Kristi Gaines

The Role of Daylighting in Skilled Nursing Short-Term Rehabilitation Facilities

Objective: The aim of this study is to investigate the best placement of windows in short-term rehabilitation facilities in terms of daylighting and outdoor views by exploring the impact of windows on resident perception of stress, mood, activities, and satisfaction. Background: The physiological and psychological benefits of daylighting have made it an increasingly important topic in multidisciplinary research. Although multiple studies have been written about the impact of daylight on physiological responses, few investigations have been made into the nonvisual effects related to resident mood, satisfaction, and stress level. In addition, researchers typically propose recommendations for quantitative aspects of illuminance, rather than addressing the behavioural outcomes. Methods: A combination of qualitative and quantitative methodologies were used to address the research questions. Thirty-four participants, who were living temporarily in the inpatient rehabilitation units of two skilled nursing facilities, were subjects in semistructured interviews and a 7-question 5-scale survey. While residents expressed the need to have direct visual access to the outdoors, they indicated that daylight was of even higher benefit. Additionally, they noted that size and location of windows impacted their stress levels, moods, and activities. More than half of the facility residents reported changing their postures for either better outdoor views or less light disturbance while sleeping. Conclusions: The results of this study emphasize the importance of daylighting for residents in rehabilitation units. Architects should acknowledge the role of daylighting and window views in the design of rehabilitation facilities.

Delivering Rural Health in a Changing Health Model A Qualitative Study Involving Four Hospitals

Objectives: An exploratory examination of rural hospital staff experiences to determine whether the physical state of rural healthcare facilities influence the healthcare experience and perception of care quality. Background: Rural hospitals have served as the backbone of rural communities in the United States. Over time, these facilities have witnessed enhanced expectations, expanding their scope of operations from acute care to diversified services through linked provider networks and disaster management. Simultaneously, financial challenges, increasing emphasis on safety and quality, and the Affordable Care Act have introduced new challenges for rural hospitals. Currently, there is little empirical knowledge in this domain from a facility perspective. Methods: An exploratory qualitative study was conducted, involving semistructured interviews of upper and mid-level administrators in four rural hospitals located in West Texas. All questions attempted to obtain the subject’s knowledge, ideas, and opinions concerning the physical design of the hospitals and the hospital experience. Results: According to data on staff experiences, two classes of factors surfaced as potential influencers of hospital experience and care quality: (1) care configuration and (2) outdated building. Care configuration pertains to positioning facilities designed with inpatient care focus to a market expanding in outpatient services. Outdated buildings affect several issue including perceived provider quality and spatial accommodations for safe/efficient care and thereby also affecting the healthcare experience. Conclusions: Physical infrastructure of rural hospitals may have important and meaningful implications for population health performance in rural America.

The Physiological Impact of Window Murals on Pediatric Patients

Objectives: To examine the magnitude of impact of two nature-themed window murals on physiological processes, as measured by heart rate and blood pressure, of pediatric patients. Background: Many children and adolescents find at least one aspect of the hospitalization process frightening or anxiety provoking. One physical feature linked to stress reduction is access to positive distractions. Views of nature are one of the most common forms of positive distractions in healthcare environments. Patient room windows are the most common way patients are exposed to natural elements. Exposure to views of nature is linked to a number of positive impacts on physiological outcomes. Unfortunately, not every patient room will be able to provide a nature-filled window view. In situations where nature scenes do not occur, enhanced nature views may be utilized to replicate many of the same benefits as actual nature views. Methods: Pediatric patients were randomly assigned to one of the three room conditions: aquatic window mural, tree window mural, or control condition. The medical data of participants (n = 90) who stayed in the rooms were gathered and evaluated for differences. Results: Data analysis supports the notion that patient stress is heightened at the time of admission. Patients in the rooms with murals were found to have improvements in heart rate and systolic blood pressure in comparison to patients in control rooms, suggesting that the murals had an impact on physiological processes. Data also suggest that subject matter played a role, as patients in tree murals rooms had the most health-related outcomes.

Human Factors Applied to the Understanding of the Importance of Therapeutic Clothing Textiles for Children with Autism Spectrum Disorders

The aim of this study was to identify significant design features and textiles that would alleviate sensitivities for children with ASD. Small groups of randomized children with ASD and their parents participated in the study, pertaining to design features and textile related to characteristics of ASD. In the experiments, we tested weighted vests with three types of textiles (neoprene, wool, and denim) and newly developed prototypes with various textiles, including bamboo jersey, nylon with durable repellent, cotton, organic cotton, and polyester fleece. In this study, individuals with ASD exhibited certain tactile design preferences. Results from this study led to the development of sensory clothing products and provide evidence based therapeutic clothing design for individuals who have the everyday challenges posed by the characteristics of ASD.