Background
In a global effort to design better hospital buildings for people and organizations, some design principles are still surrounded by great mystery. The aim of this online study was to compare anxiety in an existing single-bed inpatient hospital room with three redesigns of this room in accordance with the principles of Golden Ratio, Feng Shui, and Evidence-Based Design.
Methods
In this online multi-arm parallel-group randomized trial participants were randomly assigned (1:1:1:1) to one of four conditions, namely Golden Ratio condition, Feng Shui condition, Evidence-Based Design condition, or the control condition. The primary outcomes were anxiety, sense of control, social support, positive distraction, and pleasantness of the room.
Findings
Between June 24, 2022, and August 22, 2022, 558 individuals were randomly assigned to one of the four conditions, 137 participants to the control condition, 138 participants to the Golden Ratio condition, 140 participants to the Feng Shui condition, and 143 participants to the Evidence-Based Design condition. Compared with baseline, participants assigned to the Evidence-Based Design condition experienced less anxiety (mean difference -1.35, 95% CI -2.15 to -0.55, Cohen’s d = 0.40, p < 0.001). Results also showed a significant indirect effect of the Feng Shui condition on anxiety through the pleasantness of the room (B = -0.85, CI = -1.29 to -0.45) and social support (B = -0.33, CI = -0.56 to -0.13). Pleasantness of the room and social support were mediators of change in anxiety in the Evidence-Based Design and Feng Shui conditions. In contrast, application of the design principle Golden Ratio showed no effect on anxiety and remains a myth.
Interpretation
To our knowledge, this is the first randomized controlled trial linking design principles directly to anxiety in hospital rooms. The findings of our study suggest that Feng Shui and Evidence-Based Design hospital rooms can mitigate anxiety by creating a pleasant looking hospital room that fosters access to social support.
De innovatiewerkplaats Health Space Design (HSD) richt zich op het verbeteren van de zorgomgeving door middel van onderzoek en praktijkgerichte oplossingen. Vanuit het lectoraat Facility Management van de Hanze, werkt HSD samen met zorginstellingen, kennis- en onderwijsinstellingen, overheden en het bedrijfsleven om de kwaliteit en efficiëntie van zorginstellingen te verbeteren. HSD streeft naar een betere aansluiting tussen de ruimte en organisatie van zorginstellingen. Dit doen we door praktijkvragen van zorginstellingen te koppelen aan praktijkgericht onderzoek van onze senior-onderzoekers, onderzoekers, docenten en studenten, onder meer in architectuur, facility management, geneeskunde, psychologie en visualisatie. Onze multidisciplinaire aanpak zorgt ervoor dat oplossingen niet alleen theoretisch en empirisch uitstekend onderbouwd zijn, maar ook praktisch toepasbaar. Door de goede samenwerking met onze partners, genereert HSD oplossingen die zorginstellingen helpen om beter te functioneren en de gezondheid en het welzijn van patiënten, medewerkers en andere gebruikers van de gebouwde omgeving te verbeteren. Dit leidt uiteindelijk tot lagere operationele kosten en een hogere kwaliteit van zorg.
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