Radboud Institute for Health Sciences, IQ Health Care, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
HERD. 2020 Jul;13(3):125-139. doi: 10.1177/1937586719900885. Epub 2020 Mar 5.
Gaining an understanding of postoperative patients' environmental needs, barriers, and facilitators for optimal healing.
An optimal hospital environment (the "healing environment") can enhance patients' postoperative recovery and shorten length of stay. However, insights lack into patients' lived environmental needs for optimal healing after surgery and how these needs are being met.
A qualitative study was conducted between August 2016 and August 2017 with 21 patients who underwent elective major abdominal surgery in a Dutch university hospital. Data were collected through context-mapping exercises and interviews to capture patients' lived experiences and explore the meaning of these experiences. Data were systematically analyzed according to the principles of thematic content analysis.
Three themes were identified. First, participants want a sense of control over their treatment, ambient features, privacy, nutrition, and help requests. Participants described the need for positive distractions: personalizing the room, connecting with the external environment, and the ability to undertake activities. Finally, participants expressed the importance of functional, practical, and emotional support from professionals, peers, and relatives. According to participants, the hospital environment often does not meet their healing needs while being hospitalized.
The hospital environment often does not meet patients' needs. Needs fulfillment can be improved by practical adjustments to the physical and interpersonal environment and considering patient's individual preferences and changing needs during recovery. Patient narratives, pictures, and drawings are valuable sources for hospital managers in their efforts to design evidence-based environments that anticipate to patient-specific needs for achieving early recovery.
了解术后患者对最佳愈合的环境需求、障碍和促进因素。
一个理想的医院环境（“愈合环境”）可以促进患者术后的恢复并缩短住院时间。然而，对于患者术后最佳愈合的实际环境需求以及这些需求如何得到满足，我们的了解还很有限。
本研究是一项在 2016 年 8 月至 2017 年 8 月期间进行的定性研究，共纳入 21 名在荷兰一所大学医院接受择期大腹部手术的患者。通过情景映射练习和访谈收集数据，以捕捉患者的生活体验并探索这些体验的意义。根据主题内容分析的原则，对数据进行了系统分析。
确定了三个主题。首先，参与者希望对自己的治疗、环境特征、隐私、营养和求助请求有控制感。参与者描述了需要积极的分心：个性化房间、与外部环境联系以及能够开展活动。最后，参与者表达了对专业人员、同伴和亲属提供功能、实用和情感支持的重要性。根据参与者的说法，住院期间医院环境往往无法满足他们的愈合需求。
医院环境往往无法满足患者的需求。通过对物理和人际环境进行实际调整，并考虑患者在康复过程中的个体偏好和不断变化的需求，可以提高需求的满足度。患者的叙述、图片和绘画是医院管理者在设计基于证据的环境时的宝贵资源，这些环境可以预测患者的特定需求，以实现早期康复。
