Determination of biophilic design strategies that affecting the patients’ health in hospitals

Zare, Ghazaal; Faizi, Mohsen; Baharvand, Mohammad; Masnavi, Mohammad Reza

doi:10.30475/isau.2020.210114.1318

Determination of biophilic design strategies that affecting the patients’ health in hospitals

Document Type : Original Research Paper

Authors

Ghazaal Zare ¹

Mohsen Faizi ²

Mohammad Baharvand ³

Mohammad Reza Masnavi ⁴

¹ Ph.D. Candidate in Architecture, Department of Architecture, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.

² Professor, Faculty of Architecture and Environmental Design, Iran University of Science and Technology, Tehran, Iran.

³ Assistant Professor, Department of Architecture, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.

⁴ Professor, Department of Environmental Design Engineering, Faculty of Environment, University of Tehran, Tehran, Iran.

https://doi.org/10.30475/isau.2020.210114.1318

Abstract

Extended Abstract
Objective and background: This research proves the need to modify and develop the design of hospitals to play a perceptible role in treating and accelerating the recovery of patients. Many investigations on the influences of nature on health reveal that the relationship with nature in built environment has a noteworthy effect on the treatment and reduction of the recovery time of patients. One of the solutions suggested in this field is biophilic approach in architectural design, which has been offered by Kellert and states that humans require linking with nature in the man-made environment to preserve and promote their health and well-being. Hence, it is supposed that employing the principles of biophilic design in hospitals influences treatment and recovery time. In the study procedure of this paper, two questions were answered; Are biophilic design approaches efficient for therapeutic spaces to be healing? and What are the practical approaches for efficient biophilic design in health care spaces?
Methods: In this study, according to the purpose, the research method is applied, and the study method is descriptive-analytical. First, literature related to biophilic design and health were analyzed and reviewed with a systematic review technique. Then, the most relevant papers in the field of nature and health were selected, and theories and features of health influenced by the association with nature were presented.
Findings: Connection with nature influences the physical, psychological (mental and emotional), social, and spiritual dimensions of health. The most significant theories in this field are stress reduction theory (SRT) and attention restoration theory (ART). According to stress reduction theory, the amount of stress decreases subconsciously and spontaneously in people facing nature and being in nature, and as stress is the reason for many diseases and abnormalities, it plays a starring role in people's health, especially emotional health. Attention restoration theory reveals the ability to link with nature in subconsciously renewing and restoring attention by promoting cognitive function, which improves individuals’ productivity and mental ability, and has positive impact on the mental health of individuals and on diseases related to this field such as Autism, Alzheimer's, Parkinson's, Obesity, Schizophrenia, Blood pressure, Hyperactivity (ADHD) in children, etc. In the continuation of the research, 14 biophilic design patterns in 5 hospitals, Östra Hospital in Sweden, Khoo Teck Puat Hospital in Singapore, Ng Teng Fong Jurong Hospital in Singapore, Dell Children Hospital in Austin Texas, and The Royal Children Hospital in Melbourne Australia, are compared and assessed in 3 levels of the general aspects of building and its site plan, building organization and planning, and finally interior design of patients' rooms.
Conclusion: As a result, according to the evidence-based results, the design model of the biophilic hospital and the most practical biophilic design approaches in each of the hospital wards were obtained for the use of the design community and to improve the healing quality of the therapeutic spaces. Based on the recommended model, in the eight main internal wards of the hospital including hospitalization, intensive care, medical emergency, surgery, medical diagnostic laboratories, clinics, waiting area of patient companions and services, due to high stress and overcrowding, as well as no need to comply with certain health standards associated with other spaces, the waiting space of patient companions have the greatest potential to apply biophilic strategies. In fact, 12 of the 14 patterns of biophilic design can be applied in this area, and meaningfully can decrease anxiety and stress, increase social interactions, satisfaction, and peace of individuals. Hospitalization rooms can accelerate patients recovery and treatment time by applying 8 biophilic design patterns included patterns number 1, 2, 3, 4, 6, 8, 9, and 11. Surgery, intensive care and emergency areas should obey some special design standards, so only some biophilic design patterns such as; visual connection with nature, dynamic and diffused light and material connection to nature, are compatible with these zones design. Also, in general level using different courtyards and view to nature are the main design principles in architectural planning of biophilic hospitals, and in interior level view of nature, presence of natural light, natural air and natural materials are the most practical strategies in biophilic rooms of healthcare spaces. Nevertheless, empirical and practical assessment of the influence of biophilic patterns and their continuous development is still required.

Graphical Abstract

Determination of biophilic design strategies that affecting the patients’ health in hospitals

Highlights

- Relationship with nature in built-environment has a significant effect on human health and reducing the recovery time of patients in hospitals

- Since Biophilic design seeks to connect humans and nature in built-environment, it can provide healing strategies for the architectural design of hospitals, and affect the treatment and duration of recovery in patients.

Keywords

Health and Well-being

Biophilia Hypothesis

Biophilic Design

Therapeutic Space

Arvay, C. G. (2018). The Biophilia Effect: A Scientific and Spiritual Exploration of the Healing Bond Between Humans and Nature. Sound True. Boulder. Colorado.

Beatley, T. (2017). Biophilic Cities and Healthy Societies. Urban Planning. 2(4): 1-4.

Bowler, D. E., Buyung-Ali, L. M., Knight, T. M., Pullin, A. S. (2010). A systematic review of evidence for the added benefits of health of exposure to natural environments. BMC Public Health. 10: 456.

Bratman, G. N., Daily, G. C., Levy, B. J., Gross, J. J. (2015). The benefits of nature experience: Improved affect and cognition. Landscape and Urban Planning. 138: 41-50.

Bratman, G. N., Hamilton, J. , Daily, G. C. (2012). The impact of nature experience on human cognitive function and mental health. Ann. N.Y. Acad. 1249: 118-136.

Browning, W., Ryan, C., Clancy, J. (2014). 14 Patterns of Biophilic Design: Improving Health, Well-being in The Built Environment. Terrapin Bright Green, LLC. www.TerapinBrightGreen.com

Brymer, Eric., Cuddihy, T. F., Sharma-Brymer V. (2010). The Role of Nature-Based Experiences in the Development and Maintenance of Wellness. Institute of Health and Biomedical Innovation and School of Human Movement. Queensland University of Technology.

Cox, D. T., Gaston, K. J. (2018). Human-nature interactions and the consequences and drivers of provisioning wildlife. Phil. Trans. R. Soc. B 373: 20170092. http://dx.doi.org/10.1098/rstb.2017.0092.

Cox, D. T., Hudson, H. L., Shanahan, D. F., Fuller, R. A. (2017). The rarity of direct experiences of nature in an urban population. Landscape and Urban Planning. 150: 79-84.

Cox, D. T., Shanahan, D. F., Hudson, H. L., Fuller, R. A., Gaston, K. J. (2018). The impact of urbanization on nature dose and the implications for human health. Landscape and Urban Planning. http://doi.org/10.1016/j.landurbplan.2018.07.013.

Depledge, M. H., Stone, R. J., Bird, W. J. (2011). Can natural and Virtual Environments Be Used To Promote Improved Human Health and Wellbeing? Environmental Science, Technology. 45: 4660-4665.

From, L., Lundin S. (2017). Ostra hospital Case Study. http://www.terrapinbg.com.17.03.2018

Fromm. E. (1963). War Within Man: A Psychological Enquiry into the Roots of Destructiveness. National Peace Literature Service (AFSC). Philadelphia. Pennsylvania.

Frumkin, H. (2008). Nature Contact and Human Health: Building the Evidence Base. 7: 107-118. In Kellert, S. R., Heerwagen, J. H. (2008). Biophilic Design: The Theory, Science, and Practice of Bringing Building to Life. John Wiely, Sons. Inc. Hoboken. New Jersey.

Frumkin, H., Bratman, G. N., Breslow, S. J., Cochran, B., Kahn, H., Lawler, J. J., Levin, S., Tandon, S., Varanasi, U., Wolf, K. L., Wood, S. A. (2017). Nature Contact and Human Health: A Research Agenda. Environmental Health Perspectives. http://doi.org/10.1289/EHP1663. 075001: 1-18.

Gillis, K., Gatersleben, B. (2015). A Review of Psychological Literature on the Health and Wellbeing Benefits of Biophilic Design. Buildings. www.mdpi.com/journal/buildings/. 5: 948-963.

Gray, T., Birrell, C. (2014). Are Biophilic-Designed Site Office Buildings Linked to Health Benefits and High Performing Occupants? International Journal of Environmental Research and Public Health. 11: 12204-12222.

Grinde, B. (2009). Can the concept of discords help us find the causes of mental diseases? Med Hypothesis. 73: 106-109.

Grinde, B., Patil, G. G. (2009). Biophilia: Does Visual Contact with Nature Impact on Health and Well-Being? International Journal of Environmental Research and Public Health. 6: 2332-2343.

Hartig, T., et al. (2011). Health Benefits of Nature Experience: Psychological, Social and Cultural Processes. Chapter 5 in: Nilsson, k., Sangster, M., Gallis, C., Hartig, T., Vries, S., Seeland, K., Schipperijin, J. (2011). Forests, Trees and Human Health. Springer New York Dordrecht Heidelberg London.

Hartig, T., Mitchell, R., Vries, S., Frumkin, H. (2014). Nature and Health. Annu. Rev. Public Health. 35: 207-228.

Hettler, B. (1976). The Six Dimensions of Wellness Model. National Wellness Institute, Inc. 1-2.

Janssen, I., LeBlanc, AG. (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International Journal of Behavior Nutr. Phys. Act. 7:40.

Kellert, S. R. (2004). Beyond LEED: From Low Environmental Impact to Restorative Environmental design. Greening Rooftops for Sustainable Communities Conference. Sponsored by Green Roofs for Healthy Cities. Toronto. CA. and City of Portland.

Kellert, S. R. (2005). Building for Life: Designing and Understanding the Human-Nature Connection. Island Press. United States of America.

Kellert, S. R. (2012). Birthright: people and nature in the modern world. Yale University Press. United States of America.

Kellert, S. R. (2018). Nature by Design: The Practice of Biophilic Design. Yale University Press. New Haven, London.

Kellert, S. R., Calabrese, E. F. (2015). The practice of Biophilic Design. www.biophilic-design.com.

Kellert, S. R., Heerwagen, J. H. (2008). Biophilic Design: The Theory, Science, and Practice of Bringing Building to Life. John Wiley, Sons. Inc. Hoboken. New Jersey.

Keniger, L. E., Gaston, K. J., Irvine, K. N., Fuller, R. A. (2013). What are the Benefits of Interacting with Nature? International Journal of Environmental Research and Public Health. 10:913-935.

Kishnani, N. (2017). Singapore’s Khoo Teck Puat Hospital: Biophilic Design in Action. http://blog.interface.com/khoo-teck-puat-hospital-singapore-biophilic-design/ 21.01.2018

Li, Q., Kobayashi M., Wakayama, Y., Inagaki, H., Katsumata, M., Hirata, Y., Shimizu, T., Kawad, T., Park, Bj., Ohira, T., Kagawa, T., Miyazaki, Y. (2009). Effect of Phytoncide from Trees on Human Natural Killer Cell Function. International Journal of Immunopathology. 22(4):951-959.

Mazuch, R. (2017). Salutogenic and Biophilic Design as Therapeutic Approaches to Sustainable Architecture. IBI Grou 42-47.

Mcsweeney, J., Rainham, D., Johanson, S. A., Sherry, S. B., Singleton, J. (2014). Indoor nature exposure (INE): a health-promotion framework. Health Promotion International. 30(1): 126-139.

Nilsson, k., Sangster, M., Gallis, C., Hartig, T., Vries, S., Seeland, K., Schipperijin, J. (2011). Forests, Trees and Human Health. Springer New York Dordrecht Heidelberg London.

Ottosson, J., Lavesson, L., Pinzke, S., Grahn, (2015). The Significance of Experiences of Nature for People with Parkinson’s Diseases, with Special Focus on Freezing of Gait-The Necessity for a Biophilic Environment. A Multi-Method Single Subject Study. International Journal of Environmental Research and Public Health. 12: 7274-7299.

Oxforddictionaries. (2009). Retrived from http://www.oxforddictionaries.com/definition/english/bio- on 25.02.2015

Ryan, C. O., Browning, W. D., Clancy, J. O., Andrews, S. L., Kallianpurkar, N. B. (2014). Biophilic Design Patterns: Emerging Nature-Based Parameters for Health and Well-Being in the Built Environment. International Journal of Architectural Research. 8(2): 62-76.

Salingaros, N. A. (2015). Biophilia, Healing Environments. Terrapin Bright Green. 1-44.

Seymour, V. (2016). The Human-Nature Relationship and Its Impact on Health: A Critical Review. Frontiers in Public Health. 4: 1-12.

Shahcheraghi A., Bandarabaad A. (2015). Mohat dar Mohit: Karbord Ravanshenasi Mohiti dar Memari va Shahrsazi. Sazman Jahad daneshgahi. Tehran.

Shanahan, D. F., Bush, R., Gatson, K. J., Lin, B. B., Dean, J., Barber, E., Fuller, R. A. (2016). Health Benefits from Nature Experiences Depend on Dose. Scientific Reports. www.nature.com/scientificreports. 6: 28551.

Siu Yu Lau, S., Gou, Z., Liu, Y. (2014). Healthy Campus by open space design: Approaches and guidelines. Frontiers of Architectural Research. http://dx.doi.org/10.1016/j.foar.2014.06.006.

Soderlund, J., Newman, (2015). Biophilic Architecture: a review of the rationale and outcomes. AIMS Environmental Science. 2(4): 950-969.

Soderlund, J., Newman, (2017). Improving Mental Health in Prisons Through Biophilic Design. The Prison Journal. 97(6): 750-772.

Soga, M., Gaston, K. J. (2016). Extinction of experience: the loss of human-nature interactions. The Ecological Society of America. 14(2): 94-101.

Svalastog, A. L., Donev, D., Kristoffersen, N. J., Gajovic, S. (2017). Concepts and definitions of health and health-related values in the knowledge landscapes of the digital society. Croat Med Journal, 58:431-435.

Williams, F. (2018). The Nature Fix: Why Nature Makes Us Happier, Healthier, and More creative. W. W. Norton, company. New York | London.

Wilson, E. O. (1984). Biophilia: The human bond with other species. Harvard University Press, Cambridge, Massachusetts, and London, England.

Wilson, E. O., Kellert, S. R. (1993). The Biophilia Hypothesis. Island Press. United States of America.

Yin, J., Zhu, S., MacNaughton, , Allen, J. G., Spengler, J. D. (2018). Physiological and cognitive performance of exposure to biophilic indoor environment. Building and Environment. doi: 10.1016/j.buildenv.2018.01.006.

Yoong, Y. (2012). Designing for health and well-being. New Straits Times. Fri. Nov. 16:6-7.