“It’s Lonely”: Patients’ Experiences of the Physical Environment at a Newly Built Stroke Unit

Abstract

Objective: The aim of this study was to explore patients’ experiences of the physical environment at a newly built stroke unit. Background: For a person who survives a stroke, life can change dramatically. The physical environment is essential for patients’ health and well-being. To reduce infections, a majority of new healthcare facilities mainly have a single-room design. However, in the context of stroke care, knowledge of how patients experience the physical environment, particularly their experience of a single-room design, is scarce. Method: This study used a qualitative design. Patients ( n = 16) participated in semistructured individual interviews. Data were collected in December 2015 and February 2017 in Sweden; interviews were transcribed verbatim and analyzed using content analysis. Results: Two main themes were identified: (i) incongruence exists between community and privacy and (ii) connectedness with the outside world provides distraction and a sense of normality. In single rooms, social support was absent and a sense of loneliness was expressed. Patients were positively distracted when they looked at nature or activities that went on outside their windows. Conclusions: The physical environment is significant for patients with stroke. This study highlights potential areas for architectural improvements in stroke units, primarily around designing communal areas with meeting places and providing opportunities to participate in the world outside the unit. A future challenge is to design stroke units that support both community and privacy. Exploring patients’ experiences could be a starting point when designing new healthcare environments and inform evidence-based design.

Factors Influencing Optimal Hospital Design: A Comparative Study between Thai and Norwegian Public Hospitals

“…This study used a qualitative descriptive design with an inductive analytic approach [8,21,22]. The approach was applied to transcripts of semi structured individual in-depth interviews [21].…”

Hospital staff, volunteers’ and patients’ perceptions of barriers and facilitators to communication following stroke in an acute and a rehabilitation private hospital ward: a qualitative description study

“…However, there has been a perceived trend towards increased proportions of single rooms in newly built public hospitals to promote infection control and patient privacy which may have a detrimental effect on communication. 18 19 The predominance of single rooms and limited opportunities to access shared spaces may have increased the effect of other barriers on communication opportunities for patients. For example, a patient with poor autonomy may be more likely to remain alone in their single room when they are not attending therapy, as they perceive they are not ‘allowed’ to freely explore the hospital environment.…”

Developments in hybrid operating room, neurointensive care unit, and ward composition and organization for stroke management

“…[39] Further research suggests that patients in a SW are more active when there is a combination of single and multibed rooms when compared to single alone, which may be attributed to increased social interactions and the absence of a feeling of loneliness. [45] In addition, the availability of the various realms of therapy such as physical, occupational, speech, and recreational therapy within stroke units has augmented recovery in poststroke patients. Stroke units also allow for a smooth transition of these therapy services within the inpatient setting to inpatient-dedicated rehabilitation centers and subsequently to the outpatient setting.…”

“…It is well-documented that one of the factors influencing patient rehabilitation is the physical environment of recovering stroke patients. [45] As a result, various components of the NICU and SW ranging from the composition of care teams to the architectural features of the building have been considered for their potential to facilitate or hamper recovery from stroke. [67]…”