Design and Environmental Analysis, Cornell University, Ithaca, New York, USA.
Design and Environmental Analysis, Cornell University, Ithaca, New York, USA.
J Pain Symptom Manage. 2018 Mar;55(3):1018-1034. doi: 10.1016/j.jpainsymman.2017.09.011. Epub 2017 Sep 19.
The environment in which end-of-life (EOL) care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers.
This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in EOL care and to clarify directions for future research.
This integrated literature review synthesized and summarized research evidence from the fields of medicine, environmental psychology, nursing, palliative care, architecture, interior design, and evidence-based design.
This synthesis analyzed 225 documents, including nine systematic literature reviews, 40 integrative reviews, three randomized controlled trials, 118 empirical research studies, and 55 anecdotal evidence. Of the documents, 192 were peer-reviewed, whereas 33 were not. The key environmental factors shown to affect EOL care were those that improved 1) social interaction, 2) positive distractions, 3) privacy, 4) personalization and creation of a home-like environment, and 5) the ambient environment. Possible design interventions relating to these topics are discussed. Examples include improvement of visibility and line of sight, view of nature, hidden medical equipment, and optimization of light and temperature.
Studies indicate several critical components of the physical environment that can reduce total suffering and improve quality of life for EOL patients, their families, and their caregivers. These factors should be considered when making design decisions for care facilities to improve physical, psychological, social, and spiritual needs at EOL.
临终关怀的环境可以支持或阻碍患者、他们的家属和照顾者的身体、心理、社会和精神需求。
本综述旨在整理和分析与环境设计因素相关的现有证据，这些因素可以提高参与临终关怀的人们的生活质量和整体幸福感，并为未来的研究指明方向。
本综合文献综述综合和总结了医学、环境心理学、护理、姑息治疗、建筑学、室内设计和循证设计等领域的研究证据。
本综合分析了 225 篇文献，包括 9 篇系统文献综述、40 篇综合综述、3 项随机对照试验、118 项实证研究和 55 篇轶事证据。在这些文献中，有 192 篇是同行评审的，而 33 篇则不是。影响临终关怀的关键环境因素包括：改善 1）社会互动、2）积极的分心、3）隐私、4）个性化和营造家庭般的环境以及 5）环境氛围的因素。讨论了与这些主题相关的可能设计干预措施。例如，改善可见度和视线、自然景观、隐藏医疗设备以及优化光线和温度。
研究表明，物理环境的几个关键组成部分可以减少临终患者及其家属和照顾者的整体痛苦，提高生活质量。在为临终关怀设施做出设计决策时，应考虑这些因素，以满足身体、心理、社会和精神需求。
