The Aging Psychiatric Hospital: An Approach to Humanistic Redesign

Whitehead, Clay C.; Ellison, Gail; Kerpen, Stephen; Marshall, David C.

doi:10.1176/ps.27.11.781

Cited by 8 publications

(13 citation statements)

References 2 publications

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“…Even so, good facilities for receiving social support must be considered to enable recovery The current practice of affording space meet up with family and old friends (CHAA, 2007) is very important and, in the interests of fostering meaning, might even be extended with the provision of extra facilities for friends and family to stay over. (Osmond, 1966;Woodbury and Woodbury, 1969;Whitehead et al, 1976;Whitehead et al, 1984;Gutkowski et al, 1992) A salutogenic perspective means that affordances for pets may be considered. They have been shown to radically improve mental well-being (Searles, 1960(Searles, , 1965(Searles, , 1986Wells, 2007) and while affordances for cats and dogs may be too difficult, too dangerous and raise any number of health issues including the possibility of allergies, it must be remembered that relationships with pets are often of more significance to the mentally ill than relationships with other humans and are often important stepping stones for re-establishing human relationships and other milestones for recovery such as the development of self awareness and moral conscience (Searles, 1960).…”

Section: Compounding Numbers Diagrammentioning

confidence: 99%

Section: Meaning; a Reason For Seeingmentioning

confidence: 99%

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Golembiewski

2010

Facilities

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Purpose -This paper aims to look into the significance of architectural design in psychiatric care facilities. There is a strong correlation between perceptual dysfunction and psychiatric illness, and also between the patient and his environment. As such, even minor design choices can be of great consequence in a psychiatric facility. It is of critical importance, therefore, that a psychiatric milieu is sympathetic and does not exacerbate the psychosis. Design/methodology/approach -This paper analyses the architectural elements that may influence mental health, using an architectural extrapolation of Antonovsky's salutogenic theory, which states that better health results from a state of mind which has a fortified sense of coherence. According to the theory, a sense of coherence is fostered by a patient's ability to comprehend the environment (comprehensibility), to be effective in his actions (manageability) and to find meaning (meaningfullness). Findings -Salutogenic theory can be extrapolated in an architectural context to inform design choices when designing for a stress-sensitive client base. Research limitations/implications -In the paper an architectural extrapolation of salutogenic theory is presented as a practical method for making design decisions (in praxis) when evidence is not available. As demonstrated, the results appear to reflect what evidence is available, but real evidence is always desirable over rationalist speculation. The method suggested here cannot prove the efficacy or appropriateness of design decisions and is not intended to do so. Practical implications -The design of mental health facilities has long been dominated by unsubstantiated policy and normative opinions that do not always serve the client population. This method establishes a practical theoretical model for generating architectural design guidelines for mental health facilities. Originality/value -The paper will prove to be helpful in several ways. First, salutogenic theory is a useful framework for improving health outcomes, but in the past the theory has never been applied in a methodological way. Second, there have been few insights into how the architecture itself can improve the functionality of a mental health facility other than improve the secondary functions of hospital services.

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Section: Compounding Numbers Diagrammentioning

confidence: 99%

Section: Meaning; a Reason For Seeingmentioning

confidence: 99%

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Golembiewski

2010

Facilities

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“…Most psychiatric hospitals were built before the 1950s at a time when their purpose was seen as custodial and little or no attention was paid to the impact of the physical design on the patients being treated in them. Consequently, some would claim that in these older psychiatric hospitals we have physical environments that may inhibit the behaviours that are the expressed goals of treatment (Cotton & Geraty 1984; Whitehead et al 1976) or possibly even foster or aggravate a patient's illness (Holahan 1974; Winkel & Holahan 1985). Gulak (1991) even suggests that ‘many of the clinical and administrative problems hospitals are experiencing is due in part to unsatisfactory design and lack of architectural support’ (p. 705).…”

Section: Introductionmentioning

confidence: 99%

The impact of ward design on the behaviour, occupational satisfaction and well‐being of psychiatric nurses

Tyson

Lambert

Beattie³

2002

Int J Mental Health Nurs

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Studies have shown that modifications to the physical environment of psychiatric institutions are associated with positive changes in patients' behaviour, attitudes and perceptions. However, little attention has been paid to the impact such modifications to the physical environment have on the nursing staff. The building of two completely new wards at a rural psychiatric hospital provided an opportunity to examine this issue. Measures of the nursing staffs' observed behaviour and self-ratings of burnout and job satisfaction were obtained in both the old and the new wards. The results showed that the new wards were associated with largely positive changes in behaviour and increased burnout, but there was no change in job satisfaction. However, it was clear that a vital component in the success of any environmental manipulation is an appropriate, corresponding change in the organizational climate.

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“…Estudos mostram que simplesmente mudar a ambiência de uma instituição psiquiátrica para que essa se assemelhe a uma residência melhora o ânimo e o comportamento dos pacientes. (CHRISTENFELD et al, 1989) WHITEHEAD et al, 1976).…”

Section: Acolhimento E Confortounclassified

“…Por definição, as distrações positivas são entendidas como elementos da natureza ou obras de arte que proporcionam sentimentos bons ao paciente, prendem sua atenção e despertam o interesse, afastando-os de pensamentos sobre sua doença (ULRICH et al, 2018). Tais elementos servem à valorização estética da unidade, pois criam um ambiente interessante e estimulante, promovendo uma imagem positiva do edifício na comunidade (NOVOTNÁ; URBANOSKI; RUSH, 2011;WHITEHEAD et al, 1976).…”

Section: Distrações Positivasunclassified

Aspectos ambientais que influenciam o tratamento da saúde: uma revisão da literatura

Goulart

Ono

2021

GT Projetos

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Estudos científicos que estabelecem relações entre variáveis espaciais, variáveis de comportamento e de percepção são poderosos subsídios para a construção de espaços eficientes e atentos às necessidades dos usuários. No caso de estabelecimentos assistenciais à saúde mental, o ambiente físico é um elemento essencial na garantia da qualidade do tratamento. Entretanto esse é frequentemente subestimado pelas partes interessadas. Este artigo relata o resultado da revisão de literatura de trabalhos que fornecem evidências científicas da influência do ambiente físico na percepção e no comportamento de pessoas em sofrimento psíquico e seus cuidadores. O método escolhido foi o integrativo, que permite a inclusão de estudos empíricos e teóricos para uma compreensão mais ampla do fenômeno analisado. O resultado apresenta a síntese de 32 trabalhos científicos publicados em periódicos, centrada em três situações, a saber: o bem-estar de pessoas em tratamento, o bem-estar de trabalhadores da saúde e os conflitos de interesse entre esses dois tipos de usuários. Pessoas em sofrimento psíquico podem se beneficiar de ambientes que apresentam: (a) Acolhimento e conforto (b) Facilitadores de interação social (c) Liberdade e regulação de espaço pessoal e (d) Distrações positivas. Dois aspectos são relevantes à equipe de cuidadores: (a) Inserção do cliente no processo de projeto e (b) Ambientes funcionais. Há conflitos de interesse entre os dois tipos de usuários, no que concerne ao (a) Grau de liberdade e segurança, (b) Designação/flexibilização dos espaços, (c) Acesso de pacientes às enfermarias e (d) Número de pacientes em dormitórios. Todos os aspectos são discutidos neste trabalho.

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The Aging Psychiatric Hospital: An Approach to Humanistic Redesign

Cited by 8 publications

References 2 publications

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The impact of ward design on the behaviour, occupational satisfaction and well‐being of psychiatric nurses

Aspectos ambientais que influenciam o tratamento da saúde: uma revisão da literatura

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