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How to design a therapeutic environment and the interaction of its

tranquillity of patients

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 International Journal
Asian Research Consortium of Research in
Organizational Behavior
and
International Journal of Research in Organizational Behavior and Human Resource
Human Resource Management, Vol. 1, No. 3, 2013, pp. 32.47. Management
ISSN 2320.8724 www.aijsh.org

How to design a therapeutic environment and the

interaction of its tranquillity of patients
Mahdiyeh pourhadigavabari*, Dr. Azadeh Mahmoudi
Department of Engineering, Chaloos Branch, Islamic Azad University, Chaloos, Iran

Abstract
The use of interior design and architecture with the standard methods for therapeutic environment can
play a very effective role in reducing patients stress in therapeutic environment where is potentially full of
stress and the patient is stress-prone mentally. In this paper, we discuss and review the factors affecting
the architecture of these environments and the best way to apply them to achieve the desired goal which is
to create a comfortable environment.

Keywords: design, architecture, healthcare environment, patients, psychology, relaxation

1. Introduction

Use of interior design and architecture with standard methods in healthcare environment which is full of
stress potentially and patient is prone to stress psychologically can be very effective in reducing patient
stress.

*
Corresponding Author

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 (2013). International Journal of Research in Organizational Behavior and Human Resource Management,
Vol. 1, No.3, pp. 32.47.

Patients in a healthcare facility are often fearful and uncertain about their health, their safety, and their
isolation from normal social relationships. The large, complex environment of a typical hospital further
contributes to the stressful situation. Stress can cause a person's immune system to be suppressed, and can
dampen a person's emotional and spiritual resources, impeding recovery and healing.
Research on completed projects by organizations including the Center for Health Design, Texas A&M
University's Center for Health Systems Design, the Academy of Neuroscience for Architecture, and by a
growing number of architectural firms and their clients shows measurable benefits to patient outcomes,
safety, and quality of care, from such factors.
The general goal of this paper is to design a healthcare environment in which psychological issues of
treatment are considered as well, so that with regard to environmental issues such as color, lighting and
sound in environment design beside the functional elements necessary for any hospital make the patient
recovery faster. Recent changes in architecture style and interior design of healthcare centers may play an
important role in improving patients' health status, among cases which will be reviewed in order to
achieve this goal are effects of light, color and sound in the healthcare centers. (Mardomi et al., 2013)
2. Psychology of the environment

Environmental psychology is the complex study between people and their environment. According to
Gifford, environmental psychology is different from the main branch of psychology because it deals with
the everyday physical environment. The science provides basis of the views, research and assumptions
that could help us with a better understanding of the interrelationships of humans and the environment.
Using this knowledge, one can conduct evaluations which are considered the best tool for professional
designers before designing and constructing it. (Gifford, 2007)
3. Architectural psychology

Architectural psychology deals with the study of how people's needs and priorities reflect in the
architectural styles and how to shape behaviors in different designs. Before obtaining an acceptable
design, peer and appropriate review for cultural, social and personal needs of residents is necessary. An
effective design should maximize the freedom of behavior, mobility and flexibility. The precise
knowledge of the types of activities and programs and patterns of human interaction that will take place in
a building deems necessary in the architectural design of the building. (Buss, 2005()Blumberg and

Devlin, 2006)

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 (2013). International Journal of Research in Organizational Behavior and Human Resource Management,
Vol. 1, No.3, pp. 32.47.

4. Design criteria medical areas

In designing the medical environments due to the nature of existence and their role in maintaining the
health of communities and the growing need for their development, understanding and applying the
principles of interior design to improve the performance of treatment is essential. The aim is to accelerate
improvements in the health and wellness of mind, body and spirit through architecture. Characteristics of
interior spaces in clinical environments include integration between indoor and outdoor spaces, creating
interaction between the patient and landscape design elements, the possibility of reducing noise pollution
in the atmosphere, creating a green landscape, the quality of interior spaces, creating a sense of belonging
to the space, the understanding of space needs of the patient, presence of spaces for interaction between
patients, the possibility of a change in furniture arrangement, adjustment of space temperature and
humidity by the patient, the use of vernacular architecture, suitability of space dimensions, using colors
and designs related to the use of society culture, proper and controllable lighting which their utilization
have some outcomes such as stress reduction, relaxation and improved environmental behavior, reduce
hospital length of stay, increased pain tolerance, increased sick pleasure from space, the possibility of
patient involvement in creating the space, the possibility of contact with the environment.
A century ago, Florence Nightingale emphasized that the proper environment plays an important role in
patient recovery. Today, designers of medical environments and managers who hold the administration of
the building effort a lot in creating the right environment for their patients. (Devlin and Arneill, 2003)
(Joseph and Rashid, 2007)
Today, more attention has been paid to the vital influence of the surrounding areas; especially in a
hospital sorely felt the need for gentleness.
Interior design that the designer gives to the space is very basic and may vary from what is written in the
standards. It may be better the rooms are designed in such a way that patients see better outside as well as
having better communication with nurses or companions.
5. General principles of design for comfort of patients

Designers in planning and designing the hospital / surgery sections need to pay special attention to create
the right environment for their patients.
Items that should be considered in planning of design and implementation of the local hospital / surgical
environment for patients are as follows:
• Natural light, landscape and natural ventilation
• Artificial Light

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 (2013). International Journal of Research in Organizational Behavior and Human Resource Management,
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• Desirable and undesirable noise

• Color and its effects
• The role of green spaces in health environments
5.1 . Natural light, views and natural ventilation
Natural light, views and natural ventilation in hospitalized environment for patients to meet the needs of
patients with natural light, views and natural ventilation in patient rooms, windows is essential. Hospital
room windows can have the following characteristics:
A) The size of the window:
- The dimensions of windows in the hospitalized room must be appropriate to climate. In the hot and
humid climate, hot and cold small window should be selected.
- Windows surface should not be bigger than 20% of the surface area of the wall where the window is
installed.
- In temperate and rainy climate, the dimensions of windows can be selected larger. (About 30 % of the
wall surface with window).

B) Location of windows:
- In multi -bed hospital room with beds that are opposite each other, windows should be located in the
middle of the room where the window opposite the entrance, so both groups can easily watch the outside
views.
- In one, two or three -bed rooms where all hospital beds are located on one side, the place of windows
should be opposite the entrance, avoid creating windows back of the patients.
C) Avoiding sun exposure:
There are so many possibilities in the design of the outer shell to avoid direct sunlight into the patients'
room. Preventing sunlight into the rooms in warm and moist climates and warm and dry climate is
essential, in addition to patient comfort, also saves energy consumption.

D) The type of pop-up windows:

To use natural ventilation, windows should be designed so that it can be slightly open and then locked in
that position, the amount of opening and locking of windows should be done by nurses.
5.2. Artificial Light

ince the space that is most e posed b patients hether in hospital or in the rooms on

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 (2013). International Journal of Research in Organizational Behavior and Human Resource Management,
Vol. 1, No.3, pp. 32.47.

stretcher is roof so one should note in the design of such places the wall or ceiling lights not to directly
reflect to patients' eyes and caused no astonishment.
Based on lighting regulations in hospitals must be based on the severity of light of operating rooms (1000
lux) and ancillary operating room 500 (deluxe).
Avoiding direct sunlight at moderate cardiac care unit is necessary in all climates of the country.
5.3. Desirable and undesirable sounds

Insulation of outer shells of hospital building and double glazing of windows, in addition to saving energy
is very useful in preventing the penetration of undesirable sounds.
Voice of paging in hospital wards, just can be heard in nursing stations and have sound control.
It is recommended to avoid the creation of a bathroom (toilet, sink, shower) in rooms with two beds.
It is recommended to avoid the use of materials such as stone in walls and floors which cause echo in the
patients' rooms or in the hallway. Use materials in ceilings which have the sound absorbing properties.
two To remain silent and to reduce undesirable sounds, the designer can use correct order of spaces in
ranges of low and high volume, within the sectors places where produce sound must be on the sidelines
of the spaces and not to bother for admission of patients. Otherwise, the use of insulating materials in in
walls of re uired spaces is needed
Entry and exit of air, valves and facilities channels should be designed and implemented according to
standard so that their sound is permitted. (Mardomi 2012, et al.)
5.4. Color

in all sectors where the direct supervision of nursing on patient 's life is vital, the colors should be
selected so as not to disturb the observer 's perception and on the other side does not disturb the peace of
the patients psychologically.
Harmonies and contrasts in colors selection in this section is very important, so try to choose the
dominant color bright. Creating the walls and floor with dark and upset colors should be avoided.
Designer is free to use colors in private environments for different classes of employees, but it should be
noted that the colors that may increase stress, stress and anxieties in staff should not be selected. eidari
et al ,
Contrast of colors can be used in admission environments to enhance the visual quality of the
environment.
5.5.

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 (2013). International Journal of Research in Organizational Behavior and Human Resource Management,
Vol. 1, No.3, pp. 32.47.

Green spaces is considered as very fundamental factors in designing and human health is directly
connected with it, so one must consider the need of human to green spaces in medical environments as the
main ecosystem factor. Trees and shrubs with their shapes and colors and different textures have an
impact on the human psyche and reduce the physical and psychological stress of patients.
Today, it is proved that some trees create a calm and relaxed state in humans by secreting a substance
called Fitonesid, so the landscape plays a major role in balancing the human nervous system.
Green spaces increase providing comfort, relaxation, mental security and motivate consumers in the area
of green space, compression; depth and height of the plants and trees create a safe and relaxing
environment. This increases the impact of green space in providing comfort, tranquility, mental security,
motivation and intellectual and artistic inspiration. Green space, especially green color or its seasonal
changes has very effective impacts.
6. Single patient room: An instance
In many instances, including the need for patient isolation measures, double or multiple occupancy rooms
were viewed as not being conducive to patient safety and quality care. The floor plan shown in Figure 1
as an example illustrates how a series of standardized single-patient rooms were laid out on both sides of
hallway in a hospital. This perspective allows various features of the room to be seen in relation to each
other. There are two entrances to the room, one from the hallway (along the lower edge of the picture),
and one from the alcove on the right. In that alcove, also entered from the hallway, a desk, computer, and
chair are provided for use by staff. The alcove also contains a standardized storage area, so staff can find
everything they need for the care of the patient adjacent to the patient room.
The interior of a single-patient room incorporates many of the recommendations relating to latent
conditions and active failures in the design for safety (see Figure 2). The family area of the room is in the
right corner of the room, by the window, and includes a couch/pull-out bed, chair, desk with Internet
connection, and good natural lighting. The treatment area of the room is on the left side of the bed, with
room all around the bed for patient care. It is intentional, also, that the patient is on the nurses’ and other
caregivers’ right as that person enters the room from either door, so care can be more efficiently
provided. Note that the bathroom is at the head of the patient’s bed, allo ing the patient to get to and
from the bathroom without impediments, holding onto a rail all the way if necessary. At the head of the
bed is the headwall with connections for various gases such as oxygen; on the wall to the left of the bed is
a pull-down table the caregiver can use when it is needed. Although it is not shown in the illustration,
there will also be a portable cart in each room, with a computer on it. Last but not least, in the lower right-

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 (2013). International Journal of Research in Organizational Behavior and Human Resource Management,
Vol. 1, No.3, pp. 32.47.

hand corner of the room, between the two doorways, easily visible to the patient, there is a sink—an ever-
present and convenient reminder to nurses, all staff, and visitors to wash their hands.

Figure 1. Floor Layout of Single-Patient Rooms

Figure 2. Single-Patient Room

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 (2013). International Journal of Research in Organizational Behavior and Human Resource Management,
Vol. 1, No.3, pp. 32.47.

6. Conclusions
In the next few years, healthcare facility leaders will be involved in new construction projects to meet the
changing marketplace demands associated with the growing demand of an aging population. Many
clinicians, architects, and hospital administrators believe that the hospital built
environment can benefit the satisfaction of health care providers as well as patient satisfaction and
outcomes. There is some evidence that the built environment may influence patient and family
perceptions of the quality of and satisfaction with care received during a hospitalization.
The evidence-base is emerging to support the business case that designing for safety and quality can
improve patient outcomes and safety, promote healing, increase patient satisfaction, and reduce costs. It is
thought that the cost of building or remodeling projects based on design evidence conducive to patient
safety can result in organizational savings over time, without adversely impacting revenues.

7. References:
Web page, A, about, P, post, M, contact, B.M & Guide, K (2010). The necessity of dynamics of health
centers and proposing some practical solutions.
Schweitzer, M. Gilpin, L. Frampton, S.(2004). Healing spaces: element of environmental design that
make an impact on health
Mardomi, K, Hashem, N. H. Bagheri, M, Hassan, P. A. K, College. M. O. SH & college, A, O, S, A.
(2012). Architectural design considerations in reduction of sound pollution in clinical
environments.
Mardomi, Karim Nejad, Hashem Abad, H. P. R. Kasra Bagheri & Malihe(2013). Routing architecture-
designing the routing process in architecture of healthcare buildings. Journal of Fine Arts.
Architecture and urban planning. 3. 45-56

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