iEnvironment

Where environment meets psychology.

Hospital Room-type and Individual Differences

The pros and cons of privacy.

Hello from a brief hiatus! Having another baby has kept me from blogging for more than a few weeks. In response to my last post on incorporating natural elements in healthcare environments, I felt a bit more exposed to nature in my local hospital than when my first son was born… perhaps because my room’s window did not face the parking lot! In February, I stressed the mostly positive relations between natural elements and patient experience in hospitals. Given my recent hospital stay, I’ve now become just as interested in how different hospital rooms affect patient satisfaction and emotional wellbeing.

Like my first experience in the Mother-Babe Unit, I was assigned a room intended for two patients. Luckily for my husband and me, no one needed the other bed. This meant that my husband was allowed to sleep in the room, and it afforded the privacy of a single-occupancy space. However, part way through my stay, I was offered the option to relocate to a private room. I agreed because I assumed this would equate to a quieter, calmer, less cluttered experience. I was right… but I was wrong, too.

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After we got settled in, I was surprised by my negative reaction to the amenities I thought I’d appreciate. After all, I’ve read some of the literature. Designers aim to promote healing and wellness by creating calming spaces within healthcare settings (Douglas & Douglas, 2005). Environmental psychologists who study hospital settings know that high noise levels often mean higher stress levels for patients (Blomkvist et al., 2005). Private rooms offer more privacy (obviously!), as well as exclusive access to lighting, the television, the phone, and the bathroom. Plus, there is often more seating for visitors to supply social support to patients.  

“OK… so what’s your problem?” you ask.

“Individual differences!” I answer.

Sure, there was more space in the new room. But I soon discovered that recovering in a large quiet area, isolated from other patients, and situated further from the hub of the nurses’ station isn’t for everyone. In particular, designers should be careful to account for variation in preference when it comes to noise and stimulation. One patient’s idea of a calm setting may be another patient’s notion of loneliness.

The principles of social design outline that environments should be set up to be as congruent as possible with the desires of users – in this case, to fulfill what patients need to feel rested and healthy. For me (and, I’m sure, many others), knowledge is comfort. Because the double-occupancy room was directly across from the centralized nurses’ station, I felt closer to people and to life beyond my hospital room. I learned different nurses’ voices and heard staff talking about how busy the ward was getting, and how many new patients they were expecting that night. I listened to the day-to-day issues, like whether the rooms were low on clean blankets, and what the lunch menu would probably be the next day. Overhearing social and administrative information like this gave me something to think about in between visitors when my husband was at work. It was a distraction from the institutional setting, as well as from the physical challenges of recovery – a distraction that was lost by switching to a single-occupancy room father away from ‘noise.’

Not surprisingly, design aspects that enhance social support and positive distractions can reduce stress and, thus, promote recovery (Ulrich, 1991). These connections have been supported recently in a study by Mackrill, Cain, and Jennings (2013), showing that patients can have positive emotional responses to the hospital soundscape (e.g., “The gentle hum of people doing things is good because you don’t feel like you’re detached. You’re part of what is going on”).

So, what I’m trying to get across is that understanding that some people heal better (or at least feel better while healing) with more stimulation, information, and interaction than less is important to remember when researching healthcare settings. As usual, individual differences make it challenging to understand what it means to be comfortable in these kinds of environments. Certainly, my experience with both room types has made me a more careful thinker concerning subjectivity and design research. And, if I am ever to be a mother of three, I’ll let someone else have the private room!

References

Blomkvist, V., Eriksen, C. A., Theorell, T., Ulrich, R., & Rasmanis, G. (2005). Acoustics and psychosocial environment in intensive coronary care. Journal of Occupational and Environmental Medicine, 62, e1–e8.

Douglas, C. H., & Douglas, M. R. (2005). Patient-centred improvements in healthcare built environments: Perspectives and design indicators. Health Expectations, 8, 264-276.

Mackrill, J., Cain, R., & Jennings, P. (2013). Experiencing the hospital ward soundscape: Towards a model. Journal of Environmental Psychology, 38, 1-9.

Ulrich, R. S. (1991). Effects of interior design on wellness: Theory and recent scientific research. Journal of Health Care Interior Design, 3, 97-109. 

Lindsay J. McCunn, MSc is a Ph.D. candidate in environmental psychology at the University of Victoria in British Columbia.

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