Understanding and improving the perception of a hospital ward soundscape

Abstract

The various aspects of hospital environments have been shown to affect individuals psychologically and physiologically. One aspect of this, sound, has been thoroughly documented through acoustic measurements along with the potential adverse effects high sound level has on patients and nurses. Yet within hospitals, the character of the sound – the soundscape or the auditory landscape – is often overlooked in favour of this focus on sound level. This project has led to an improved understanding of the character and perception of hospital sounds using a triangulation of methods, with the intention of contributing to knowledge on how to improving the soundscape. Firstly, an interview study with patients and nurses within a cardiothoracic (CT) ward at a UK hospital was carried out to understand perceptions of, and thoughts towards, the soundscape. This led to the development of a conceptual model linking the relationships between various concepts and components of perception thereby mapping the perception of the soundscape and the feelings it evoked. A key aspect to perception – the notion of coping through habituating to sounds, became the foundation for subsequent work testing positive interventions. These complex feelings elicited by the soundscape were then reduced into a twodimensional perceptual space, extracted from a listening evaluation using Principal Component Analysis. Labelled ‘Relaxation’ and ‘Interest & Understanding’, these axies can represent the emotional-cognitive response stimulated by the CT ward sounds. Finally, potentially positive interventions were assessed using listening evaluations with participants rating additional natural and steady state sounds, along with a cognitive intervention of sound source information (SSI). It was found that the interventions resulted in a small (ƞ2=0.05) but significant effect (p=.001) on the ‘Relaxation’ response. Natural sounds were most effective, with a less conclusive but still significant effect present for steady state sounds and SSI. The ‘Interest & Understanding’ dimension was non-significantly affected. Exploring this further, a between groups in-situ study assessed the benefit of SSI. The first group received SSI, the second received none. It was found that SSI had a small to medium significant effect (r=0.26-0.31, p=<.05) on ‘Interest & Understanding’ but not ‘Relaxation’. The project successfully developed a new way of assessing the perception of hospital sounds in a perceptual space. Using this approach it was concluded that natural sounds (here, the sounds of birdsong and a stream) provide a consistent way to improve the soundscape. However, a new approach of using SSI was successfully tested and was supported by a theoretical underpinning of cognitive reappraisal. Importantly, this offers an easier way to manipulate perception through potentially a reappraisal of the soundscape. Therefore, it was also concluded from the new findings and new theory that SSI could be used to create a positive response from people within hospital ward environments