تاثیر محیط کالبدی فضاهای درمانی بر کاهش استرس بیماران (بررسی نمونه موردی مطب دندان‌پزشکی)

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار دانشکده معماری، پردیس هنرهای زیبا، دانشگاه تهران

2 کارشناس ارشد معماری، پردیس بین المللی کیش، دانشگاه تهران، کیش

چکیده

هدف از انجام این پژوهش، بررسی میزان تاثیر محیط کالبدی فضاهای درمانی بر کاهش استرس بیماران است. پژوهش در یک مطب دندان­پزشکی از طریق مقایسه نگرش و ادراک دوگروه از بیماران (80 نفر) که طی چند سال گذشته پیش و پس از تغییرات معماری داخلی به مطب مراجعه می­نمودند، صورت پذیرفت. این نوع مطالعه از نوع تحلیلی- محتوایی است. تلفیقی از روش تحقیق همبستگی و کیفی به کار رفته است تا بتوان ارزیابی چند متغیر و روابط بین آنها را در شرایط واقعی امکان­پذیر ساخت. ابزار گردآوری داده­ها از طریق تحلیل کیفی مفاهیم و نظریه­های موجود انتخاب گردیده است. از پرسشنامه برای بررسی کمّی شاخص­ها در نمونه­ موردی استفاده شده است. برای تجزیه و تحلیل از برنامه SPSS و آمار توصیفی نظیر فراوانی مطلق و نسبی، میانگین، انحراف معیار و نیز آمارهای استنباطی، آزمون پیرسون استفاده شده است. پایایی درونی پرسشنامه از طریق آلفای کرونباخ صورت پذیرفته است. نتایج حاصل از بررسی پرسشنامه مشخص نمود که عوامل محیطی در کاهش استرس بیماران تاثیر بسزایی دارد. تحلیل داده­ها نشان می­دهد که نباید هدف از طراحی داخلی یک فضای درمانی، صرفاً درمان فیزیکی افراد باشد؛ بلکه علاوه بر ارایه خدمات درمانی، تامین مناسبات روحی و روانی کاربران از اساسی­ترین اهداف طراحی چنین مکان­هایی به شمار می­رود

کلیدواژه‌ها

عنوان مقاله [English]

Effect of Physical Environmental of Medical Space in Reducing Patients’ Anxiety and Stress (Case Study: a Dental Office)

نویسندگان [English]

  • Ghasem Motalebi 1
  • Ladan Vojdanzadeh 2
1 Assistant Professor, School of Architecture, College of Fine Art, University of Tehran, Tehran
2 Master of Architecture, Kish International Campus, University of Tehran, Tehran
چکیده [English]

The purpose of this article is to explore whether the physical environmental of medical space can affect the patients’ stress and anxiety. (Numerous studies have suggested that anxiety is found in most clinical/medical settings. Stress occurs when there is an imbalance of environmental demands and human resources. The environment may add to this stress, with overcrowding, noise, lack of privacy, and glare, especially when coupled with poor interior color schemes. All of these stress factors can negatively affect the process of healing). The particular definition in this research was the relationship between environmental factors (brightness, peaceful, noisy, color, privacy and crowding) and stress. A dental office is considered as an effective environment which changed decoration and interior design during the time according to dentists and staffs demands. To research this, a study was carried out between two groups: peoples who referred to dental office before interior design changes and peoples who referred to dental office after interior design changes. The attitudes and perceptions of the two groups of patients (through questionnaires distributed) compared. Before the results of the analysis were determined, the reliability of the dependent and independent variables was tested with Cronbach’s test. The Cronbach alpha for variables was more than 0.70. Results from 80 patients showed that environmental factors such as brightness, peaceful, noisy, color, privacy and crowding could effect on patients and reduce their stress and anxiety. It is obvious; changing the interior design of dental office could increase quality-in-perception by:  ● Promoting the content of mental with increasing legibility and image ability of environment and changing the location of activities and territorial behavior. ● Reducing stress and anxiety and avoiding spatial ambiguity by defining the territorial behavior and personal space or user activity. ● Optimizing the quality of space with changing light, color furniture, television, music, artworks and etc. ● Eliminating the negative impact of the stress known by physical design of a waiting area (waiting area indeed buffer). Also it was found that according to patient’s position during treatment, design of ceiling which located in the field of patients’ view is important to reduced stress significantly. Utilizing color, light and especially picture of nature is more effective. In the other words, an important part of curing relates to the quality of care that patients receive. Studies on perceived quality of care suggest that patient-perceived quality of care is heavily defined by the amount of empathy, warmth, and friendliness that the patient experiences. The environment plays an important role in conveying empathy, warmth, and friendliness even before the patient interacts with staff. In this research, data analysis indicated that the purpose of medical environmental design should not be focused on curing people physically or in the limited sense of bricks and mortar. In addition to providing medical services, it should prepare appropriate mental and physical spatial for users (patients and staff). The design of health-care facilities should be human-centered and functionally efficient, to benefit patients, their families, and staff alike. In other words, interior design of medical space is necessity not luxury.

کلیدواژه‌ها [English]

  • Environmental Influences on Behavior
  • Environmental Stress
  • Medical Space’s Perception
  • Dental Office Design
  • Interior Design
  • Environmental psychology

مراجع

آلتمن، ایروین (1382)، محیط و رفتار اجتماعی: خلوت، فضای شخصی، قلمرو و ازدحام، ترجمه علی نمازیان، دانشگاه شهید بهشتی، تهران.
دمیستر، وبر (1387)، ارگونومی برای مبتدیان، ترجمه علی پور قاسمی، چاپ سوم، نشر مرکز، تهران.
سلمانی، ناصر (1385)، لحاظ کردن فاکتورهای روانشناسی در طراحی محصولات صنعتی (با گرایش خودرو)؛ماهنامه مهندسیخودرو و صنایع وابسته، شماره 5، صفحه 38- 52
لنگ، جان (1388)، آفرینش نظریه معماری، ترجمه علیرضا عینی فر، انتشارات دانشگاه تهران، تهران.
Akalin-Baskayaa, A; Yildirimb, K (2007), Design of circulation axes in densely used polyclinic waiting halls, Building and Environment, No 4 , pp 1743–1751.
Almerud, S; Petersson, K (2003), Music therapy-a complementary treatment for mechanically ventilated intensive care patients, Intensive Criti Care Nurs, 19(1), pp 21-30.
Ananth, S (2008), Healing environments: the next natural step, Explore, 4(4), p 274.
Arneill, AB; Devlin, S (2002), Perceived quality of care: the influence of the waiting room environment, Journal of Environmental Psychology, 2(4), pp 345–60.
Baker, CF(1984), Sensory overload and noise in the ICU: sources of environmental stress, Critical Care Quarterly, 6, pp 66–80.
Beauchemin, K.M and Hays, P (1996), Sunny hospital rooms expedite recovery from severe and refractory depressions, Journal ofAffective Disorders, 40(1), pp 49-51.
Beatrice, DF; Thomas, CP; Biles, B (1998), Grant making with an impact: the Picker/Commonwealth patient-centered care program, Health Affairs, 17, pp 236–44.
Berg, A.V.D (2005), Health impacts of healing environments - A review of evidence for benefits of nature, daylight, fresh air and quiet in healthcare settings, University Hospital Groningen, Groningen.
Bonadies, V(2009), Guided Imagery as a Therapeutic Recreation Modality to Reduce Pain and Anxiety, Therapeutic RecreationJournal, Arlington: Second Quarté 2009, 43(2), p 43.
Chiang, CM ; Chou, PC ; Lai, CM ; Li, YY (2001), A methodology to assess the indoor environment in care centers for senior citizens, Building andEnvironment, 36, pp 561–8.
Cooke, M; Chaboyer, W; Hiratos, M.A (2005), Music And Its Effect on Anxiety in Short Waiting Periods: A Critical Appraisal, Journal of Clinical Nursing, 14(2), pp 145-155.
Cronbach, L.J (1951), Coefficient alpha and the internal structure of tests, Psychometrika, 16 (3), pp 297–334.
Daykin, N; Byrne, E; O'Connor, S; Soteriou,T (2008), The impact of art, design and environment in mental healthcare: à systematic review of the literature, The Journal of the Royal Society for the Promotion of Health, 128(2), pp 85-94
Devlin, AS; Arneill, AB (2003), Health care environments and patient outcomes, Environment and Behavior, 35(5), pp 665–94.
Dutro, A.R (2007), Light Image Therapy in the Health Care Environment, East Tennessee State University, Dissertation..
Eisen, S.L (2006), The Healing Effects of Art in Pediatric Healthcare: Art Preferences of Healthy Children and Hospitalized Children, Texas A&M University.
Eroglu, SA; Harrel, GD(1986), Retail crowding: theoretical and strategic implications, Journal of Retailing, 62, pp 347–63.
Eroglu, SA ; Machleit, KA ; Barr, TF (2005), Perceived retail crowding and shopping satisfaction: the role of shopping values, Journal of Business Research, 58, pp 1146–53.
Evans, GW; Cohen, S (1987), Environmental stress. In: Stokols D, Altman I, editors. Handbook of environmental psychology, New York, Wiley, p. 571–610.
Evans, D (2002), The effectiveness of music as an intervention for hospital patients: A systematic review, Journal of AdvancedNursing, 37(1), pp 8-18
Ghazali, R; Abbas, M.Y (2010), Healing Environment of Pediatric Wards, Procedia – Social and Behavioral Sciences, 5, 948-957. Elsevier, available online 21 September 2010.
Hill, T.R (2008), Using Color to Create Healing Environments (Report), Healthcare Interior Designer, Little Fish Think Tank. pp. 12.
Ingham, B; Spencer, C (1997), Do comfortable chairs and soft light in the waiting area really help reduce anxiety and improve the practice’s image?, Health Psychology Update, 28, pp 17–20.
Kellett, P; Coleman, S; Collins, P; Macnaughton, J; Purves, G; Suokas, A; White, M (2004), Health, Art and Design: Evaluation of a New Hospital Environment, The Proceeding of IAPS: 18- Health, Art and Design: Evaluation of a New Hospital Environment Conference, 7-9 July.
Lemprecht, B (1996), The gap between design and healing, Metropolis, 77, p 123.
Machleit, KA ; Eroglu, SA ; Mantel, SP (2000), Retail crowding and shopping satisfaction: what modifies this relationship?, Journal of ConsumerPsychology, 9, pp 29–42.
Mallay, J.M (2002), Art Therapy, An Effective Outreach Intervention With Traumatized Children With Suspected Acquired Brain Injury, Arts in Psychotherapy, 29(3), 159-172.
Moran, T (1993), Hospital Hotel Crain's Detroit Business, Detroit, 9(18), 11.
NACHRI (2008), Evidence for Innovation, National Association of Children’s Hospitals and Related Institutions (NACHRI) Issue http://www.healthcaredesignmagazine.com, Date: Online, Posted On: 7/8/2008
Nesmith, EL(1995), Health care architecture: designs for the future, The American Institute of Architects Press, Washington, DC.
Oberlin, J(2008), Evidence that pediatric settings can heal, Health Care Design, Available on  www.healthcare designmagazine.com
Omachonu, VK (1990), Quality of care and the patient: new criteria for evaluation, Health Care Management Review, 15, pp 43–50.
Phiri, M (2003), One Patient One Room – Theory and Practice: An evaluation of The Leeds Nuffield Hospital University of Sheffield, NHS Research Project, School of Architecture, Arts Tower, Sheffield.
Rapoport, A (1977), Human Aspect of Urban Form, Pergamon, New York.
Ruga, W (1997), Designing for the senses. In: Marberry SO, editor, Healthcare design, New York, Wiley, pp 217–31.
Scanlon, M (2007), Human Factors and Ergonomics in Pediatrics in Pascale Carayon, (Ed) Handbook of Human Factors and Ergonomics in Health Care and Patient Safety, Lawrence Erlbaum Associates, London.
Sherman, S. A; Varni, J. W; Ulrich, R. S; Malcarne, V. L(2005), Post-occupancy evaluation of healing gardens in a pediatric cancer center, Landscape and Urban Planning. 73(2-3), pp 167-183.
Topf, MA (1984), A framework for research in aversive physical aspects of the environment, Research in Nursing and Health, 7, pp 35–42.
Topf, M (1994), Theoretical considerations for research on environmental stress and health, Image, The Journal of Nursing Scholarship, 26, pp 280–93.
Topf, M (2000), Hospital noise pollution: an environmental stress model to guide research and clinical interventions, Journal of AdvancedNursing, 31, pp 520–8.
Turner, J; Fralic, J; Newman-Bennett, K; Skinner, L(2009), Everybody Needs a Break! Responses to a Playgarden Survey, Pediatric Nursing, 35 (1), p 27.
Ulrich, RS (2003), Effects of environmental simulations and television on blood donor stress, Journal of Architectural and Planning Research, 20, pp 38–47.
Ulrich, R. S (1992), How Design Impacts Wellness, Healthcare Forum Journal, September/October, pp 20-25.
Volicer, BJ; Volicer, L (1978), Cardiovascular changes associated with stress during hospitalization, Journal of Psychosomatic Research, 22, pp 159–68.
Williams, MA (1988), The physical environment and patient care, AnnualReview of Nursing, 6, pp 61–84.
Winkel, GH (1986), The environmental psychology of the hospital: is the cure worse that the illness?, Prevention in Human Services, 4, pp 11–33.
 
 
 
 
 
 
 
 
 
 
 
 

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