The Impact of the Environment on the Experience of Hospitalized Stroke Patients – An Exploratory Study

  • Elke Daemen
  • Evert van LoenenEmail author
  • Roel Cuppen
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 8850)


The aim of this study is to understand neurology patients, family and caregivers experiences of in-patient care environments and to investigate the aspects of the healing process that can be supported by the environment. Our goal is to identify the role the environment plays during the process of being treated for and recovering from a stroke. The stroke patient’s description of experiences during hospitalization will help researchers, medical professionals and architects in adjusting the environment according to their specific needs. A set of research methods was used to capture the experience, changing the role of researcher as an observer to a participatory approach, integrating the caregivers as creators of the research data [1], [2]. These methods included: shadowing, observation and interviewing, allowing nurses to describe their experiences and to obtain a voice in decision making. We built insights from healing environment literature combined with own field studies. Specific environmental needs identified include: dosing stimulus load, having social support, having access to single patient rooms, balancing clinical and personal environments, having a clear structure of the day, undisturbed sleeping and the need for information.


Healing environments Stroke Contextual research 


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  1. 1.
    Goodman, E., Kuniavsky, M., Moed, A.: Observing the User Experience, p. 585. Elsevier Inc. (2012)Google Scholar
  2. 2.
    Martin, B., Hanington, B.: Universal Methods of Design. Rockport Publishers (2012)Google Scholar
  3. 3.
    Biley, F.C.: Hospitals: healing environments? Complement. Ther. Nurs. Midwifery 2(4), 110–115 (1996)CrossRefGoogle Scholar
  4. 4.
    Dossey, B.: Florence Nightingale: Mystic, Visionary, Healer. Springhouse Corp, Springhouse (2000)Google Scholar
  5. 5.
    Ulrich, R.S.: Effects of Interior Design on Wellness: theory and recent scientific research. J. Healthc. Inter. Des. 3(1), 97–109 (1991)Google Scholar
  6. 6.
    Dijkstra, K.: Understanding healing environments: effects of physical environmental stimuli on patients, thesis, University of Twente (2009)Google Scholar
  7. 7.
    Becker, G., Kaufman, S.R.: Managing an uncertain illness trajectory in old age: patients’ and physicians’ views of stroke. Med. Anthropol. Q. 9(2), 165–187 (1995)CrossRefGoogle Scholar
  8. 8.
    Ulrich, R.S., Zimring, C.: A review of the research literature on evidence-based healthcare design. HERD 1(3), 1–75 (2008)Google Scholar
  9. 9.
    Ulrich, R., Quan, X., Health Systems and Design, College of Architecture, Texas: The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity (September 2004)Google Scholar
  10. 10.
    Arneill, A.B., Devlin, A.S.: Perceived Quality of Care: the Influence of the Waiting Room Environment. J. Environ. Psychol. 22(4), 345–360 (2002)CrossRefGoogle Scholar
  11. 11.
    Altimier, L.B.: Healing environments: for patients and providers. Newborn Infant Nurs. Rev. 4(2), 89–92 (2004)CrossRefGoogle Scholar
  12. 12.
    Grinde, B., Patil, G.G.: Biophilia: does visual contact with nature impact on health and well-being? Int. J. Environ. Res. Public Health 6(9), 2332–2343 (2009)CrossRefGoogle Scholar
  13. 13.
    Ulrich, R.S.: View Through Surgery Window May Influence Recovery from surgery. Science 224(21), 420–421 (1984)CrossRefGoogle Scholar
  14. 14.
    Velarde, M.D., Fry, G., Tveit, M.: Health effects of viewing landscapes – Landscape types in environmental psychology. Urban For. Urban Green 6(4), 199–212 (2007)CrossRefGoogle Scholar
  15. 15.
    Walch, J.M., Rabin, B.S., Day, R., Williams, J.N., Choi, K., Kang, J.D.: The effect of sunlight on postoperative analgesic medication use: a prospective study of patients undergoing spinal surgery. Psychosom. Med. 67(1), 156–163 (2005)CrossRefGoogle Scholar
  16. 16.
    Wakamura, T., Tokura, H.: Influence of bright light during daytime on sleep parameters in hospitalized elderly patients. J. Physiol. Anthropol. Appl. Human Sci. 20(6), 345–351 (2001)CrossRefGoogle Scholar
  17. 17.
    Bringslimark, T., Hartig, T., Patil, G.G.: The psychological benefits of indoor plants: A critical review of the experimental literature. J. Environ. Psychol. 29(4), 422–433 (2009)CrossRefGoogle Scholar
  18. 18.
    Tranmer, J.E., Minard, J., Fox, L.A., Rebelo, L.: The sleep experience of medical and surgical patients. Clinical Nursing Research 12(2), 159–173 (2003)CrossRefGoogle Scholar
  19. 19.
    Southwell, M.T., Wistow, G.: Sleep in hospitals at night—Are patients’ needs being met? Journal of Advanced Nursing 21(6), 1101–1109 (1995)CrossRefGoogle Scholar
  20. 20.
    Novaes, M., Aronovich, A., Ferraz, M.B., Knobel, E.: Stressors in ICU: Patients’ evaluation. Intensive Care Medicine 23(12), 1282–1285 (1997)CrossRefGoogle Scholar
  21. 21.
    Dogan, O., Ertekin, S., Dogan, S.: Sleep quality in hospitalized patients. Journal of Clinical Nursing 14(1), 107–113 (2005)CrossRefGoogle Scholar
  22. 22.
    Kuivalainen, L.R.A., Isola, A., Meriläinen, P.: Sleep disturbances affecting hospital patients. Hoitotiede 10(3), 134–143 (1998)Google Scholar
  23. 23.
    Shafiq, M., Salahuddin, F.F., Siddiqi, M., Shah, Z., Ali, R., Siwani, R.A., et al.: Sleep deprivation and its associated factors among general ward patients at a tertiary care hospital in Pakistan. Journal of the Pakistan Medical Association 56(12), 614–617 (2006)Google Scholar
  24. 24.
    Topf, M., Thompson, S.: Interactive relationships between hospital patients’ noise induced stress and other stress with sleep. Heart and Lung 30(4), 237–243 (2001)CrossRefGoogle Scholar
  25. 25.
    Potts, L., Bartocci, G.: Experience Design. In: Proceedings of the 27th ACM International Conference on Design of Communication, SIGDOC 2009, pp. 17–22 (2009)Google Scholar
  26. 26.
    Spinuzzi, C.: The methodology of participatory design. Technical Communication 52(2), 163–174 (2005)Google Scholar
  27. 27.
    van de Glind, I., de Roode, S., Goossensen, A.: Do patients in hospitals benefit from single rooms? A literature review. Health Policy 84(2–3), 153–161 (2007)CrossRefGoogle Scholar
  28. 28.
    Chaudhury, H., Mahmood, A., Valente, M.: Nurses’ perception of single-occupancy versus multioccupancy rooms in acute care environments: an exploratory comparative assessment. Appl. Nurs. Res. 19(3), 118–125 (2006)CrossRefGoogle Scholar
  29. 29.
    van de Glind, I., van Dulmen, S., Goossensen, A.: Physician-patient communication in single-bedded versus four-bedded hospital rooms. Patient Educ. Couns. 73(2), 215–219 (2008)CrossRefGoogle Scholar
  30. 30.
    Doolittle, N.D.: Stroke Recovery: Review of the literature and suggestions for future research. J. Neurosci. Nurs. 20(3), 169–173 (1988)CrossRefGoogle Scholar
  31. 31.
    Doolittle, N.D.: Clinical Ethnography of Lacunar Stroke: Implications for Acute Care. J. Neurosci. Nurs. 23(4), 235–240 (1991)CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  1. 1.Philips ResearchEindhovenThe Netherlands
  2. 2.Eindhoven University of TechnologyEindhovenThe Netherlands

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