Sensory Design in the Birth Environment: Learning from Existing Case Studies

Studies have shown how built environments for hospitals can influence psychological and physiological conditions and status for childbearing women. Sensory attributes of birth spaces can enhance comfort, feelings of wellbeing, and, to some extent, clinical outcomes. Recently, some case studies of multisensory rooms for the birth environment have been developed based on, e.g., Snoezelen room examples. The aim of this research is to develop an overview of how sensory aspects for birth environments are designed, used, and tested in current and recent studies. Case studies were selected according to sensory aspect significance, observing space factors, and relationship with the experience and comfort of users (women, partners, midwives). All case studies were analysed to collect information about the design and validation process. The collected data were organised in categories and compared for the selected case studies. Main findings were summarised in tables with the aim of underlining how sensory design processes and projects can positively influence comfort for birthing. Conclusions about how to bring forward the issue of sensory design so that it can be used and applied to support childbearing women is discussed

Claiming and Reclaiming Settings, Objects, and Situations: A Microethnographic Study of the Sociomaterial Practices of Everyday Life at Swedish Youth Homes

The aim of this study is to explore social interactions in the spatial and material environment within everyday life at special youth homes in Sweden, where youths with psychosocial problems, or criminal behavior are cared for involuntary. A microethnographic approach was chosen, and data was collected through participant observation. A theory integrating analysis, using Burke’s (1969) dramatistic pentad as a tool for structuring the data and Goffman’s (1956; 1961) dramaturgical perspective was undertaken. The findings demonstrate that the staff’s control over settings and objects also means control over the definition of what kind of place the special youth home is, and what takes place there. This is shown through a decorous behavior of sociomaterial control practices, rather than care practices, by the staff. This study contributes to knowledge on spaces and objects as crucial parts of care practices highlighting the intentions inscribed in institutional design and objects

Be prepared and do the best you can: a focus group study with staff on the care environment at Swedish secure youth homes

PURPOSE: This study examined staff members\u27 experiences of the institutional care environment within secure youth homes. METHODS: Data were collected through three focus group discussions with 17 staff members at two secure youth homes. Subsequently, a thematic analysis was conducted. RESULTS: The analysis indicated two main themes: risk management and damage control in a restricted environment and compensating and reconstructing ordinariness-trying to make the best of it; each theme had three subthemes. The care environment seems to be experienced by staff as characterized by conflicting demands, thus constituting a gap between needs and what is possible to achieve-a balancing act that constitutes a constant struggle. CONCLUSIONS: The staff members\u27 constant struggle could be interpreted as conflicting moral and instrumental demands; they know what the youths need, but the environment of the secure youth homes demands the decorous behaviour of sociomaterial control practices-rather than care practices

Health promotion and the built environment - views from Swedish healthcare organisations

Objective– The study examined the role and integration of the built environment in health promotion as perceived and described by representatives of Swedish health promotive healthcare organisations (HPHs).Background– A majority of Swedish healthcare organisations haveimplemented health promotion strategies in their plans and actions [1]. These HPHs engage in an ongoing reorientation from a disease focus to a health focus,which includes a person-centred approachthatconsiders people as active participants controlling their own health and care [2].Swedish HPHs are supported by the Swedish HPHnetwork in introducing health promotion. The HPH network aims are guided by health promotion standards [3-6], which indicate the importance of creating health-promoting environments [4, 7]. These aims are confirmed in a letter of intent and membership contract. The aims are also expected to have implications for the planning of healthcare buildings [8]. However, knowledge of the relationship between HPH strategies and the built environment is limited [9, 10]. Additionally, health promotion, when used by building designers, often seems to be reduced to a focus on the enhancement of health [11]. To continue developing health promotion and fulfilling the intentions of the letter of intent as a driver for HPHs, it is important to understand and actively include the built environment in analysis, planning and design [12, 13].Research question– How do Swedish HPH representatives perceive and describe the relationship between HPHs and the built environment?Methods– An explorative study including both qualitative and quantitative data was carried out. First, data were collected through a survey with county representatives of Swedish HPHs (n=17). Then,qualitative datawere obtained from interviews with the Swedish HPH network committee members. The combined data wereanalysed through descriptive statistics and content analysis.Results– The resultsshowed varied and limited perspectives on the relationship between the built environment and health promotion and diverse HPH intentions related to health equity, health, empowerment, population health, and preventive measures. The results indicated that the documentation meant to support HPHs was not used or well known. Surprisingly, representatives who worked on healthcare building projects did not necessarily consider the built environment to be related to design strategies or characteristics or to their health promotion work within the framework of their HPHs.Conclusion– The results indicate the need to recognise the diverse dimensions and interpretations of health promotion to be able to integrate the built environment in HPHs

How Virtual Reality is used when involving healthcare staff in the design process

The design process of a new hospital is often recognized as a complex task involving a diverse group of actors. The most common information media used today are project related documents and drawings. Hospital users\ub4 ability to interpret information through these varies. This affects the design feedback from users. However, an increasing use of Virtual Reality (VR) support possibilities to facilitate better understanding. This paper presents six case studies of hospital design projects, where VR has been used with the purpose of involving end-users, investigating how and when VR has been implemented and which effects and experiences that could be noted.The findings show different levels of involvement, engagement, collaboration, and interactivity. Using VR contributes throughout the design process but is dependent on purpose and setup. Furthermore, there is a strong connection between engagement and the interactivity of the VR model

Health promotive ambitions related to building design – the case of Angered Nearby Hospital

The healthcare system in Sweden is re-orienting and transforming to embrace a holistic perspective on health, which includes a focus on Health Promotion. This development has led to new ambitions and processes in healthcare and has thus changed the requirements for related building design. This explorative study, based on a content analysis of 9 semi-structured interviews with stakeholders involved in the planning and design process of Angered Nearby Hospital (N\ue4rsjukhus), investigates how the building design was influenced by Health Promotion ambitions. Questions focused on expectations and challenges for the new building. The results illustrate how Health Promotion was interpreted in the design process and how expectations were described, e.g., as a “welcoming environment” or “active environment”. It is found that the understanding of how to interpret Health Promotion in design is vague and performed without any guidelines other than at the policy level. This lack of clarity is also related to the difficulty of finding studies on the topic. The results also point to a need for clarification of how Health Promotion can be interpreted in design, the need for Health Promotion-related design guidelines, and the need for definitions of requirements at the project level to measure health-promotive effects

Women’s Experiences of Physical Features in a Specially Designed Birthing Room: A Mixed-Methods Study in Sweden

Aim: To explore women’s experiences of physical features in a birthing room designed to be adaptable to personal wishes and needs during labor and birth. Background: Childbirth is a central life event influenced by numerous factors, including the healthcare environment; however, there is insufficient knowledge on how the physical design affects women during birth. Methods: This study was part of a randomized controlled trial in the Room4Birth research project, including women randomized to receive care in a new birthing room designed with physical features changeable according to personal wishes. Data consisted of responses to two questions analyzed with descriptive statistics (n = 202) and semi-structured interviews analyzed for content (n = 19). Results: A total of 93.6% (n = 189) assessed the physical features in the birthing room as meaningful to a very high or high extent. The overall impression of the room was positive and exceeded women’s expectations. They felt welcomed and strengthened by the room, which shifted the focus to a more positive emotional state. The room differed from traditional hospital birthing rooms, contained familiar features that maintained integrity, and had space for companions. The variety of physical features was appreciated. Of nine listed physical features, the bathtub was ranked most important, followed by the projection of nature scenery, and dimmable lighting, but the room as a whole appeared most important. Conclusions: When planning and designing hospital-based birthing rooms, it is crucial to offer possibilities to adapt the room and physical features according to personal wishes

Exploring diffrent design spaces - VR as a tool during building design

During the design process of a building different medias are often used to depict the design. Traditional media, especially 2D requires high spatial skill and cognitive demand on the designers. For inexperienced designers, this process can be demanding, be difficult and can cause potential biased designperceptions that are significantly different from the reality. However, studies have also shown that different media and representation facilitates different cognitive reasoning processes about the design. Immersive Virtual Reality (VR) is assumed to give another level of understanding and perception of design space from an egocentric perception than 2D plan drawings or bird-eye views, which have been argued to provide opportunities for better pattern and object recognition that is suitable when studying spatial organization in an allocentric reasoning process. This paper investigates, the different design medias and spatial space explorations further, by studying how students used the different representations and medias (e.g. sketches, 3d-models and VR) during their design process. By combining and using both of these two design space representations, (e.g. egocentric and allocentric) in the design process, it gives a possibility to achieve a more developed design outcome. The methods used in this study were observations and un-structured interviews during the design process and a follow up questionnaire at the end of the design project. The result show, by combining and using both VR and traditional design sketching tools that it is possible to support the two design space representations together and give the designer the possibilities to explore, understand, discuss and work with the design in a more elaborate way from both an egocentric and allocentric perspective. The paper also presents in what way VR can contribute to the Evidence Based Design (EBD) criteria and how the students used different design spaces representations for design and spatial reasoning about the healthcare design of the psychiatric facility they were designing

FROM TOOL-MAKING TO TOOL-USING - AND BACK: RATIONALES FOR ADOPTION AND USE OF LCC

Real estate- and property owners\u27 rationales behind the adoption of Life Cycle Costing (LCC) respectively how LCC is actually used in renovation projects, is investigated through empirical data from a questionnaire survey sent to managers in Swedish real estate organisations. The study shows a positive attitude towards LCC. It is perceived to as a flexible and multi-functional tool with a familiar monetary format. Nevertheless, the study also reveals simplistic and undeveloped views of how to use LCC. While much research has focused on developing sophisticated LCC tools, the findings indicate that practitioners\u27 interest in these refinements seems limited. The importance of understanding that LCC is used in a context of multiple and partly competing institutional logics of renovation is emphasised. The paper contributes to a more informed research in development of LCC tools as well as better informed LCC use among real estate and property owners

Flexibility during the covid-19 pandemic response: Healthcare facility assessment tools for resilient evaluation

Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the ex-traordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies