تاثیر ویژگی‌های چیدمان فضایی بر ارتقای کیفیت محیط بستری

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری، گروه معماری، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

2 دانشیار، گروه شهرسازی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

3 دانشیار، گروه معماری، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

10.30495/jhm.2022.65150.11009

چکیده

مقدمه: این تحقیق به بررسی تاثیر ابعاد و چیدمان فضایی اتاق های بستری بر بهبود بیماران با رویکردی میان دانشی در تحلیل محیط میتنی بر علوم داده پرداخت.
روش پژوهش: پژوهش حاضر به روش ترکیبی (Mixed method) از مرور شواهد مطالعات پیشین و کدنویسی در محیط برنامه نویسی پایتون انجام گرفت. داده‌های تحقیق شامل ﻣﺸﺨﺼﺎت دﻣﻮﮔﺮاﻓﻴﻚ، شرح حال بیماران و ویژگی های محیطی بود که از طریق سیستم HIS بیمارستان (Hospital Information System)  و مشاهده میدانی گردآوری شد. این مطالعه به صورت مقطعی در سال 98 و با حجم نمونه 330 بیمار در بیمارستان امید انجام شد. همبستگی داده‌ها از طریق ترسیم نقشه‌های حرارتی و آزمون مجذور کای با سطح معنی‌داری (α < 0.05) سنجیده شد.
یافته‌ها: بر اساس آزمون Chi-squared دو ویژگی شامل تعداد تخت‌ها و چشم‌انداز قابل مشاهده از پنجره با مدت بستری بیماران همبسته بودند. هم‌چنین طبق نقشه حرارتی فاصله اتاق‌ها از ایستگاه پرستاری و ورودی بخش به ترتیب با مقادیر همبستگی 0.69 و 0.76 در مقایسه با وسعت اتاق‌ها با مقدار همبستگی0.5 ارتباط بیشتری با مدت بستری بیماران داشتند. تاثیر طول اتاق نسبت به عرض آن به ترتیب با مقادیر همبستگی 0.52 و 0.48 بیشتر بود. میان دو ویژگی‌های راست یا چپ دست بودن و هم‌چنین موقعیت تخت‌ها نسبت به پنجره با مدت بستری بیماران ارتباط معناداری یافت نشد.
نتیجه‌گیری: نتایج کلی تحقیق تاثیر چیدمان محیط بر بهبود بیماران را تایید کرد. هم‌چنین این تحقیق گامی در توسعه حوزه طراحی مبتنی بر شواهد ارائه کرد.

کلیدواژه‌ها


1- Heydari A.S, Bahrami M. A, Eslami S & Keshmiri F. Evaluation of the internal environment of teaching hospitals under the auspices of Yazd University of Medical Sciences based on a six-dimensional Weisboard model. Journal of Healthcare Management Research, 2014; 3(3): 53-62. [In Persian]
2- Nanda U, Pati D, Ghamari H, Bajema R. Lessons from neuroscience: form follows function, emotions follow form. Intelligent Buildings International, 2013; 5(sup1): 61-78. https://doi.org/10.1080/17508975.2013.807767
3- Durmisevic S, Ciftcioglu Ö. Knowledge modeling tool for evidence-based design. HERD: Health Environments Research & Design Journal, 2010; 3(3): 101-23. https://doi.org/10.1177/193758671000300310
4- Zhang Y, Tzortzopoulos P, Kagioglou M. Healing built-environment effects on health outcomes: Environment–occupant–health framework. Building research & information, 2019; 47(6): 747-66. https://doi.org/10.1080/09613218.2017.1411130
5- Lang J, Creating Architectural Theory, The Role of Behavioral Sciences inEnvironmental Design, Fourth Edition with Additions, Translated by Alireza Einifar, Tehran, Tehran University Press; 2002. [In Persian]
6- Tanja‐Dijkstra K, Pieterse ME. The psychological effects of the physical healthcare environment on healthcare personnel. Cochrane database of systematic reviews; 2011. https://doi.org/10.1002/14651858.CD006210.pub3
7- Dijkstra K, Pieterse M, Pruyn A. Physical environmental stimuli that turn healthcare facilities into healing environments through psychologically mediated effects: systematic review. Journal of advanced nursing, 2006; 56(2): 166-81. https://doi.org/10.1111/j.1365-2648.2006.03990.x.
8- Schweitzer M, Gilpin L, Frampton S. Healing spaces: elements of environmental design that make an impact on health. Journal of Alternative & Complementary Medicine, 2004; 10(1): S-71. https://doi.org/10.1089/acm.2004.10.S-71
9- Salonen H, Lahtinen M, Lappalainen S, Nevala N, Knibbs LD, Morawska L, Reijula K. Physical characteristics of the indoor environment that affect health and wellbeing in healthcare facilities: A review. Intelligent Buildings International, 2013; 5(1): 3-25. https://doi.org/10.1080/17508975.2013.764838
10- Harris PB, McBride G, Ross C, Curtis L. A place to heal: environmental sources of satisfaction among hospital patients 1. Journal of Applied Social Psychology, 2002; 32(6): 1276-99. https://doi.org/10.1111/j.1559-1816.2002.tb01436.x
11- Drahota A, Ward D, Mackenzie H, Stores R, Higgins B, Gal D, Dean TP. Sensory environment on health‐related outcomes of hospital patients. Cochrane Database of Systematic Reviews; 2012 (3). https://doi.org/10.1002/14651858.CD005315.pub2.
12- Ulrich RS. Effects of healthcare environmental design on medical outcomes. InDesign and Health: Proceedings of the Second International Conference on Health and Design. Stockholm, Sweden: Svensk Byggtjanst; 2001; 49: 59. yun.ir/14u8s8
13- Andrade C, Lima ML, Fornara F, Bonaiuto M. Users' views of hospital environmental quality: Validation of the perceived hospital environment quality indicators (PHEQIs). Journal of Environmental Psychology, 2012; 32(2): 97-111. https://doi.org/10.1016/j.jenvp.2011.12.001
14- Joseph A, Rashid M. The architecture of safety: hospital design. Current opinion in critical care, 2007; 13(6): 714-9. doi: 10.1097/MCC.0b013e3282f1be6e
15- Alereza Amiri M, Habib F, Shahcheraghi A. Evaluation of Components of Environmental Quality in Hospital, From a Naturalistic Perspective (Case Study of Shariati Hospital, Tehran). Journal of Healthcare Management Research, 2020; 10(34): 21-37. [In Persian]
16- Gao C, Zhang S. The restorative quality of patient ward environment: Tests of six dominant design characteristics. Building and Environment, 2020; 180: 107039. https://doi.org/10.1016/j.buildenv.2020.107039
17- MacAllister L, Zimring C, Ryherd E. Environmental variables that influence patient satisfaction: A review of the literature. HERD: Health Environments Research & Design Journal, 2016; 10(1): 155-69. https://doi.org/10.1177/1937586716660825
18- Greer V, Johnson E, Hsu J. Variables and Outcomes in Patient Room Design: A Study of Design Hypotheses. HERD: Health Environments Research & Design Journal, 2021; 14(2): 219-33. https://doi.org/10.1177/1937586720954952
19- Andrade CC, Devlin AS, Pereira CR, Lima ML. Do the hospital rooms make a difference for patients’ stress? A multilevel analysis of the role of perceived control, positive distraction, and social support. Journal of Environmental Psychology, 2017 1; 53: 63-72. https://doi.org/10.1016/j.jenvp.2017.06.008
20- De Korte EM, Spiekman M, Hoes-van Oeffelen L, van der Zande B, Vissenberg G, Huiskes G, Kuijt-Evers LF. Personal environmental control: Effects of pre-set conditions for heating and lighting on personal settings, task performance and comfort experience. Building and Environment, 2015; 86: 166-76. https://doi.org/10.1016/j.buildenv.2015.01.002
21- Andrade CC, Lima ML, Devlin AS, Hernández B. Is it the place or the people? Disentangling the effects of hospitals’ physical and social environments on well-being. Environment and Behavior, 2016; 48(2): 299-323. http://dx.doi.org/10.1177/0013916514536182.
22- Mohammadesmaeil S, Kianmehr S. Data Mining as an Intangible Model of Information Therapy and Seeking Behaviors in Immune Deficiency Disease Specialists. Journal of Healthcare Management Research, 2021; 11(38): 7-17. [In Persian]
23- Halawa F, Madathil SC, Gittler A, Khasawneh MT. Advancing evidence-based healthcare facility design: a systematic literature review. Health Care Management Science, 2020; 23: 453-80. https://doi.org/10.1007/s10729-020-09506-4
24- Schreuder E, Lebesque L, Bottenheft C. Healing environments: What design factors really matter according to patients? An exploratory analysis. HERD: Health Environments Research & Design Journal, 2016; 10(1): 87-105. https://doi.org/10.1177/1937586716643951
25- Ullán AM, Belver MH, Fernández E, Serrano I, Delgado J, Herrero C. Hospital designs for patients of different ages: Preferences of hospitalized adolescents, nonhospitalized adolescents, parents, and clinical staff. Environment and Behavior, 2012; 44(5): 668-94. https://doi.org/10.1177/0013916511403802.
26- Nikabadi S, Zabihi H, Shahcheraghi A. Evaluating the Effective Factors of Hospital Rooms on Patients’ Recovery Using the Data Mining Method. HERD: Health Environments Research & Design Journal; 2021. https://doi.org/10.1177/19375867211031305
27- Verderber S. Dimensions of person-window transactionsin the hospital environment. Environment & Behavior, 1986; 18(4): 450-66. http://dx.doi.org/10.1177/0013916586184002
28- Sengke MM, Atmodiwirjo P, Yatmo YA, Johanes M. Design consideration for window placement to provide the view within the patient's visual range. Journal of Design and Built Environment, 2020; 20(1): 13-23. https://doi.org/10.22452/jdbe.vol20no1.2
29- MacAllister L, Zimring C, Ryherd E. Exploring the relationships between patient room layout and patient satisfaction. HERD: Health Environments Research & Design Journal, 2019; 12(1): 91-107. https://doi.org/10.1177/1937586718782163.
30- Cai H, Zimring C. Out of Sight, Out of Reach: Correlating spatial metrics of nurse station typology with nurses’ communication and co-awareness in an intensive care unit. In Proceedings of the 8th International Space Syntax Symposium, Santiago, Chile, 2012; 36: 381-391.
31- Choi YS, Lawler E, Boenecke CA, Ponatoski ER, Zimring CM. Developing a multi‐systemic fall prevention model, incorporating the physical environment, the care process and technology: a systematic review. Journal of advanced nursing, 2011; 67(12): 2501-24. https://doi.org/10.1111/j.1365-2648.2011.05672.x
32- Gurascio-Howard L, Malloch K. Centralized and decentralized nurse station design: An examination of caregiver communication, work activities, and technology. HERD: Health Environments Research & Design Journal, 2007; 1(1): 44-57.  https://doi.org/10.1177/193758670700100114
33- Nehrke MF, Morganti JB, Willrich R, Hulicka IM. Health status, room size, and activity level: Research in an institutional setting. Environment and Behavior, 1979; 11(4): 451-63. https://doi.org/10.1177/0013916579114002.
34- Huisman ER, Morales E, van Hoof J, Kort HS. Healing environment: A review of the impact of physical environmental factors on users. Building and environment, 2012; 58: 70-80. https://doi.org/10.1016/j.buildenv.2012.06.016
35- Van de Glind I, de Roode S, Goossensen A. Do patients in hospitals benefit from single rooms? A literature reviews. Health Policy, 2007; 84(2-3): 153-61. https://doi.org/10.1016/j.healthpol.2007.06.002
36- Chaudhury H, Mahmood A, Valente M. Advantages and disadvantages of single-versus multiple-occupancy rooms in acute care environments: a review and analysis of the literature. Environment and Behavior, 2005; 37(6): 760-86. https://doi.org/10.1177/0013916504272658
37- Ulrich RS, Zimring C, Zhu X, DuBose J, Seo HB, Choi YS, Quan X, Joseph A. A review of the research literature on evidence-based healthcare design. HERD: Health Environments Research & Design Journal, 2008; 1(3): 61-125. https://doi.org/10.1177/193758670800100306