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School of Architecture

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College of Design

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Publication Search Results

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The Role of Positive Distraction in the Patient’s Experience in Healthcare Setting: A Literature Review of the Impacts of Representation of Nature, Sound, Visual Art, and Light

(Georgia Institute of Technology, 2020-12-08) Dabrowska, Maria Anna

Background One of the key strategies to help patients reduce stress and anxiety in healthcare settings is positive distraction defined as “an environmental feature that elicits positive feelings and holds attention without taxing or stressing the individual, thereby blocking worrisome thoughts” (Ulrich, 1991, p. 102). While several studies found the impact of positive distraction on health-related outcomes, few studies have categorized the distractors and collected the evidence from experiments. Despite the common use in design and broadly accepted assumption that positive distraction brings psychophysiological benefits, there has not been a comprehensive evaluation of research on positive distraction. Methods The present literature review examined 40 peer-reviewed articles from the last 20 years on nature, artwork, music, and light to describe the phenomenon of positive distraction, review the evidence on the impact of interventions on outcomes, and investigate the quality of the research. This paper explored historic background, definitions, and organized the key information from articles into a table. Based on the similarities of themes, I categorized and described the interventions. This paper presents a framework that links the categories to healthcare settings, outcomes, and measures which were used to assess each outcome. Finally, I marked the number of studies in each category that indicated the beneficial influence of interventions for each outcome. The significance of this study lies in collecting and analyzing the studies, describing the crucial aspects that need to be considered when designing positive distractions, and pointing out the directions for future research. Results I organized interventions into the following seven categories: Real and artificial nature, Visual representation of nature, Music and Sound, Light, Illuminated projection, Audiovisual, and Audiovisual with light. The most common interventions were plants placed in a patient room as well as Illuminated projection and Audiovisual interventions with light in diagnostic imaging rooms. Pain and anxiety were the most studied outcomes. While 16 out of 22 studies found a statistically significant improvement in perceived pain, only 10 out of 24 articles found this effect for anxiety. More than 60% of studies that measured the impact of interventions on pain, satisfaction, environmental satisfaction, reduction in restlessness and calm behavior, and perceived attractiveness found statistically significant positive results. Although the positive distraction was initially recognized for its potential to reduce stress, only eight articles investigated stress and distress, but more than half of those studies found a beneficial effect. Interventions in Real and Artificial Nature, and Music and Sound, and Audiovisual with Light showed a beneficial impact on more than six outcomes and emerged as the most promising. Conclusions Despite the 40-years tradition, the field of positive distraction is still in an exploratory phase. This analysis confirmed that there is a positive correlation between positive distraction and outcomes and strong evidence that positive distraction helps reduce perceived pain. Future work should consider the division of the term positive distraction into more precise sub-terms to account for different characteristics of interventions categorized as a positive distraction as well as focus on defining the beneficial features of the distractors, explaining the underlying mechanisms, determining the effect size of interventions, and improving both aesthetics of interventions and the methodological quality of studies.
Application of the functional scenarios method on alternative settings

(Georgia Institute of Technology, 2016-05-09) Bushehri, Yousef

Goals of this study are to set up the frame-work for analyzing residential buildings using the functional scenarios method and to tests the applicability of the method on large scale projects. The metrics for the analysis are based on guidelines for designing spaces that promote healthy aging. In addition, the study was providing an opportunity to developing and refined the method. The result of the analysis determines that the functional scenarios method is applicable to large scale buildings as effectively as smalls scale buildings; design configurations can be extracted from the results of the analysis to inform future designs. The limitations of the analysis are due to the available resources. Opportunities for continued work include 1) developing standard ways of representing the results of the analysis; and 2) developing a systematic approach for extracting design configurations based on the research questions asked.
"Challenging families": the roles of design and culture in nurse-family interactions in a high acuity intensive care unit

(Georgia Institute of Technology, 2011-03-18) Rippin, Allyn Sager

The trend towards patient-and family-centered care (PFCC) invites families of critically ill patients to participate more fully in the care and recovery of their loved ones through partnerships with the medical team and personalized care that respects the values, beliefs and experiences of the individual. In response to the growing needs of families, healthcare institutions are re-designing the way patient and family care is delivered in terms of policy, culture and the physical environment. Despite the many benefits that come with closer collaboration, nurses report that "challenging" families are a key source of workplace stress. This exploratory case study documents some of these challenges as perceived by staff nurses at Emory University Hospital's Neuro ICU while examining the role the built environment plays in shaping such perceptions. Through a series of ethnographic interviews and observational methodologies, the study identifies some of the challenges and benefits that come with balancing patient and family needs. Nurse strategies developed to reassert spatial and temporal control over work environments are also identified. The second phase of research compares communication patterns generated from two different ICUs to explore the link between unit design and the frequency and quality of nurse-family interactions. Findings suggest that space plays a role in moderating the degree of nurse exposure to the often unstructured and unpredictable aspects of family interactions. These encounters, set within a highly charged critical care setting, may contribute to these perceived challenges. Healthcare stands at an important moment of transition in which attitudes, behaviors and expectations are changing. Together these results reinforce the need for adequate tools, training and education to further support nurses in the transition to this new care culture.
Redefining the Community Hospital: a Small Town Approach to Medical Planning and Design

(Georgia Institute of Technology, 2007-04-09) Dooley, Anthony Jason

Rural hospitals in America hold a critical position within their communities because they possess the duty and responsibility of not only providing adequate healthcare services for the population, but also bearing the heavy burden of functioning as one of the main socio-economic engines within the area. These factors, along with drastically inadequate operating budgets, often create programmatic and operational challenges for these entities to confront as they fight to provide the technologically current facilities and services needed to adequately care for their community. All of this must be done in the most cost effective way possible. This thesis will look at current trends being administered within the widespread replacement effort of these facilities, and propose several alternative strategies aimed at facilitating feasible solutions to these and other issues that are not currently being addressed. Design resolution strategies will be formulated and tested. These will then be directly implemented through a specific project design exercise that will then be evaluated.
Taking the stairs: Environmental features that explain why people use stairs in 3 to 4 story academic workplace buildings

(Georgia Institute of Technology, 2006-05-19) Nicoll, Gayle

Although increasing stair use among adults with sedentary occupations can provide an accessible means of integrating moderate physical activity within daily work routines, there is little evidence-based information available to guide architects on how to design buildings that promote stair use. This study examined the relationship between stair use and a broad range of features of the physical environment within 10 buildings. Based on a review of the literature, a thematic framework (Appeal, Convenience, Comfort, Legibility and Safety) was developed for identifying the features of buildings that may influence stair use. Three methods of investigation were used to examine the relationship between stair use and variables of the five themes and their constructs. Buildings users were surveyed for their reasons for both single and multi-level route choice. The results indicated that reasons associated with convenience and legibility of route had greater influence on route choice than appeal, comfort or safety. Stair and elevator use were measured in the ten buildings along with variables that operationalized the thematic framework. Regression analysis was utilized to examine the relationship between stair use and the operationalized variables of the thematic framework. The results of regression analysis indicated that stair use was associated with 8 key spatial variables of convenience and legibility (travel distances from stair to nearest entrance and to the elevator; percentage of total building area or total occupant load attributed to each stair; physical accessibility of each stair; area of stair isovist; number of turns from the stair to closest entrance and to the most integrated path). Most local environmental features of stairs such as lighting levels and views were not statistically influential. Multivariate regression analysis indicated that three variables (effective area of each stair, area of stair isovist, and number of turns required between the stair and the most integrated path) explained 53% of stair use. A graphic analysis of the arrangement of the 8 key spatial variables within the ten buildings indicated that buildings with high overall levels of stair use optimized the key spatial variables in respect to the location of stair(s) within the building floor plan.
Space and education a proposal for the design of a College of Architecture

(Georgia Institute of Technology, 1993-08) Chiappina, Federico
The development of public housing policy and design

(Georgia Institute of Technology, 1993-05) Auld, Susan E.
The topological properties of wayfinding in architecture

(Georgia Institute of Technology, 1992-05) Willham, Daniel Brian
In an other sense : architectural order and building narrative in three museums

(Georgia Institute of Technology, 1990-12) Pence, Tara Leigh
Postsurgical recovery care : spatial organization and social relationships

(Georgia Institute of Technology, 1990-08) Stegenga, Paul William