شناسایی و دسته‌بندی الگوهای ذهنی متخصصان با تاکید بر کاهش افسردگی بیماران در طراحی فضاهای درمانی با استفاده از تحلیل عامل اکتشافی

نوع مقاله : برگرفته از رساله دکتری

نویسندگان

1 دانشجوی دکترای معماری، گروه معماری، دانشکده هنر و معماری، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.

2 استاد، گروه معماری، دانشکده معماری و شهرسازی، دانشگاه تربیت دبیر شهید رجایی، تهران، ایران.

3 دانشیار، گروه معماری، دانشکده هنر و معماری، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.

چکیده
بر مبنای تعریف سازمان بهداشت جهانی، سلامتی یک مساله چند بعدی است که علاوه بر بعد جسمی، دارای ابعاد روحی- روانی است. هدف از طراحی فضای درمانی، علاوه بر ارایه خدمات درمانی، باید تامین نیازهای روحی و روانی کاربران باشد که هنوز به طور کامل مورد توجه قرار نگرفته است. اخیرا بیماری افسردگی علاوه بر افراد عادی، در بین بیماران جسمانی مانند کرونا، بیماران قلبی، ریوی، دیابت و ... نیز بسیار شایع شده است. این پژوهش با هدف شناسایی و دسته‌بندی ویژگی‌های کالبدی مؤثر بر کاهش میزان افسردگی در طراحی فضاهای درمانی و تعیین الگوی غالب در میان اساتید متخصص حوزه معماری و روانشناسی انجام گرفته است. روش پژوهش توصیفی-پیمایشی است. شناسایی عوامل مؤثر کاهش میزان افسردگی در سه بخش 1- تحلیل محتوای اسنادی؛ 2- پیمایش دلفی طی دو مرحله و 3- تحلیل عاملی اکتشافی از نوع کیو جهت شناسایی و دسته‌بندی الگوی ذهنی متخصصان انجام گرفته است. در پیمایش دلفی از میان متخصصان فعال در حوزه معماری و روانشناسی، تعداد 15 نفر به شیوه نمونه‌گیری در دسترس انتخاب گردید. در گام پیمایش دلفی جهت دستیابی به الگوهای ذهنی افراد متخصص، پرسشنامه در میان 20 نفر متخصص توزیع و تحلیل عامل اکتشافی از نوع کیو و با استفاده از نرم افزار SPSS، انجام شد. در نهایت شش الگوی ذهنی غالب از نظر متخصصان شامل توالی منطقی، فضای طبیعت‌گرا، فضای متنوع، فضای اجتماع‌پذیر هدفمند، فضای امن و آسایش بصری استخراج گردید که معمار از این عوامل در طراحی فضاهای درمانی استفاده می‌کند و در اثر نهایی او منعکس می‌گردد.

چکیده تصویری

شناسایی و دسته‌بندی الگوهای ذهنی متخصصان با تاکید بر کاهش افسردگی بیماران در طراحی فضاهای درمانی با استفاده از تحلیل عامل اکتشافی

تازه های تحقیق

- استخراج دیدگاه متخصصان در رابطه با ویژگی‌های کالبدی مؤثر بر کاهش میزان افسردگی بیماران در طراحی فضاهای درمانی.
- اکتشاف الگوی ذهنی غالب متخصصان در ارزیابی ویژگی‌های کالبدی فضاهای درمانی مؤثر بر کاهش میزان افسردگی.
- استفاده از روش تحقیق ترکیبی کمی و کیفی شامل: 1- تحلیل محتوای اسنادی، 2- پیمایش دلفی طی دو مرحله و 3- تحلیل عامل اکتشافی از نوع کیو.

کلیدواژه‌ها

موضوعات


عنوان مقاله English

Exploratory factor analysis of specialists’ mental patterns in the design of therapeutic spaces with an emphasis of the reduction of patient depression

نویسندگان English

Marziyeh Faghiholislam 1
Hamid Reza Azemati 2
Hadi Keshmiri 3
1 Ph.D. Candidate in Architecture, Faculty of Art and Architecture, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
2 Professor, Department of Architecture, Faculty of Architecture and Urban Design, Shahid Rajaee Teacher Training University, Tehran, Iran.
3 Associate Professor, Department of Architecture, Faculty of Art and Architecture, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
چکیده English

Extended Abstract
Background and Objectives: According to the World Health Organization, health is a multi-dimensional issue that, in addition to the physical aspect, includes mental and psychological dimensions. The goal of designing therapeutic spaces, beyond providing medical services, should be to address the mental and psychological needs of users—an aspect that has not yet been fully considered. Recently, in addition to the general population, depression has become increasingly common among patients with physical illnesses such as COVID-19, heart disease, lung conditions, diabetes, and others. This research aims to identify and categorize the physical characteristics that are effective in reducing the level of depression in the design of therapeutic spaces, and to determine the dominant mental pattern among expert professors in the fields of architecture and psychology.
Methods: This study adopts a descriptive-survey research method. The process of identifying factors that influence the reduction of depression involved three main phases: content analysis of existing literature and documents, a two-stage Delphi survey, and exploratory factor analysis of the Q type to recognize and classify the mental patterns of experts. In the first part of the Delphi survey, interviews were conducted with fifteen experts in the fields of architecture and psychology, and the opinions of expert professors who were available at the time of the study were used. In the second part, twenty people participated in two stages through a closed questionnaire to analyze the Q factor.
Findings: To check the content validity of the questionnaire, the opinions of five architecture experts were used. The questionnaire was distributed among them, and based on their feedback, items were added or removed. Therefore, the content validity of the questionnaire was confirmed by the experts. Cronbach’s alpha coefficient for the experts’ questionnaire was 0.716, indicating good reliability. Bartlett’s KMO test, with a value of about 0.7 and a significance level less than 0.05, confirmed the adequacy of sampling for this analysis. To ensure accuracy in calculations and due to the non-uniformity of participants in each component, the average response to the questions of each component was used to calculate the total variance. According to the scree chart, perceived factors were identified among 20 participants. The data matrix was rotated, and the factor loading of each individual was determined. In the end, the most important factors affecting the reduction of patients’ depression were identified, categorized, and named by the experts.
Conclusion: In the end, according to experts, six dominant mental patterns were extracted: logical sequence, nature-oriented space, diverse space, targeted sociable space, safe space, and visual comfort. These are used by architects in the design of therapeutic spaces and are reflected in the final outcome. A nature-oriented space should be able to incorporate various elements such as still and flowing water on the site, the presence of water at different levels, the sound system and the effect of water, diversity of vegetation, and the use of plants at different levels. These factors can reduce patients’ internal psychological stress and increase their vitality. A targeted social space plays an important role in fostering social interactions among patients. Considering elements such as creating a purposeful open collective space for patients’ physical activity and designing for environmental interactivity can lead to meaningful social connections among patients. Additionally, an appropriate recreational and sports area should be provided next to the treatment space to facilitate interaction between patients and medical staff and to prevent personal harm. Spatial diversity—through varied materials for surface finishes, diversity in exterior, intermediate, and interior spaces, as well as variety in texture, material, color, and lighting—creates dynamism, movement, and vitality. Using these elements in both interior and exterior space design helps reduce anxiety, internal pressure, and social stress, and enhances liveliness. Visual comfort in hospitals should ensure the visual and physical ease of patients. This includes components such as appropriate views and landscapes, ambient lighting, light control, shadowed areas, light play, and energy efficiency for temperature and ventilation control. Logical sequence within the structural system of enclosed spaces should support patient well-being and reduce external stress in treatment areas. It is essential to establish continuity and logical connections between entrance spaces, waiting areas, and inpatient and surgical departments. A safe space should enhance both the physical and psychological safety of patients in treatment environments, while reducing external and social pressures. The use of these patterns can shape the final processing elements in the design process and lead to the development of architectural products, which here are therapeutic spaces.

کلیدواژه‌ها English

Depression
Therapeutic Spaces
Mental Pattern
Exploratory Factor Analysis

این مقاله برگرفته از رساله دکتری نویسنده نخست با عنوان «شناسایی و دسته‌بندی الگوهای ذهنی متخصصان با تاکید بر کاهش افسردگی بیماران در طراحی فضاهای درمانی با استفاده از تحلیل عامل اکتشافی» می‌باشد که به راهنمایی نویسنده دوم و مشاوره نویسنده سوم در دانشگاه آزاد اسلامی واحد شیراز انجام گرفته است.

This article is derived from the first author`s doctoral thesis entitled “Identifying and categorizing the mental patterns of specialists with an emphasis on reducing costs in the design of therapeutic spaces using exploratory factor analysis”, supervised by the second and advised by the third authors, at Islamic Azad University Shiraz Branch.

  1. Adl Gharebagh, E., (2016), physical components affecting healing in therapeutic environments, PhD, supervisor: Masoud Yousefi Tazakor; Ghasem Motalebi, Islamic Azad University, Ardebil branch. [In Persian]
  2. Akalin - Baskayaa A, Yildirim K. (2007). Design of circulation axes in densely used polyclinic waiting halls. Building &environment 29. Elsevier: 1743 – 50.
  3. American Psychological Association, (2020), DSM-5 Diagnostic and Statistical Manual of Mental Disorders, translated by: Yahya Seyed Mohammadi, Tehran, Ravan. [In Persian]
  4. Ansari, M., Momeni, k., (2010), A Study of the Role of Environmental Factors on Human Behavior, Report, pp. 66 and 67, pp. 105 and 106. [In Persian]
  5. Atarod, F., & Kashi, H. (2018). Constituent Elements of Urban Facade. Armanshahr Architecture & Urban Development, 10(21), 173-192. [In Persian]
  6. Azemati, H., Pourbagher, S., Bahrami, M., (2018), architecture based on stress reduction and academic vitality enhancement in female students, the first international conference and the fifth conference on architecture and sustainable urban development, Tehran. [In Persian]
  7. Azemati, S., Mozaffar, F., Saleh Sedgh Pour, B., & Hosseini, S. (2018). Principles of university open spaces design based on vitality model and promotion of training. Technology of Education Journal (TEJ), 12(2), 161-170. doi: 10.22061/jte.2018.3160.1801. [In Persian]
  8. Bentley, Yin et al., (2011), Responsive Environments, translated by Mostafa Behzadfar, University of Science and Technology Publications.
  9. Burns, David, (2017), Psychology of Depression, translated by Mehdi Qaracheh Daghi, Tehran, circle.
  10. Ctrees A, 2011. Benefits of Trees and Urban Forests: A Research List. In: http:www.ACTrees.org*
  11. Del Nord, R., (2006), Environmental Stress Prevention in Children’s Hospital Design, Motta Architettura Srl, Milan.Dilani, Alen (2000), Psychosocially Supportive Design: Scandinavian Healthcare Design.
  12. Downing-Our, K., (2008), Rethinking Depression: Why Current Treatment Fail
  13. Dubaten, A., (2008), Architecture of happiness, Tehran, Malaek. [In Persian]
  14. Fairhall, Kate, et al. (2009), “Single Bed Versus Multi-Bed Hospital: The Case for Patient Safety, in World Health Design Journal, October: 57.
  15. Ferasati, F., (2018), Design of Spinas Hospital in Rasht. Gilan University, Department of Architecture and Art, Master's Thesis*. [In Persian]
  16. Ghomeishi, M., Bin Mohd Jusan, M. (2013). Investigating different aesthetic preferences between architects and non-architects in residential façade designs. Indoor and built environment, 22(6), 952-964. [In Persian]
  17. Gruter, Y., (2013), Aesthetics in Architecture, translated by Mojtaba Dolatkhah and Solmaz Hemmti, Dolatmand, Tehran. [In Persian]
  18. Guyton, A., (2004), Physiology of the human body, translated by the Department of Physiology of Tabriz University, Tehran, Farozesh. [In Persian]
  19. Hall, Edward T., (2018), The Hidden Dimension, Tehran, University of Tehran. [In Persian]
  20. Haratoon, Davidian, (2013), Recognition and Treatment of Depression in Iranian Culture, Academy of Medical Sciences of the Islamic Republic. [In Persian]
  21. Hasanpour, K., Bagheri, M., Almasi, A., (2013), The role of the architecture of medical centers in improving the safety and health of employees' working environment. First National HSE Health, Safety and Environment Conference. [In Persian]
  22. Jahanbakhsh, Z., Mehdizadeh Seraj, F., (2016), the effect of architectural features on improving the vitality of public spaces, international conference on civil engineering, architecture and urban planning in contemporary Iran*. [In Persian]
  23. Jam, F., Azemati, H. R., Ghanbaran, A., & Saleh Sedghpour, B. (2019). Identification and Classification of Architects’ Mental Patterns in Aesthetic Judgment of Residential Building Façade, Using the Q- Q-Factor Analysis. Journal of Architectural Thought, 3(5), 141-154. doi: 10.30479/at.2019.10578.1198. [In Persian]
  24. Karimi Azari, A., Safarnejad, M., (2016), Identifying objective and subjective components effective in facade design to improve the identity of the urban landscape and increase the sense of belonging of the citizens, Manzar Shahr Researches, third year, number 6, 89- 106. [In Persian]
  25. Kebapcı, A., Güner, P. (2020), "Noise Factory": A qualitative study exploring healthcare providers' perceptions of noise in the intensive care unit, Intensive & critical care nursing, 102975.
  26. Kaps, G., (2017), "Image language", translator: Firouzeh Mohajer, Tehran, Radio and Television of the Islamic Republic of Iran, Soroush. [In Persian]
  27. Keramati M., (2016), surveying the level of feeling of social security among the country's citizens, Social Security Studies Quarterly, 57-66. [In Persian]
  28. Khanifar, H., Moslami, N., (2019), Principles and Basics of Qualitative Research Method, Tehran: Negah Danesh. [In Persian]
  29. Khodaie, Z., Rafiyan M., Dadashpour, H., Taghvaie, A., (2014), investigating the level of social security on place attachment from the perspective of the adolescent group in Tehran, Strategy, 4 (13), 45-74*. [In Persian]
  30. Kreitzer, Mary Jo. & Zborowsky & J. Larson. (2011) What is a Healing Environment, Available on: http://takingcharge. csh.umn.edu/explore-healing-practices/healingenvironment.
  31. Kreitzer, Mary Jo. & Zborowsky & J. Larson. What Impact Does the Environment Have on Us? (2012), Available on http://takingcharge.csh.umn.edu/explore-healing-practices/healing-environment/what-impact-does-environmenthave- us.
  32. Lang, J., Creation of architectural theory, (2018), translated by Alireza Einifar, Tehran University. [In Persian]
  33. Lynch, Kevin, (2017), The face of the city, translated by Dr. Manouchehr Mozayeni, University of Tehran*. [In Persian]
  34. Mahmoudi, M., (2017), Designing educational spaces with a flexibility approach, 3rd edition, Tehran, University of Tehran*. [In Persian]
  35. McAndrew, Francis T., (2014), Environmental Psychology, Tehran, Vania.
  36. Mehdizadeh Seraj, F., & Ahadi, A. A. (2013). Accelerating the Recovery Process of Hospitalized Patients with the Proper Design of Windows in Hospital Rooms, Case Study: Mild and Humid Climate (Orbit 36 to 38 Degrees). Armanshahr Architecture & Urban Development, 5(9), 153-164. [In Persian]
  37. Montazerolhoje, m., Ekhlasi, A., (2018). Analysis of Factors Affecting the Patient Effectiveness and Satisfaction Level in Therapeutic Spaces, Case Study: Yazd Hospitals, Hospital, 17(2), 81-96. magiran.com/p1870730. [In Persian]
  38. Mosallanejad, A., movahed, K., & Keshmiri, H. (2019). Evaluating the Effect of Physical Architectural Elements on Upgrading Citizens’ Vitality in Urban Pass Ways, Case Study: Afifabad Street in Shiraz. Armanshahr Architecture & Urban Development, 11(25), 177-188. [In Persian]
  39. Moslehi, M., Rafati, M., Ahmadi, A., (2013), Investigating the effects of green space on human societies: physical activity, mental and physical strength and reducing accidents, Human and Environment, No. 30, 13-26*. [In Persian]
  40. Motalebi, G., & Vojdanzadeh, L. (2015). Effect of Physical Environmental of Medical Space in Reducing Patients’ Anxiety and Stress (Case Study: a Dental Office). Journal of Fine Arts: Architecture & Urban Planning, 20(2), 35-46. doi: 10.22059/jfaup.2015.56716. [In Persian]
  41. Mottalebi, G., & Vojdanzadeh, L. (2016). Identifying Factors for Creating Healing Environments. Soffeh, 26(1), 25-48. [In Persian]
  42. Openshaw, S., Taylor, E., (2020), Ergonomics and design (a reference source), Tehran, Roza*. [In Persian]
  43. Pakzad, J., (2020), theoretical foundations and process of urban design, 10th edition, Tehran, Shahidi*. [In Persian]
  44. Papageorgiou, C, Goring, H, Haslam, J. (2017), Coping with depression, Oneworld Publications*
  45. Pourbagher, S., Azemati, H. R., & Saleh Sedgh Pour, B. (2020). Classroom wall color: a multiple variance analysis on social stress and concentration in learning environments. International Journal of Educational Management*. [In Persian]
  46. Pourdeihimi, S., Haji Seyyed Javadi, F. (2008). Daylight and the Human Being: Perception and Biopsychology of Daylight. Soffeh, 17(46),67-75. [In Persian]
  47. Rahimi Mehr, V., Motedayen, H., Mehrabani, M., (2016), Creating healing spaces in hospitals with an attitude towards traditional Iranian medicine teachings, Journal of Traditional Islamic Medicine and Iran, 8, 4, 451-462. [In Persian]
  48. Rahimlou, S., Hadafi, F., (2017), Investigation of the effective components in the interior architecture of therapeutic spaces with an emphasis on children's relaxation in dental clinics, Haft Hesar Environmental Studies, No. 25, 7th year, pp. 63-80. [In Persian]
  49. Raisi, A., Shams, L., Atigheh Chian, G., Nouri, M., (2013), Designing therapeutic spaces in a hospital, Isfahan, Publisher: Isfahan University of Medical Sciences. [In Persian]
  50. Samadi, S., (2015), Acquaintance with the principles of ergonomics (human engineering), Tehran, Chehr. [In Persian]
  51. Sarmad, Z., Bazargan, A., Hejazi, E., (2013), Research Methods in Behavioral Sciences, 26th edition, Tehran, Agah Publications. [In Persian]
  52. Scanlon, M. “Human Factors and Ergonomics in Pediatrics in Pascale Carayon”, in Handbook of Human Factors and Ergonomics in Health Care and Patient Safety, Lawrence Erlbaum Associates, London, 2007, pp. 865-882.
  53. Sedigh Akbari, S., & Noori, R. (2014). The Status of Light and Color in Environmental Psychology in Designing Child-Focused Treatment Spaces (Case Study: Mofid Pediatrics Hospital). Armanshahr Architecture & Urban Development, 7(1), 45-53. [In Persian]
  54. Shahcheraghi, A., Bandarabad, A., (2014), surrounded by the environment, application of environmental psychology in architecture and urban planning, Tehran, Jahad Daneshgahi Organization*. [In Persian]
  55. Shamgholi, Gh., Yekita, H., (2012), Basic Concepts in Hospital Design, Tehran, Soroush Danesh. [In Persian]
  56. Sodagar, H., Mohit Mafi, S., (2018), hospital design, first edition, Tehran, Danesh and Fan*. [In Persian]
  57. Tabaian, M., (2013). Man and environment, psychological approach to architecture and urban planning, Khorasgan Azad University, Isfahan. [In Persian]
  58. Taghizadeh, K., & Minaei, A. (2012). The Method of Plants Selection in Planning and Architecture of Urban Green Spaces in Iran (Represented by Using Mathematic Base and Totality Theory). Human Geography, 44(3), 127-140. doi: 10.22059/jhgr.2012.24984. [In Persian]
  59. Takaneh, Y., Ferguson, G., (2012), Statistical analysis in psychology and behavioral sciences, translator: Ali Delavar and Siavash Naghshbandi, Tehran: Arasbaran. [In Persian]
  60. Turner, J. & J. Fralic & K. Newman-Bennett & L. Skinner. (2009), “Everybody Needs a Break! Responses to a Playgarden Survey”, in Pediatric Nursing, 35 (1), pp. 27. Date: Online, Posted On: 7/8/2008*
  61. Werdmeister, B.,  Dal, J., (2014), Ergonomics for beginners, translated by Ali Pourqasimi, Tehran, Markaz. [In Persian]
  62. Windle, P. E. (2004). Delphi technique: assessing component needs. Journal of PeriAnesthesia Nursing, 19(1), 46-47.
  63. World Health Organization, (2018), Depression and other common mental disorders, global health estimates.
  64. Zakeri, S. M. H., & Safarpour, F. (2014). Designing Waiting Spaces in Hospitals. Soffeh, 24(4), 33-44. [In Persian]
  65. Zebardast, E. (2017). Exploratory Factor Analysis in Urban and Regional Planning. Journal of Fine Arts: Architecture & Urban Planning, 22(2), 5-18. doi: 10.22059/jfaup.2017.240054.671801. [In Persian]

  • تاریخ دریافت 25 خرداد 1401
  • تاریخ بازنگری 29 مهر 1401
  • تاریخ پذیرش 20 بهمن 1401