Evaluation of supportive environmental design elements to reduce patient stress in the hospital of Bangladesh

Abstract

Hospitalization itself is a critical phenomenon in one's life. It creates physical and psychological stress in patients. In addition, the poor physical environment of the hospital works against the wellness of patients and negatively affects patients' psychological well-being. According to Dr Roger Ulrich's supportive design theory, three environmental design factors help patients cope with stress in a hospital environment: (a) Sense of control over physical–social surroundings, (b) Access to social support, and (c) Access to positive distractions. However, in Bangladesh, patients' socio-psychological comfort has been ignored over functional requirements in the hospital environment, and patients' stress is rarely recognized in the hospital design phase. Therefore, this study aims to understand the impact of supportive environmental design elements on patients' stress and satisfaction in the ward environment. The study collects data from two public and two private hospitals and surveys 150 patients from different wards through literature review, observation, and questionnaire surveys. The systematic observation reveals that healing through physical environmental design is still not practised and is often unrecognizable in hospitals. This study reveals that patients in public hospitals often suffer additional stress due to the wards' poor psycho–social environmental conditions. Lack of control is a major problem for patients that produces stress and adversely affects patient satisfaction in the public hospital. Due to free visitors' access and male attendance in female wards, female patients of public hospitals face privacy problems, affecting their satisfaction level. In addition, lower levels of social support create stressful situations in the Public hospital ward environment. Both public and private hospitals have very few supportive elements for positive distraction. On the other hand, patients in private hospitals get a comparatively better quality hospital environment that helps them reduce their perceived stress. In conclusion, the research suggests that the design of the hospital ward environment should accommodate supportive design elements to reduce patient stress and improve overall patient satisfaction and experience. As a research outcome, some generic design recommendations are proposed focusing on the sense of control, social support, and positive distraction. These recommendations are expected to help architects, planners, interior designers, and hospital authorities to transform the stressful ward environment into a healing environment in public and private hospitals in Bangladesh.