Healing Window: Linkage between Window Opening and Patient Recovery

A Research Proposal Presented to Dr. Romeo B. Santos

College of Architecture
University of the Philippines
Diliman, Queon City
!n
Partial "ulfillment of the Course Re#uirements for Arch $%&
'!ntroduction to Architectural Research(
By
Alvin )*er +. Arlana
,cto*er $&, $%&&
I. Title of Proposal
Healing Window: Linkage between Window Opening and Patient Recovery
II. Keywords to describe te s!b"ect st!dy:
-indo- openings, out*ound scenery, access to daylight, treatment history, patient
recovery
III. Researc #!estion $ Proble% &tate%ent
.here are recent studies in fields of healthcare, *ehavioural and architectural science that
daylight, scenery and visual access through -indo- and other openings has positive
impact in the occupant/s physical condition in *uildings. .hese studies imply that the
connection *et-een the outdoor and the controlled condition of indoor environment can
*e actively related to human health. !n the study of 0ilson '&12$(, the occurrence post3
operative delirium in !ntensive care units '!CU( are t-ice higher for !CU/s that do not
possess -indo- openings compared to those !CU/s that has -indo- openings. 0ilson
concluded that the presence of -indo- openings may *e desira*le in preventing sensory
deprivation. Richard 4uller '&11$( and 5isa 6eschong '$%%$( conducted separate study
a*out health, *ehaviour and academic performance of children in classroom. .he
findings, students in classrooms -ith most -indo- areas or daylight -ere found to have
higher scores on standardied test than those -ith least -indo- areas.
Base on these studies, -indo- openings, daylight and out3*ound scenery has direct
relation to human/s -ell *eing. 6o-ever, the importance of -indo- openings and
out*ound scenery are either unconsciously ignored or given less preference in design of
various *uilding typologies may*e of three primary reasons namely7 in order to ma8imie
the use of *uilda*le footprint especially in ur*an areas, the physical conditions site and
the character of immediate surroundings.
0indo- openings and out*ound sceneries are significant to healthcare facilities more
importantly to its indoor environment and patient/s condition. .herefore, this
architectural feature shall not *e ignored.
.his study aims to find out the correlation of -indo- opening, out*ound scenery and
hospitaliation time in patients/ recovery. .he study -ill *egin at the assumption that
-indo- opening and the out*ound scenery affects the recovery of patient in hospital
patient rooms.
I'. Ob"ectives
&. .o study a specific hospital in 9etro 9anila focusing on -indo- openings of patient
rooms and the treatment history of patient
$. .o ma:e a profile of patient3-indo- opening variations and character of treatment
history of patient.
;. .o compare $ types of patient room -ith dissimilar features of -indo- openings vis
<a vis the treatment history of patient
a. Room -ith limited -indo- opening
*. Room -ith li:ely ade#uate -indo- opening and variation of out*ound sceneries.
=. .o determine -hether there is a lin:age *et-een patient room -indo- openings and
patient recovery.
'. I%portance$&ignificance of te &t!dy
.he significance of this study is evident in design of healthcare facilities. .he study may
esta*lish and clarify the correlation of physical space and patient recovery. !ts innovation
in research methodology could *e important contri*ution to medical research.
.he organie *ody of :no-ledge and materials -ould serve an important reference for
technical, professional, medical practitioner and the academe and can open3up further
studies related today. .his study -ill also validate results of other similar related
researches. .he result -ill *e also significant contri*ution and its replica*ility could *e a
good *asis for policy decisions in health sector. !f realied and adopted, a model or guide
can *e constructed and help Philippines to stand out as leading provider of healthcare
services.
'I. Review of Related Literat!re
.he >ournal ( &yste%atic &t!dy of te Terape!tic I%pact of )ayligt (ssociated
wit *linical Recovery *y ?oarder, Price and 9ourshed of 5ough*orough University
compiled evidences from diverse research sources e8ploring the impact of daylight and
patient/s health and recovery. .he study discussed the effects of light on human *ody
starting from *iological and chemical reaction in the *ody, factors affecting mood and
*ehaviour, and finally relating this to clinical outcomes in hospital setting.
.he importance of light in the *ody is discussed in t-o categories7 light incident to the
retina and light incident to the s:in.
!t *riefly e8plains that light facilitates the production of t-o important neurotransmitter7
Serotonin and 9elatonin. Serotonin is a neurotransmitter that facilitates emotions
including desire, *ody temperature, sleep, appetite and meta*olism through e8posure to
daylight. ,n the other hand, a*sence of daylight increases melatonin associated -ith
increased car*ohydrate cravings, depression, heightened sensitivity to pain, and trou*led
sleep patterns.
.he paper also cited the e8posure and consciousness to daylight pattern improves sleep
and circadian rhythms. ,ptimising daylight in hospital interiors most li:ely reduce
depression, agitation, an8iety, stress level, and length of stay of patients.
!n the *oo: Healing +ardens: Terape!tic ,enefits and )esign *onsideration *y
Clare Cooper39arcus and 9arni Barnes, they discussed ho- gardens helps in relieving
stress, lessens physical symptoms of medical procedures and improves the overall sense
of -ellness for *oth patients and hospital staff. .o create a successful therapeutic garden
they have formulated design principles to loo: into. .he design principles discussed are
variety of spaces, green materials, encourage e8ercise, positive distraction, minimie
intrusion and am*iguity.
@arieties of spaces mean giving the patient choice of get3a-ay from the sterilied
environment of the hospital. +reen material connotes that plant materials should
dominate the garden. 9a:ing gardens that -ould encourage -al:ing as a form of
e8ercise and *uffering that -ould minimie ur*an noise, pollution, and intrusion. .hese
are the principles that are *elieved to lo-er levels of depression and stress among
patients.
,n the other hand, this study -ill loo: into ho- out*ound scenery affects patient
recovery in the a*sence of gardens in ur*an environment.
'II. -.pected O!tp!t
A clearer understanding of the relationship *et-een attri*utes of physical space and
patient recovery -ill *e a significant contri*ution to studies dealing -ith patient length of
stay. !t -ill !ncrease a-areness on the significance of the -indo- openings, the nature of
out*ound scenery vie-ed from the hospital *ed and patient recovery. Policy ma:ers,
hospital administrators, medical practitioners, design professionals, academics and
among others, may find the study results and materials important for their respective
fields of practice. Policy decisions and can open up other opportunities for further
studies.
Presentation in conferences, pu*lications and peer research >ournal are tangi*le outputs
e8pected to this study
'III. /etodology
Methods of Getting the Data:
.he research -ill follo- a mi8ed3method approach, applying *oth #ualitative and
#uantitative perspectives in carrying out the study. !t -ill apply a selected of techni#ues
in getting the data. Aas applica*leB
a. Revie- of related records and research
*. Stratified Random Sampling
c. 4ey Research Person !ntervie- '4RP!Cstructured individuals(
d. Structured Survey
e. Site inventoryCmapping
f. "+D Cfocus group discussion Dpatients3relatives3doctor3nurses3health -or:er
g. .ransect >ournal
h. Conduct a case study
Mechanics of Analysis
!n order to achieve the o*>ectives of this study, the researcher -ill used primary and
secondary data.
)8tensive revie- of documents, studies and pu*lications -ill *e focus on the relevance
and *earing on matters related to the study to-ards the formation of *ac:ground
information. A systematic analysis and synthesis of this information can *ring a*out a
clearer perspective of the theoretical, methodological and technical *ases of the research.
An initial survey, listing, and categoriing of different hospitals in 9etro 9anila -ill *e
done to identify the hospitals that passes the criteria for the study. Selection shall *e done
through stratified random sampling.
Structured intervie-s of -ill *e done through :ey resource persons on the *asis of their
direct :no-ledge, involvement and familiarity -ith the su*>ect. Suggested :ey resource
persons shall include hospital administrators, medical practitioners, health officialsE
technical persons specialied in hospital planning and design, and among others.
A #uestionnaire survey of randomly respondents specifically the patients shall *e
conducted randomly to elicit response that includes perception, suggestions and
complaints, among others. .he survey -ill purposely target getting information on the
e8tent ho- -indo- openings relate to patient/s recovery.
,cular visits, inventory and mapping of rooms that -ill *e use for controlled study.
Physical dimensions of -indo- openings, orientation, illumination level, and the
out*ound scenery, among others shall *e noted. .he researcher shall e8amine the medical
records of patients admitted on selected patient room.
"ocus +roup Discussion shall *e conducted among selected sta:eholders to get first hand
information on the e8tent ho- people #ualify of space and their perception.
Using the same esta*lished procedure and methods, a similar case shall *e conducted
from another hospital for comparative analysis.
Analysis and Triangulation
.he analysis -ill *e done through systematic means of comparing and triangulating the
data and information gathered from diverse sources. Patterns, trends, and inclination from
*oth #ualitative and #uantitative analysis -ill *e used to ma:e inferences and >udgement
in getting evidence necessary for determining the lin: *et-een -indo- openings and
patient recovery.
References:
Cooper39arcus, Claire and Barnes 9arni, +ardens7 .herapeutic Benefits and Design
Consideration '&111(
"arley, 4elly and @eitch, ?ennifer, '$%%&( A Room -ith a @ie-7 A revie- of the effects of
-indo-s on -or: and -ell3*eing.
6eschong, 5isa '$%%$( Daylighting and 6uman Performance, ?ournal of AS6RA),
?oarder, A. et. al. , A Systematic Study of the .herapeutic !mpact of Daylight Associated -ith
Clinical Recovery, 5ough*orough University, $%%1
4uller, Richard and 5indsten, Carl '&11$( 6ealth and Behavior of Children in Classroom -ith
and -ithout 0indo-s, ?ournal of )nvironmental Psychology.
0ilson, 5.9. '&12$( !ntensive Care Delirium7 .he effect of outside deprivation in -indo-less
unit, Archives of !nternal 9edicine