Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia.
Flinders University, Bedford Park, South Australia, Australia.
Health Expect. 2019 Jun;22(3):396-404. doi: 10.1111/hex.12859. Epub 2019 Jan 10.
Design of rehabilitation environments is usually "expert" driven with little consideration given to the perceptions of service users, especially patients and informal carers. There is a need to engage with consumers of services to gain their insights into what design aspects are required to facilitate optimum physical activity, social interaction and psychological responses when they are attempting to overcome their limitations and regain function.
Qualitative exploratory study.
Interviews were conducted with patients (n = 54) and informal carers (n = 23), and focus groups with rehabilitation staff (n = 90), from the three metropolitan South Australia rehabilitation health services, comprising different building and environmental configurations. Thematic analysis was assisted by the use of NVivo 11 qualitative software, with pooled data from all interviews and focus groups undergoing open, axial and finally selective coding.
Four major themes were identified as follows: (a) choice can be an Illusion in a rehabilitation ward; (b) access to outside areas is a priority and affects well-being; (c) socialization can be facilitated by the environment; and (d) ward configuration should align with the model of care.
Participants who encountered the most restrictive environments accepted their situation until probed to consider alternatives; those who enjoyed the most choice and access to facilities showed the greatest enthusiasm for these affordances. Future architectural designers should therefore consider the perceptions of a wide range of consumers with varying experiences to ensure they understand the complex requirements of patients and that the ward design facilitates the optimum rehabilitation model of care.
康复环境的设计通常由“专家”主导,很少考虑服务使用者(尤其是患者和非正式照顾者)的看法。有必要让服务使用者参与进来,了解他们需要哪些设计方面来促进最佳的身体活动、社交互动和心理反应,当他们试图克服自己的限制并恢复功能时。
定性探索性研究。
对来自南澳大利亚州三个大都市康复保健服务机构的 54 名患者(n=54)和 23 名非正式照顾者(n=23)以及 90 名康复工作人员(n=90)进行了访谈,并进行了焦点小组讨论,这些机构的建筑和环境配置各不相同。使用 NVivo 11 定性软件协助主题分析,对所有访谈和焦点小组的汇总数据进行开放式、轴向和选择性编码。
确定了以下四个主要主题:(a)在康复病房中,选择可能是一种幻觉;(b)进入外部区域是首要任务,会影响幸福感;(c)环境可以促进社交;(d)病房配置应与护理模式一致。
遇到最具限制性环境的参与者会接受自己的处境,直到被问到是否有其他选择;那些享受最多选择和设施访问权限的人对这些便利设施表现出最大的热情。因此,未来的建筑设计师应该考虑到具有不同经验的广泛消费者的看法,以确保他们了解患者的复杂需求,并且病房设计有利于最佳的康复护理模式。