Patient well-being, adaptation of and to indoor conditions, and hospital room design: two mixed methods case studies

Abstract

Research indicates that adaptation influences how people experience indoor conditions (ICs), and that the built environment influences both adaptation, via perceived control, and well-being. Their interlinkage is, however, not well understood. Therefore, we investigated how the design of hospital rooms can contribute to patients' well-being by supporting their adaptation of and to ICs via perceived control. Two mixed methods case studies were conducted at hospital wards in Belgium, each concurrently collecting qualitative and quantitative data.These included interviews with 16 (case 1) and 19 (case 2) patients, selfdocumentation by 8 patients, sensor measurements of indoor environmental quality indicators (e.g. sound, light and temperature levels) and questionnaires among 84 (case 1) and 238 (case 2) patients. Focusing on the built environment's role in adaptation allows characterizing known adaptation strategies in more detail. When perceiving control over adaptable building characteristics, patients can adapt ICs or adapt to ICs by choice. When not perceiving such control, they may still adapt sensations or their position. Without any perceived control, adapting to ICs is imposed. The built environment can support patients' adaptation by supporting their autonomy and competences. In this way it can foster both patients' eudaimonic as well as their hedonic well-being.

Discrepancies between predicted and actual indoor environmental (dis)comfort: the role of hospitalized patients’ adaptation strategies

“…First, designers can increase comfort by stimulating perceived control, via adaptable and static building characteristics. Within the larger research project this study is part of, we observed, e.g., that patients like the possibility to dim the lighting, or perceive more control in double rooms where they reside face-to-face instead of next to each other (Willems et al 2021).…”

“…The grouping built on the adaptation strategies identified by Willems et al (2021) and mentioned in the introduction, but differs slightly from it. We focused only on adaptation strategies that differ in how patients interact with indoor conditions via adaptable building characteristics.…”

“…Relationships between adaptation and spatial and adaptable building characteristics have already been investigated in other contexts (e.g. Schweiker and Wagner 2016, Marín-Restrepo et al 2020aand 2020b and in hospitals (Willems et al 2021). More insight is needed into the relationship between adaptation and building physical and spatial characteristics.…”

“…Seventh, Willems et al (accepted for publication) argue that patients continuously search the highest possible overall comfort via adaptation. Further research (Willems et al 2021) shows that sometimes adapting indoor conditions to improve an IEQ parameter results in choosing to worsen and adapt to another IEQ parameter. Therefore adaptation seems to link with another point of attention in current IEQ research: interactions between IEQ parameters in people's experience (e.g.…”

“…Based on two mixed methods case studies with hospitalized patients, Willems et al (2021) identified five adaptation strategies, next to the respondents who showed no wish for adaptation. Four strategies were identified among respondents who perceived control to align indoor conditions with their preferences: (1) behaviorally adapting indoor conditions, (2) behaviorally adapting sensations or the experienced environmental information (i.e.…”