Recognizing the limited research and design guidelines for these essential health care settings, this study gathered pilot data on the design of outpatient rehabilitation therapy (RT) facilities as a foundation for future research.
Background
Providing RT is core to addressing health conditions that might otherwise lead to higher and more costly levels of medical intervention. The World Health Organization estimates that 2.4 billion people worldwide would benefit from RT; however, only half receive care. As a result, more space may be sought for ambulatory clinics and hospital-based settings that cater to both inpatients and outpatients.
Methods
Interviews (n = 21) and questionnaires (n = 43) involving RT patients and staff and RT facility designers were conducted with overlap between the interview and questionnaire participants. Both methods explored amenities and features of RT environments.
Results
Among the findings, there were several significant differences regarding the importance and effectiveness (presence) of specific environmental elements. Additionally, there were some significant differences among patients, staff, and designers in terms of their perceptions of importance and effectiveness.
Conclusion
Eight potential design guidelines are suggested, rather than recommended, as of yet. They are topics for future research and include the provision of an appropriate balance of private and shared spaces, acoustical treatment of open therapy areas, efficient and restorative staff areas, outdoor spaces, window views and daylight, flexible lighting, and appropriate furniture and wall coverings.
AtwaA.MoneyA. G.SpiliotopoulouG.McintyreA. (2013). Occupational therapists’ perceptions about the clinical utility of the 3D interior design software. Disability and Rehabilitation: Assistive Technology, 8(4), 348–355. https://doi.org/10.3109/17483107.2012.713437
3.
BazaidR.PatiD. (2023). Exploring hospital physical environment influencing users first impressions of the healthcare organizations: A conceptual framework based on literature review. HERD: Health Environments Research & Design Journal, 16(4), 335–358. https://doi.org/10.1177/19375867231184573
4.
BertuzziA.MartinA.ClarkeN.SpringateC.AshtonR.SmithW.McPhersonD. (2023). Clinical, humanistic and economic outcomes, including experiencing of patient safety events, associated with admitting patients to single rooms compared with shared accommodation for acute hospital admissions: A systematic review and narrative synthesis. BMJ open, 13(5), e068932. https://doi.org/10.1136/bmjopen-2022-068932
5.
BeukeboomC. J.LangeveldD.Tanja-DijkstraK. (2012). Stress-Reducing effects of real and artificial nature in a hospital waiting room. The Journal of Alternative and Complementary Medicine, 18(4), 329–333. https://doi.org/10.1089/acm.2011.0488
6.
BoerD. E.SterkeS.SchmidtC. B.Vliet VlielandT. P. M. (2022). The perceptions, needs and preferences of informal caregivers of nursing home residents with dementia regarding physical therapy: A qualitative study. Geriatric Nursing, 44(March-April), 167–175. https://doi.org/10.1016/j.gerinurse.2022.01.014
7.
BrambillaA.RebecchiA.CapolongoS. (2019). Evidence based hospital design. A literature review of the recent publications about the EBD impact of built environment on hospital occupants’ and organizational outcomes. Annali di Igiene Medicina Preventiva e di Comunita, 31(2), 165–180. https://doi.org/10.7416/ai.2019.2268
Carmel-GilfilenC.PortilloM. (2016). Designing with empathy. HERD: Health Environments Research & Design Journal, 9(2), 130–146. https://doi.org/10.1177/1937586715592633
10.
Ciezar-AndersenS.King-ShierK. (2021). Detriments of a self-sacrificing nursing culture on recruitment and retention: A qualitative descriptive study. Canadian Journal of Nursing Research, 53(3), 233–241. https://doi.org/10.1177/0844562120908747
11.
DavisB. E. (2011). Rooftop hospital gardens for physical therapy: A post-occupancy evaluation. HERD: Health Environments Research & Design Journal, 4(3), 14–43. https://doi.org/10.1177/193758671100400303
12.
FirbyH.RaineR. (2023). Engaging with nature and the outdoors: A scoping review of therapeutic applications in contemporary occupational therapy. British Journal of Occupational Therapy, 86(2), 101–115. https://doi.org/10.1177/03080226221126893
13.
HalawaF.MadathilS. C.GittlerA.KhasawnehM. T. (2020). Advancing evidence-based healthcare facility design: A systematic literature review. Health Care Management Science, 23(September), 453–480. https://doi.org/10.1007/s10729-020-09506-4
14.
IyendoT. O.UwajehP. C.IkennaE. S. (2016). The therapeutic impacts of environmental design interventions on wellness in clinical settings: A narrative review. Complementary Therapies in Clinical Practice, 24(August), 174–188. https://doi.org/10.1016/j.ctcp.2016.06.008
15.
JetteD. U.HalbertJ.IversonC.MiceliE.ShahP. (2009). Use of standardized outcome measures in physical therapist practice: Perceptions and applications. Physical Therapy, 89(2), 125–135. https://doi.org/10.2522/ptj.20080234
16.
JinH. Y.GoldC.ChoJ.MarzbanF.LimL. (2023). The role of healthcare facility design on the mental health of healthcare professionals: A literature review. HERD: Health Environments Research & Design Journal, 16(1), 270–286. https://doi.org/10.1177/19375867221118685
17.
KalantariS.TripathiV.KanJ.RoundsJ. D.MostafaviA.SnellR.Cruz-GarzaJ. G. (2022). Evaluating the impacts of color, graphics, and architectural features on wayfinding in healthcare settings using EEG data and virtual response testing. Journal of Environmental Psychology, 79(February), 101744. https://doi.org/10.1016/j.jenvp.2021.101744
18.
KimA. K.VakkalankaJ. P.Van HeukelomP.TateJ.LeeS. (2022). Emergency psychiatric assessment, treatment, and healing (EmPATH) unit decreases hospital admission for patients presenting with suicidal ideation in rural America. Academic Emergency Medicine, 29(2), 142–149. https://doi.org/10.1111/acem.14374
19.
KingN.WileyM.RoseA.FergusA. (2024). Delivery of school-based physical therapy via telehealth: Perceptions and attitudes of school-based physical therapists. Physical & Occupational Therapy In Pediatrics, 44(2), 180–197. https://doi.org/10.1080/01942638.2023.2228898
20.
KinneyA. R.Stearns-YoderK. A.HoffbergA. S.MiddletonA.WeaverJ. A.RoseenE. J.JuckettL. A.BrennerL. A. (2023). Barriers and facilitators to the adoption of evidence-based interventions for adults within occupational and physical therapy practice settings: A systematic review. Archives of Physical Medicine and Rehabilitation, 104(7), 1132–1151. https://doi.org/10.1016/j.apmr.2023.03.005
21.
LahtinenM.NenonenS.RasilaH.LehteläJ.RuohomäkiV.ReijulaK. (2014). Rehabilitation centers in change: Participatory methods for managing redesign and renovation. HERD: Health Environments Research & Design Journal, 7(2), 57–75. https://doi.org/10.1177/193758671400700204
22.
MaloneE. B.DellingerB. A. (2011). Furniture design features and healthcare outcomes. The Center for Health Design.
23.
McCluskyJ. F. (2008). Creating engaging experiences for rehabilitation. Topics in Stroke Rehabilitation, 15(2), 80–86. https://doi.org/10.1310/tsr1502-80
24.
Medina-MirapeixF.Del Baño-AledoM. E.Oliveira-SousaS. L.Escolar-ReinaP.CollinsS. M. (2013). How the rehabilitation environment influences patient perception of service quality: A qualitative study. Archives of Physical Medicine and Rehabilitation, 94(6), 1112–1117. https://doi.org/10.1016/j.apmr.2012.11.007
NehmeJ.Torres IrribarraD.CumsilleP.YoonS. Y. (2021). Waiting room physical environment and outpatient experience: The spatial user experience model as analytical tool. Journal of Interior Design, 46(4), 27–48. https://doi.org/10.1111/joid.12205
27.
NejatiA.ShepleyM.RodiekS.LeeC.VarniJ. (2016). Restorative design features for hospital staff break areas. HERD: Health Environments Research & Design Journal, 9(2), 16–35. https://doi.org/10.1177/1937586715592632
28.
NimlyatP. S.KandarM. Z. (2015). Appraisal of indoor environmental quality (IEQ) in healthcare facilities: A literature review. Sustainable Cities and Society, 17(September), 61–68. https://doi.org/10.1016/j.scs.2015.04.002
29.
PashaS.ShepleyM. M. (2024). A systematic review on the research and design of physical therapy environments. Health Environments Research & Design, 17(3), 354–371. https://doi.org/10.1177/19375867241248604
30.
PierretteM.ParizetE.ChevretP.ChatillonJ. (2015). Noise effect on comfort in open-space offices: Development of an assessment questionnaire. Ergonomics, 58(1), 96–106. https://doi.org/10.1080/00140139.2014.961972
31.
R Core Team. (2023). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/
32.
SatoH.MorimotoM.OhtaniS.HoshinoY.SatoH. (2017). Subjective evaluation of speech privacy at consulting rooms in hospitals: Relationship between feeling evoked by overhearing speech and word intelligibility score. Applied Acoustics, 124(September), 38–47. https://doi.org/10.1016/j.apacoust.2017.03.020
33.
ShenX.ZhangH.LiY.QuK.ZhaoL.KongG.JiaW. (2023). Building a satisfactory indoor environment for healthcare facility occupants: A literature review. Building and Environment, 228(January), 109861. https://doi.org/10.1016/j.buildenv.2022.109861
34.
ShepleyM. M.WatsonA.PittsF.GarrityA.SpelmanE.FronsmanA.KelkarJ. (2017). Mental and behavioral health settings: Importance & effectiveness of environmental qualities & features as perceived by staff. Journal of Environmental Psychology, 50(June), 37–50. https://doi.org/10.1016/j.jenvp.2017.01.005
35.
SullivanM. B.HillK.BallengeeL. A.KnoblachD.FowlerC.HaunJ.SaengerM. (2023). Remotely delivered psychologically informed mindful movement physical therapy for pain care: A framework for operationalization. Global Advances in Integrative Medicine and Health, 12, 1–14. https://doi.org/10.1177/27536130231209751
36.
SyndorD.AileenJ. (2020). Hospital furniture: Expectations of patients toward furniture in healthcare setting. Proceedings on Engineering Sciences, 2(3), 305–310. https://doi.org/10.24874/PES02.03.009
37.
SzymczakS. E.ShellhaasR. A. (2014). Impact of NICU design on environmental noise. Journal of Neonatal Nursing, 20(2), 77–81. https://doi.org/10.1016/j.jnn.2013.07.003
38.
UlrichR. S.ZimringC.ZhuX.DuBoseJ.SeoH.-B.ChoiY.-S.QuanX.JosephA. (2008). A review of the research literature on evidence-based healthcare design. HERD: Health Environments Research & Design Journal, 1(3), 61–125. https://doi.org/10.1177/193758670800100306
39.
WattsG.KhanA.PheasantR. (2016). Influence of soundscape and interior design on anxiety and perceived tranquility of patients in a healthcare setting. Applied Acoustics, 104(March), 135–141. https://doi.org/10.1016/j.apacoust.2015.11.007
ZaniboniL.Sarey KhanieM.PernigottoG.ToftumJ.GasparellaA.OlesenB. (2022). Lighting conditions in physiotherapy centres: A comparative field study. Lighting Research & Technology, 54(4), 377–408. https://doi.org/10.1177/14771535211046521
42.
ZhouT.WuY.MengQ.KangJ. (2020). Influence of the acoustic environment in hospital wards on patient physiological and psychological indices. Frontiers in Psychology, 11(July), 1600. https://doi.org/10.3389/psyg.2020.01600
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