Proposal for a Raised Garden for the Spinal Injuries and Rehabilitation Units
An Initiative supported by Diversity Health, POWH, December 2005
Overview of the literature
The field of health care design has increasingly recognised the impact of physicalenvironments on the well-being of patients, staff and family in terms of healthoutcomes such as healing rates, reduced stress and overall quality of health caredelivery. There has also been a renewed acknowledgment of the relationship betweenconnecting with nature and our state of health and well-being (theory of ‘biophylia’).Based on this theory there is now more acceptance of the positive responses inducedthrough human contact with living things.The restorative and therapeutic qualities of gardens have also been highlighted in theliterature, especially the research work by Ulrich, which focuses on the effects of builtand natural environments on people's psychological well-being and health. Ulrich hasinvestigated extensively the links between nature, specifically access to gardens andresulting improved health outcomes of hospital patients. The benefits for health careworkers and families in reducing stress have also been noted.The concept of a community garden where people interact and work alongside eachother to create a beautiful space has been used as a health promotion strategy invarious settings, especially in public housing estates. The positive outcomes in termsof fostering community building, developing social supports and inclusion incommunity are well recognised and as a result community gardens have been adoptedin many other settings. The act of creating the garden as a communal, participativeactivity and the use of the garden setting for creative art pursuits is a newly emergingarea. Creative arts have a well-recognised potential to promote health and wellbeingand the ‘art for health movement’ is being adopted by many services and programs.The above concepts are explored in more detail below.
Healing environments in health care design
The physical environment affects well-being and there is growing internationalacceptance that the design of health care facilities should be human centred andfunctionally efficient to benefit patients, their families and staff.
In a review of 600studies in peer reviewed journals establishing how hospital design can affect clinicaloutcomes, the physical environment was found to be linked to patient and staff outcomes in four areas, namely, reduced staff stress and fatigue and increasedeffectiveness in delivering care, improved patient safety, reduced stress and improvedoutcomes, and improved overall health care quality.
Ulrich has written several theoretical articles focusing on the effects of design onhealing and wellness and how we need to move away from health care and design thatis ‘psychologically hard’ to design that is more physically and psychologicallysupportive.
Ulrich proposes a stress model stating that there are two major sources of stress for hospital patients: ‘illnesses’ that reduce control and physical capability and
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The role of the physical environment in the hospital of the 21
century: a once in a lifetimeopportunity.
Ulrich RS. Cited in Mroczek J, Mikitarian G, Vieira EK, Rotarius T. Hospital Design and Staff Perceptions: An Exploratory Analysis.
The Health Care Manager.