Document Type : Original Article

Authors

1 Faculty of Architecture and Urban Planing, Isfahan University of Art, Isfahan, Iran

2 School of Managment and Medical Information Science, Isfahan University of Medical Sciences, Isfshan, Iran

Abstract

BACKGROUND: In recent years, among managers and designers of health‑care spaces, there
has been a growing tendency to move toward hospital design by combining patient perceptions
and expectations of the physical environment of the care area. The main idea of this study was
to present a conceptual model of hospital architecture in our country with a patient‑centered
approach based on some factors that were affecting the sense of place. This model determined
the architectural features of treatment spaces from a patient’s lived experience that could have a
positive mental effect on patients as well. The main question of the research was how to adapt the
objective perception to the patient’s mental perception to create a sense of place in the hospital
space?
MATERIALS AND METHODS: This research was qualitative with a phenomenological approach,
conducted between July and December 2020. Purposeful sampling consisted of 23 patients, 13 males
in the male surgery unit and 10 females in the gynecology unit, who were interviewed in‑depth. They
were hospitalized for at least 3 days in two hospitals (Dr. Pirooz in Lahijan and Ghaem in Rasht).
The data were analyzed by the Colaizzi method.
RESULTS: The results consisted of 530 primary codes, 57 subthemes, and 7 main themes. The main
themes were hospital location, access to hospital, hospital identity, hospital dependency, hospital
attachment, human interactions in the hospital, and hospital evaluation.
CONCLUSION: The hospital form guided the patient, and the hospital function directed and obviated
the patient’s needs. The healing environment and human interactions with it caused the patient to
be satisfied with the hospital environment.

Keywords

1. Ministry of Health and Medical Education, Deputy of
Management and Resources Development, Office of Physical
Resources and Civil Affairs Development. Safe Hospital Planning
and Design Standard. Tehran: Medical Imaging Department; 2017.
2. Bromley E. Building patient‑centeredness: Hospital design as an
interpretive act. Soc Sci Med 2012;75:1057‑66.
3. Pourahmadi GA. Strategic Change Management in Health Care
Organization (Introduction of Strategic Transformation Charter
Model), 4th Congress on Hospital Construction and Resource and
Equipment Management. Tehran, Iran: University of Iran; 2017.
4. Marzo RR, Bhattacharya S, Ujang NB, Naing TW, Fei AT,
Chun CK, et al. The impact of quality provided by health‑care
centers and physicians on patient satisfaction. J Edu Health
Promot 2021;10:160.
5. Epestin RM, Fiscella K, Lesser C, Stage KC. Why the nation
needs a policy push on patient‑centered health care? Health Aff
2010;29:1489‑95.
6. Guner AF. Evaluation of quality components in architectural
design of healthcare building. Online J Art Design 2018;4(3):73-79.
7. UlrichRS. Effects of interior design on wellness: Theory and recent
scientific research. J Health Care Inter Des 1991;3:97‑109.
8. Harte RP, Glyn LG, Broderick BL, Rodrigues‑Molinero A,
Baker PM, McGuiness B, et al. Huaman centered design
considerations for connected health devices for the older adult.
J Pers Med 2014;4:245‑81.
9. Agency for Healthcare Research and Quality. What is Patient
Experience?; 2021. Available from: https://www.ahrq.gov/cahps/
about-cahps/patient-experience/index.html#:~:text=Patient%20
Experience%20Defined,practices%2C%20and%20other%20
healthcare%20facilities. last access was 15/ December/ 2021.
10. Wolf JA, Niederhauser V, Marshburn D, lavela SL. Defining
patient experience. Patient Exp J 2014;1:7‑19.
11. Zhao Y, Mourshed M. Patients, perspectives on the design of
hospital outpatient areas. Buildings 2017;7(4):1-13.
12. Andrade C, Lima ML, Fornara F, Bonaiuto M. User’s views of
hospital environmental quality: Validation of the perceived
hospital environment quality indicators (PHEQIS). J Environ
Psychol 2012;32:97‑111.
13. Stichlere J. Patient‑centered healthcare design. J Nurs Adm
2011;41:503‑6.
14. Stern LA, Mac Rae S, Gertis M, Harrison T, Fowler E,
Edgman‑Levitan S, et al. Understanding the consumer perspective to improve design quality. J Archit Plann Res 2003;20(3):16-28.
15. Netherland Board for Healthcare Institutions. Quality of the
Physical Healthcare Environment. Report number 617; 2008.
16. Abusamah Z, Ibrahim N, Shah Amir J. Translating quality care
factors to quality space: Design criteria for outpatient facility.
Procedia Soc Behav Sci 2013;105:265‑72.
17. Dijkstra K. Physical environmental stimuli that turn the healthcare
facilities into healing environments through psychologically
media‑led effects: A systematic review. J Adv Nurs 2006;56:166‑81.
18. Surrenti S. Hospital Design and Cultural Diversity. Viale
Morgagni, 48, 0134 Firenze, Italy: Department of Public Health,
University of Florence; 2009.
19. Harris PB, McBride G, Ross C, Curtis L. A place to heal:
Environmental source of satisfaction among hospital patients.
J Appl Soc Psychol 2002;32:1276‑99.
20. Douglas CH, Douglas MR. Patient‑centered improvements
in health care‑built environments: Perspectives and design
indicators. Health Expect 2005;8:264‑76.
21. Salonen H, Lappalainen S, Lahtinen M, Knibbs L, Morawska L.
Positive Impacts of Environmental Characteristics on Health and
Wellbeing in Health – Care Facilities: A Review. Queensland
University of Technology: Finnish Institute of Occupational
Health; 2012.
22. Jorgensen B, Stedman RC. Measuring the spatial components
of space of place: A methodology for research on the spatial
dynamics of psychological experiences of places. Environ Plann
Plann Design 2011;38:795‑813.
23. Mansoorian Y. Phenomenology Outside the Borders of
Philosophy. Tehran: Iranian Monthly of Wisdom and Art; 2015.
24. Emami Sigaroudi A, Dehghan Nairi N, Rahnavard Z, Ali Nouri S.
Qualitative research methodology: phenomenology. Compr Nurs
Midwifery 2012;22(68):56-63.
25. Morse JM. What Is Qualitative Research? Qualitative Nursing.
3rd ed. Philadelphia: Lippincott; 2005.
26. Mohammadpour A. Anti‑Method, Logic, and Design in
Qualitative Methodology. Vol. 1. Tehran: Sociologists; 2010.
27. AdibHajBagheri M, Parvizi S, Salsali M. Qualitative Research
Methods. Tehran: Bashari; 2010.
28. Javad R. You are Neither Old Nor Young. Iran Online; 2018.
Avaialble from: https://www.Ion.ir/news/437760.
29. Mac Alister L, Zimring C. Environmental variables that influence
patient satisfaction: A review of the literature. Center Health
Design 2016;10:155‑69.
30. Hooman HA. Practical Guide for Qualitative Research. Tehran:
The Organization for Researching and Composing University
Textbooks in the Humanities (SAMT); 2006.
31. Abedi Jafari H, Taslimi MS, Faghihi A, Sheikhzadeh M. Theme
analysis and theme network: A simple and efficient method for
explaining patterns in qualitative data. In: Strategic Management
Thought. Fall and Winter; 2001. p. 151‑98.
32. Seamon D. Architecture, Place, and Phenomenology: Building as
Lifeworld, Atmospheres, and Environmental Wholes. Manhattan,
KS USA: Kansas State University; 2017.
33. Zevi B. Zevi Architecture as Spaces: How to Look at Architecture.
New York: Horizon Press; 1993.
34. Yi‑Fu T. Space and Place, The Perspective of Experience.
Minneapolis: University Of Minnesota Press; 2001.
35. Van Manen M. Researching Lived Experience: Human Science
for An Action Sensitive Pedagogy. London: The Althouse Press;
1997.
36. Polkighorne D. Methodology for The Human Science: Systems
of Inquiry. Albany: State University of New York; 1983.
37. Rapoport A. The Meaning of the Built Environment: A Nonverbal
Communication Approach. Tucson: The University of Arizona
Press; 1990.
38. NeginTaji S. The Role of Physical Factors in the Formation of the
Concept of Place and Sense of Place. Manzar; 2011.