Homelike environments for adolescents’ psychological well-being in hospital settings

Presented by: Dr. Eun Young Kim

The home provides not only a private physical shelter but also a restorative environment with privacy and comfort for its occupants’ well-being. One of the significant ways that the home can provide restoration is based on individuals’subjective perception formed by their positive and personal experiences with their homes. Details such as personal possessions and interior decorations within the home communicate residents’ self-identities and self-esteem with oneself and with others (Lawrence, 1987; Marcus, 1995). In particular, familiarity related to physical features of home were identified as a prominent design attribute contributing positive perception of hominess (Marsden, 1999). These positive impacts of homelike ambience on psychological well-being is required for all age groups, but prior research has been focused mainly on the elderly. Patients in hospitals face physical and psychological challenges due to impaired physical conditions, medical procedures, unfamiliar environments, and isolation from family and friends. If patients feel hospital rooms are like home, they may receive less stress from their surroundings. Recent decades’ efforts on healthcare design and research have taken a patient-centered approach, focusing on patients’ psychological well-being. Research has suggested enhanced healthcare outcomes from homelike ambiences (Devlin & Arneil, 2003; Hodnett at al, 2005). The potential restorative effect of homelike environments needs to be estimated with various age groups using different hospital settings to cover age-related characteristics and needs. However, adolescent patients who must spend time in unfamiliar hospital environments during this critical stage in life are poorly represented in current research. The goal of the study is to investigate potential healing design attributes of hospital rooms for adolescent patients and to analyze the significant roles of a homelike ambience in promoting psychological well-being. A total of 106 adolescents, 47 patients and 59 non-patients, aged 14 to 18 years participated in this study. Based on the concept of health-related quality of life (HRQOL), the study evaluated adolescents’ self-reported emotional states and their environmental preference value on hospital rooms (5-point Likert Scale). This study also collected emotional data related to items reminding adolescents of home using open-ended questions. The findings from this study indicated that participating adolescents put the highest priority on the needs of ‘privacy control’ and the least priority on ‘staying in a single-bed room’. The obtained results also suggest that ’privacy control’ does not necessarily mean “to be alone” but implies adolescents’ needs for privacy and peer connection at the same time. The need for an ‘outside view’ was the second most important preference value in hospital environment; however, ‘outside view’ was less important amongst the items reminding adolescents of a homelike environment. Correlation between emotional states and environmental value indicated that the level of ‘stress’ and ‘comfort’ were the most influential emotional states related to adolescents’ perception of hospital rooms. The items adolescents most strongly associated with feelings of being at home were ‘family or family photos’ and ‘interior colors’. The second most strongly associated items were ‘[their] own beds’ and ‘private (my own) spaces’ along with the description of ‘comfortable’. The results imply that adolescent’s environmental needs in hospital rooms are associated with the core qualities of home.

References:

  • Devlin, A.S. & Arneill, A.B. (2003). Health care environments and patients outcomes: A Review of literature. Environment and Behavior, 35(5), 665-694.doi: 10.1177/0013916503255102
  • Lawrence, R.J. (1987). What makes a house a home? Environment and Behavior, 19, 154-168. doi: 10.1177/0013916587192004
  • Hodnett, E., Downe, S., Edwards, N., & Walsh, D. (2005). Home-like versus Conventional Institutional Settings for Birth. The Cochrane Database of Systematic Reviews (1). doi: 10.1111/j.0730-7659.2005.0359a.x
  • Marcus, C. C. (1995). House as a Mirror of Self: Exploring the Deeper Meaning of Home. Berkeley, CA: Conari Press.
  • Marsden, J.P. (1999). Older persons’ and family members’ perception of homeyness in assisted living. Environment and Behavior, 1, 84-106. doi: 10.1177/00139169921972010
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