ABSTRACT
AIM: This literature review is conducted to identify knowledge gaps and shape a framework for the development of guidelines and future research on programming and design of rehabilitation environments. BACKGROUND: Patients suffering from trauma, stroke, neurological or cardiopulmonary conditions, or recovering from surgery or cancer treatment require rehabilitation services. A comprehensive rehabilitation program can support continuum of care for inpatient and outpatient groups. However, within most facilities, rehabilitation environments are found to be outdated and undersized compared to other programs or lack the correct adjacencies within the facility. Unfortunately, this deficiency is echoed by limited guidelines on programming, planning, and design of these environments. General guidelines derived from healthcare environments research is not adaptable to rehabilitation environments, because the paradigm used in most healthcare environment research does not address specific needs of rehabilitation patients in regaining confidence or relearning daily life skills. METHOD: We conducted a structured literature review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a basis for reporting the available body of work on evidence-based research in rehabilitation environments. RESULT AND CONCLUSION: Through analysis of the limited literature, specific mediators such as patient confidence and motivation were identified. An environment that creates a balance between privacy and social interaction can promote these mediators. Creating enriched environments through elements that engage the senses and encourage more social and physical interaction is essential for recovery. Finally, accessibility and wayfinding are of great importance in these environments due to potential limited mobility or cognitive impairments of patients.
ABSTRACT
OBJECTIVE: This study aimed to identify barriers to use of outdoor spaces in Texas pediatric healthcare facilities. BACKGROUND: Available research on hospital healing gardens and outdoor spaces has indicated that despite several health benefits of garden visitation for staff, patients, and family members, these amenities are not being used to their fullest capacity. Previous researchers have recommended design features such as comfortable seats and adequate shade to increase garden visitation in healthcare setting. However no quantitative data have demonstrated significance of correlation between presence of these design features and garden use. The present study served to statistically support design guidelines suggested by previous researchers and introduce new guidelines. METHODS: Site visits and surveys were conducted in five green outdoor spaces in three pediatric hospitals in east Texas. Hospital visitors, family members, and staff responded to questions concerning barriers to garden visitation, their visitation habits, and satisfaction with the garden features. The study was reviewed and approved by Institutional Review Boards of the relevant hospitals and academic institutions. RESULTS: A negative significant correlation was found between staff garden use and dissatisfaction with quality of seats and poor shade. While quality of seats didn't impact visitor and family member garden visitation, a significant negative correlation was found between poor shade and their garden use. CONCLUSIONS: The study served to statistically support previous design suggestions for hospital gardens, and introduced new design guidelines. Design recommendations include functionality, visibility, accessibility, exclusivity, and availability of shade and seats. KEYWORDS: Design process, evidence-based design, healing environments, hospital.
