmental factors of IDNU were associated with the nurses' fatigue, particularly on the physical aspect. Environmental interventions of design could be adopted to alleviate the fatigue by these factors such as reducing the ND and improving the spatial privacy. The accurate interventional measures should be applied to fit nurses' conditions due to their technical titles. More attention should be given to the low-ranking nurses, who account for the majority and are much vulnerable to the physical fatigue by environmental factors.

Functional Settings of Hospital Outdoor Spaces and the Perceptions from Public and Hospital Occupant during COVID-19.

Hospital outdoor spaces play an important role for the safety and well-being of users (patients, visitors, and staff), particularly during a pandemic. However, the actual needs of these spaces are often overlooked due to the design and management process. This study investigates the perceptions of the public and occupants on the functional settings of outdoor spaces, and provides evidence for building a safe and resilient hospital during (and after) COVID-19. A multi-method approach of web content analysis (WCA) and a web-based survey was employed. Reports were collected from three mainstream websites; keywords were extracted and then categorized, pertaining to the functional settings of outdoor spaces. Three groups of occupants from Southwest Hospital (staff n = 47, patients n = 64, visitors n = 73) participated in the survey to identify their perceptions of these functional settings. Based on the 657 reports and 33 keywords selected, 7 functional settings were identified: health check (HC), quarantine and observation (QO), food and delivery (FD), healing and restoration (HR), waiting and rest (WR), transportation and parking (TP), load and unload (LU). From all users, HC (4.13) was thought to be the most expected function setting while FD (2.61) was the least. Regarding the satisfaction level, most users were satisfied with HC (3.22) while WR (2.16) was the least satisfying. The users also showed significant differences regarding expectation and satisfaction pertaining to their groups. The results indicate that the current outdoor space could not fully meet the needs of users, regarding the emerging functional setting, due to the pandemic. Users showed significant different perceptions on the functional setting due to their roles. The mismatch between the outdoor space and the users' needs on emerging functional settings resulted in low satisfaction and high expectation in the survey. Environmental interventions with adaptive and flexible strategies should be adapted for these functional settings. The differences of users should be fully recognized by administrators, decision-makers, and designers.