PSYCHOLOGY IN CANCER

H O SP I T A L

A d i s c u s s i o n o n b u i l t en v i r o n m e n t

SEMINAR REPORT

SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE AWARD OF THE DEGREE OF BACHELOR OF ARCHITECTURE

HIMANSHU TRIPATHI 2008BARC033 TENTH SEMESTER, April.’12
DEPARTMENT OF ARCHITECTURE SCHOOL OF PLANNING AND ARCHITECTURE, BHOPAL April -2013

PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment

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CERTIFICATE

Certified that the thesis entitled “PSYCHOLOGY IN CANCER HOSPITAL" submitted by Himanshu Tripathi in partial fulfilment for the award of the degree of Bachelor of Architecture at the School of Planning and Architecture, Bhopal (deemed to be a university), is a record of the student's own work carried out by him under my supervision and guidance. The matter embodied in this thesis work, other than that acknowledged as reference, has not been submitted for the award of any degree or diploma.

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Thesis Guide (Sukanta Mujumdar) School of Planning and Architecture Bhopal

Dr. Savita Raje Head of Department School of Planning and Architecture, Bhopal

Himanshu Tripathi, 5th Year Architecture, 2008BARC033

5th Year Architecture.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 3 ACKNOWLEDGEMENT I would like to acknowledge and extend my heartfelt gratitude to the following persons who have made the completion of this report possible: Our H.2012 Himanshu Tripathi. Dr.for his vital encouragement and for giving this subject.O. who made all things possible. subject coordinator for the constant support and much needed motivation. Finally. Dr Sukanta Mujumdar. my Mentor . guidance and support. Dr Rachna Khare and Ar Arti Grover. 2008BARC033 . to God.D. Himanshu Tripathi 20008BARC033 School of Planning and Architecture Bhopal. Most especially to my family and friends. for his understanding. advice. Sanjeev Singh . April . I would also like to extend my sincere gratitude to all faculty members and Staff for assisting in the collection of the topics for the chapters.

garden and space between buildings 4. List of figure Page No. The designer’s role 7. Inference 8. Interior features 5. Himanshu Tripathi.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 4 INDEX Table of Content Cover page Certificate Acknowkedgement Introduction Relationship of topic with thesis (advance objective) 1. Departmental components of hospitals 3. 5th Year Architecture. List of tables 11. Conclusion 9. List of graphs 12. Select bibliography 10. Case Study a. 2008BARC033 . Landscape. Dharamshila cancer hospital. Jawaharlal Nehru cancer hospital and research centre 6. Psychological effects of hospitalization 2. New Delhi b.

it still possesses an image of fear and false anticipation. Advance objective The main reason behind development of the report is to better design the health care facility. There are many reasons for the person to be reluctant from being admitted to or even going to hospital during illness. generating positive thoughts and feelings. 2008BARC033 . The possibility of having a view helped some cancer patients to connect with good memories and personal life stories that enabled them to recall some of their feelings of identity. Data were obtained at a general hospital in Denmark by interviewing six cancer patients at two different wards. not only the patients but also the staff. A view to nature also helped them to forget their negative thoughts for a while. Two main themes were identified: to preserve identity and positive thoughts and feelings. In simple words. decoration and the interior. Furthermore. The participants experienced that positive sensory impressions in the hospital environment had a significant impact on their mood. 5th Year Architecture. This study explores how cancer patients experience the meaning of positive sensory impressions in the hospital environment such as architecture.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 5 Introduction Health care are one of the most prominent and vital industry of 21 st century. This paper adds knowledge about how cancer patients experience sensory impressions in the hospital environment. Though hospital provides vital service to humankind. The analysis process was guided by the hermeneutical-phenomenological theory of interpretation as presented by the French philosopher Paul Ricoeur. Himanshu Tripathi. And give the building a better identity. positive sensory impressions and the opportunity for recreation through environmental facilities strengthen the patient's positive thoughts and feelings. The seminar deals with the understanding of the factors responsible for making the hospital a disliked building. which tends to increase the positive psychological impact on its intended user. and effective measure that shall be taken during the planning / designing stage to eradicate the cause. An environment that provides homeliness and offers a view to nature seems to help some patients to preserve their identity. people fear hospitals and negative psychology affects them severely.

5th Year Architecture. There are various reasons behind such behavior. Loss of independence. Problem with medication. Having strangers sleep with you in the same room. ii. Separation from family. Involved lack of communication a. Lack of information. g. 2008BARC033 . Medical and surgical hospital patient were asked to perceive Stressfulness. 2. d. 3. f. From this results it can be seen that some of the most stressful events.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 6 Chapter 1 GENERAL PATIENT’S PSYCHOLOGY Introduction The general perception of patients towards the hospital and hospitalization has always been reluctant and stressful. Stress events a. He/she prefers to stay at home rather than to be in an environment which has trained personnel who can cure the ailment he/she has. Himanshu Tripathi. Threat of severe illness. Psychological effect of hospitalization a. Unfamiliarity of the surrounding : i. b. e. Financial problem. c. 1. Unfamiliarity of the surrounding. Having to sleep in strange bed.

v. f. unfriendly. ii. Being aware of unusual smells around you. b. iv. Having to be assisted with bathing. Being fed through tubes thinking you may lose your weight. Having to be assisted with a bad – pan. Losing income because of illness e. Being in a room that is too cold or too hot. Lack of information i. Isolation from society i. Loss of independence: i. Not being able to get newspaper radio or TV when you want to. Himanshu Tripathi.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 7 iii. Thinking you might have pain because of test or procedures. c. 2008BARC033 . 5th Year Architecture. Having a seriously ill roommate. Fear of medical jargon iv. iv. v. iii. Lack of knowledge of proper diagnosing. or cannot talk to you. Having to eat at different times than you usually. Separation from family d. Having to eat cold or tasteless food. ii. Not knowing when to expect the results. vi. Having to wear a hospital gown. iii. Financial problem i.

PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 8 g.and display their suffering other appear to be able to tolerate complaint. 2008BARC033 . great deal of discomfort without Himanshu Tripathi. Problem with medication i. Not having family visit you ii. Threat of serious illness h. complain . Being hospitalized far from home i. The need for attention during illness patient may use behavior pattern quite unconsciously such as cry . 5th Year Architecture. Separation from family i.

2008BARC033 .PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 9 Himanshu Tripathi. 5th Year Architecture.

Lighting f. Landscape d. Subjects were exposed to QuickTime 360° panorama photos of a first aid examination room and a private ward room. Air. Exterior a. Built environment 1. 2008BARC033 . such as medical care.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 10 Chapter 2 – PHYSICAL AND NON-PHYSICAL FACTORS. Anthropometry d. Ambience c. Color b. Shade and shadows e.quality e. 5th Year Architecture. the physical environment can strongly influence customer evaluation. Color b. Various factors are responsible for altering over all ambience of hospital building and heavily affects the psychology of the patients. 1992) on consumer behavior have long been recognized. Texture c. This experiment investigates the effect of interior color on patients’ emotional and cognitive appraisal and perceived service quality. Noise / sound 2. Interior a. Especially in high-stress services. Scene and scenery Effects of Interior Color on Healthcare Consumers: A 360 degree Photo Simulation The effects of the ‘servicescape’ (Bitner. Blue Himanshu Tripathi.

2003). evaluation of the room and perceived service quality in a simulation of a general hospital. 1983.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 11 walls (as compared to white walls) reduce anxiety and increase cognitive and affective appraisal and even perceived service quality. Valdez & Mehrabian. Color can be used effectively for this purpose (Calkins. and to appraise the quality of the service higher than subjects exposed to a white hospital room. 2000). 1959). In this study we investigated the effects of wall color on anxiety. Bellizzi.. 1979. A considerable amount of empirical evidence is available about the effects of environmental factors on a wide variety of consumer responses (Turley & Milliman. 1984). To reduce this uncertainty. Therefore. to evaluate the room more positively. 1995).g. the atmosphere in clinical environments has been cold and sterile due to color. 1994). Yet. 2008BARC033 . relaxing atmosphere in order to relieve patients’ stress and anxiety. patients will be inclined to infer their judgment of service quality from other indicators. such as the tangible environment. Himanshu Tripathi. 5th Year Architecture. A patient’s health is at stake. We expected subjects exposed to a hospital room with blue walls to experience more positive emotions. as patients lack insight into the procedure and effects of the treatment. patients display a strong need for information concerning their health and treatment (Engström. Under such conditions. and (s)he is temporarily separated from family and friends. Some cause us to be more aggressive. and stress-reducing effects of short wavelength colors (blue. Blue has been found to be the most preferred color throughout color literature (e. Guilford & Smith.g. and lower anxiety. Marberry & Zagon. Historically. reliable information about the quality of healthcare is rather difficult or even impossible to obtain. everybody seems fascinated with the phenomenon. physical aspects of the service environment play an important role in customers’ evaluation of healthcare services (Arneill & Devlin. lighting and furniture. improve their emotions and hence encourage the healing process (Devlin & Arneill. pleasure. 2002). However. From psychologists to interior designers. whereas others have a soothing effect on us. solid empirical evidence for anxiety-reducing and affect-enhancing effects of interior color in healthcare settings is largely lacking. green) are welldocumented (e. Scientific studies have proven that our emotions and mood are affected when surrounded by particular colors. 2002. There's hardly a secret anymore that human behavior is highly influenced by colors. Crowley & Hasty. Birren. The current trend in hospital interior design is to create an attractive. Introduction Hospitalization can have a great psychological impact.

Blue and green are considered to be the most relaxing and refreshing colors. once inside. Hospital walls are usually covered in colors such as white. a hospital room wouldn't be painted in the same shades as a private residence's living room. How do they manage to do that? It's simple to find the answer by just taking a quick look at the walls and noticing the colors they are painted in. When coming inside a hospital. hospital waiting rooms and even psychiatric wards are painted in this color. As their ideas come as colors do. Because green has a calming effect on our nerves. specialists are extremely careful to make the right choice. it has often been noticed that children in pain are put in hospital rooms painted in light blue due to its healing effect it conveys. It implies sterility. Before knowing anything about the staff's professionalism. And the hospital's walls.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 12 No wonder then that when it comes to paints. hospitals have this huge power of conveying a sensation of calm and peace. There is an explanation behind these choices and it has to do with the psychological effects these colors have. we are most certainly overwhelmed by their presence. which has the effect of making patients feel reassured. 2008BARC033 . Designers. intimidating places which are hospitals. green or blue. White is the most common color to be seen on a hospital wall. one way or another. the general atmosphere must make us feel reassured and calm. 5th Year Architecture. This is also why doctors and nurses wear white uniforms. green and blue. For instance. in a wide variety. And that is due to the peaceful and calm mood it provides. green or blue ones. psychologists and feng-shui experts. white. our worried look will check for visible signs that we will be well taken for. But. We all may have in contact. The patients would it find difficult to cope with some red painted walls instead of the usual white. promoting peaceful atmosphere which encourages concentration. Either as patients or visitors. Himanshu Tripathi. As for blue. are our first impression. with the imposing. they all tend to consider that shades of blues and greens make us fell calmer. ultimately the only thing they have to consider is the appropriateness of their vision. And surgeons wear green scrubs for the same reason. more balanced and less emotional. Other reason for choosing it is the fact that it denotes cleanness.

entrance halls. Circulation areas: corridor and staircase 5. Public areas for private use.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 13 Chapter 3 – DEPARTMENTAL COMPONENT OF HOSPITAL BUILDING In this chapter we shall discuss all the functional components o=in terms not only of efficiency but also their aesthetics quality. mortuaries. Car park and route to the main door 3. Kitchens and serving hatches 9. Traditional rooms: management boardrooms. 2008BARC033 . bathroom 13. rooms for death. Interview and counseling rooms 7. committee and meeting rooms. Living and activity areas: day room 12. Patient wards. rooms for birth. bedroom Himanshu Tripathi. Specialist examination and treatment areas: body scanner and x-rays units. operating theatre. rest room. canteens. including comfort and delight. 8. 11. Staff areas: changing rooms. General eating areas: dining rooms 10. How can the car parks. Large communal areas: reception foyers and waiting rooms 4. 6. Main roadway entrance 2. The average hospital building will have following areas: 1. corridors and all the other necessary functional components of any hospital building be designed and maintained not only to work well but also to give pleasure. Washing area: lavatory versus toilet. 14. 5th Year Architecture. anaesthetics and recovery rooms.

flowers.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 14 15. nature and town. disabled parking. For people arriving on foot or by bus. small direction signs at bus stops and streets intersections. with a well lit. 2008BARC033 . and then repeated at the entrance. 5th Year Architecture. Positive unreassurers – small notices and small prints Information about name and nature of hospital not given Poorly lit at night Signs hidden by trees No notice for pedestrians in the streets near the hospitals Litter at the hospital entrance. safe route such as footpath beside a road clearly leading to the main reception / information points. Storage Main roadway entrance General layout Positive reassurers – a large notice of the hospital name. visitors car parks. litter free. neat verges. dropping. Clear directions as to what the visitor does next: main reception / information point. Himanshu Tripathi.off points for patients. Administration areas: general and personal offices 16. well lit at night. direct route to emergencies. A well maintained entrance. shrubs. placed first at some distance from the main entrance with an indication for drivers that the main entrance is one hundred yards further on. Notice too near the entrance to enable a driver to indicate and make a safe turning. A forest of signs at the hospital entrance.

Staff who work in reception can tell you which question people ask most often and you can get expert advice on how to sign spot them in those directions. It is very easy to make people feel hesitant and uncomfortable from the first moment they enter a building . Cautions against theft and speed 3. Signsposting systems are available to enable you to alter and add information easily and quickly. signposting gives you an opportunity to achieve comfort and confidence. organise them according to rank. or whether they move confidently and approach the destination or information desk readily. dogs and trespassers. They are worth the investment. Car park and route to the main door Vehicular access Himanshu Tripathi. Multiple and contradictory general directions Solutions Treat main entrance signs like an army. Exoneration of blame should the worst occur 4. Information about good signposting is available and an important part of the management of health service building is constantly checking that every effort is being made to guide people as they come on to the site or enter the main reception area will give a good picture of whether people hesitate look anxiously around and appears uncertain. Information about closure.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 15 A large number of signs with negative messages Subsidiary signs – 1. 2008BARC033 . which avoids the situation whereby staff put up a handwritten notice. Prohibition on parking. 5th Year Architecture. demonstrate authority over underlining and do not keep changing your mind. select wisely. 2. resting 5. shoot to kill. when they can see the whites of its eye. However handwritten notice at least indicate a well meaning attempt to make direction clearer. The enemy muddle so make sure everyone understands what muddle looks and can recognise it.

they must be emptied before they reach overflow point. Most hospitals now realise that it is essential to involve disabled people in planning access and adapting facilities. highly manufactured automatic glass doors often have shabby notices stuck all over them. Clarity – it is clear where you go for information? 2. attached to drips and equipment. Signposts – are they clear. Doors – expensive. Large communal areas Reception foyers The checklists of essential furnishing continue with these items: 1. Trying out your own facilities in a wheel chair. If you do charge parking fees it is worth thinking about how you explain them to the public.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 16 Most people arrive by private car and the sheer numbers that have to be accommodated have led to vast car parks. wearing ear plugs and fogged glasses. can give the able-bodied useful insight. A notice on the fee system saying that by charging fees to cover the cost of car parking more is available for patient care or for site surveillance is helpful. Smoking – Hospitals that have non-smoking policies have carpets of cigarette butts outside often the main entrance. logical and organised? Himanshu Tripathi. Pedestrian access There has been such determination to accommodate the disabled in the hospital that this is now less of a problem than formerly. 5th Year Architecture. 2008BARC033 . Some common mistakes at the entrance Rubbish – impermanent skips or permanently parked wheeled rubbish bins situated besides the main entrance ar not inviting. sometimes in dressing gowns and nighties. The possible landscaping of the car park to make them as attractive and welcoming as possible. and frequently a group of furtive smokers too. If there are litterbins. and offer a critique of existence provision. confusing direction s and sometimes-unpopular parking fees.

are they unambiguous in telling people what to do next. 9. sick and incontinent. Most hospitals will have lots of different areas where people wait. it is hard to combine these policing tasks with being available for ordinary questions. comfortable. Telephone – are they working and well sited? 8. Himanshu Tripathi. 10. on the other occasions their long wait is essential while life savings procedures are performed on their relatives. apparently unnecessarily. Sometimes they wait and wait. accessible and maintained. people may be accompanied by small children. as in a five –hour wait to have a limb plaster removed in ten minutes. On the arrival. Written instruction – maps. or someone old. Furniture – is it clean. such as switchboard duties or typing. 5th Year Architecture. passing management staff and visiting peripatetic staff look approachable and pleasant? Waiting rooms The best way of reducing anxiety is to provide something of the interest to compete with the anxiety. Lavatories – are they well signposted. well arranged? 6. Refuse sacks and laundry – are piles of these in views. 4. Cleanliness – are the premises clean? 5. are they clean or surrounded by rubbish. In one hospital the most obvious information point is staffed byy the people in charge of security and keys . 7. 2008BARC033 . Items for repair – are old chairs and broken telephone hoods left near the door for eventual collection.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 17 3. An aura of helpfulness This is the most important requirement. leaflets etc. so what sort of diversions can be introduced. is there someone who would notice people in distress and help them appropriately? Are reception staff ease to identify and available? In a number of reception arrangements staffs are given other tasks to do. and it is easy for the vivitors to feel they are interruption. Do porters. Drinking and food dispenses – do these offer a variety of goods.

you want them to reach their destination in a good shape . the anaesthetics room is where conscious patients are wheeled for their operation pre0medication and then full anaesthetics. avoiding exhaustion and despair. Specialist examination and treatment areas In any hospitals there will be several areas where the demand demands of clinical technology will dominate design unless these areas are given special attention. 2008BARC033 . So what can be done? The problem of perspective There are many architectural precedent of interior and garden perspective vistas handled with visual eloquence which rely on three basic things Vista end attraction Intersection and interval interest High quality décor. that attracts the attention is an old ruse for achieving this. Long. Vista end attraction The aim of a corridor is to encourage people to progress along it. Sometimes in the visible distance.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 18 Circulation areas Corridors The designs treatment of corridors is a major challenge. Himanshu Tripathi. bleak. but even the most utilitarian of fire escapesstaircase have opportunities of design delight. They are the main roads which have to carry the traffic of many people and heavy good. featureless corridors are the enemies of the comfort and reassurance.. Anaesthetics and recovery rooms There is a difference in design requirement between these two. Staircase Corridors and staircase are like the outside street in that they are public pathways and can suggest menace. They can also look as though their main function is an escape in the event of fire and have notices telling you so. 5th Year Architecture.

cares what it looks like. They are like the oldest child and the youngest. committee and meeting rooms It is unknown for a hospital to remove all original features. Therefore. Operating theatres are traditionally green because in the colour-spectrum green is the opposite of red and blood is red.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 19 There is no need for bacterial sterility while and anaesthetics is administered. skirting boards. fireplaces. floor joint must be sealed and the curved . so one such room was wallpapered on the ceiling and upper walls with a William Morris paper. 5th Year Architecture. what better way than to float off looking at his magical forest full of birds. flooring and so on and lower the ceiling before inviting and interior designer to give it character. well behaved people still meet. sir down Himanshu Tripathi. No one. least of all the post-operative patient. it is these traditional senior-staff meeting rooms that tend to be the only interiors to have been allowed to retain the quality and dignity of their period because their function has not changed. However. The recovery room is where patients come round from the anaesthetics and the need for sterility is absolute. We are not suggesting that everything old is beautiful and everything modern is not. Blood and other fluids are shiny surfaces should be matt and never glossy. pre-moulded skirting boards is usually used for cleaning ease. Post-operative bleeding and projectile vomiting mean the room has to be washed down with hoses. Management boardrooms. Operating theatre It is surprising to those of us who regards surgeons and airline pilots as professional who are ipso facto swathed in glamour that boredom is a hazard of their profession. both valuable but different. 2008BARC033 . for this is not the case . by this time the original period character is lying in the rubbish skips. but older things are more difficult to replace one lost and it takes professionalism to make the two blend together. although only staff see operating theatres. some Dutch hospitals have still regarded them as sufficiently important to decorate and appoint carefully.

there will nearly always be urban features but when the buildings dominate the scene visually. like garden and water body at different intervals of negotiation. town halls sported flower clocks each summer and hospitals used to welcome all comers with banks of carefully tiered geraniums and an heraldic concern with formal. Certain features of home like garden. and implies both size and scale. Design should maximize the exposure of public area to the natural sunlight and ventilation.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 20 Chapter 4 – LANDSCAPE. Generally the departments and the public places like the waiting lobby and the corridors widely runs on artificial ventilation and lighting. TRADITIONAL HOSPITAL LANDSCAPE Landscape is what you can see from one vantage point. otherwise. It may not have mountains. In the case of hospital. The nature and extent of a hospital’s land will depend on its past history and current situation. Prolonged exposure to such environment may be harmful in some cases. and similarly the quantity and imagination of its care will jdepend upon the management in charge. and then it becomes the ‘space between buildings’. it is the patient who perceives it more than any other. 2008BARC033 . this cause some of the patients to feel congested and suffocated. Often the requirement with the good and livable built environment is its resemblance to home and homely features. Garden are a defined area which has received at some time systematic and intensive planting for athe purpose of pleasure and delight. 5th Year Architecture. it is a mere ‘outlook’. coloured shapes of Himanshu Tripathi. Many public institution have a tradition of a formal garden: railway stations used to have a good display. GARDEN AND SPACE BETWEEN BUILDINGS The built environment has the largest and direct psychological impact on its inhabitant. whether stationary or moving along. Certain features in built environment tend to enhance its efficiency in psychological terms. waterfall and cantons but it ought to have some elements of maturity and a horizon to qualify. In our hospital context of landscape. living area which applies to hospital ward tends to make the patient more relaxed about it. as do its building.

ENVIRONMENTAL ISSUE Land has become a precious commodity. beyond which was probably of many gardnerrs. 5th Year Architecture. 1. while intensive farming and the toll of herbicides and pesticides have diminished much of its quality. this expectation is true. can now expect to make. playing fields and cemeteries are so precious. Land care is often the responsibilities of estates staff for whom it is a less urgent priority than the maintenance of the building and technical resources. Their replacement is probably contract labour that gives a basic service of mowing and chopping. at first for the glory of the gentry. now a days. Nowadays. the tube and urns sitting like exclamation marks in the expanse. the average public expectation of a garden is generally stuck in this time warp whereby fine gardens imply labor and. strumming and spraying and spraying. modern alternatives but first we needed to look more specifically at the average hospital and its land. many of the experienced. and death to the aesthetic. There is an accelerating demand for allotment and city farms and organic farmers and environmentalist urge a restricted use of herbicides and pesticides. then the pleasure of the public and perhaps eventually the hospital management committee. Such tradition garden take many hours of greenhouse and site work and this expenditure inb not the sort that many modern institutions. However. retired and taken their dibbers and twine with them. which is why squares. All around there would have been raked gravel. Open land in towns and cities has always been valued by urban inhabitant. CURRENT NHS LAND USAGE There are four main reasons why so many modern hospitals do not use their land better. Parks and gardens. We believe there are viable. some new area such as community gardens and green-lines are developing.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 21 flower-planting within a border boundary. strumming and chopping. The old traditions of formal gardens and estates management have been largely lost and have not been replaced by any new form of garden creations and land management. Urban sprawl and our road network have grossly reduced its acreage. Himanshu Tripathi. traditional gardens have gone. 2. including hospitals . to an extent. These voices should be heard and the handling of the hospitals land has a part to play in this. 2008BARC033 .

But since such borders have such a strong traditions perhaps one good outside the main entrance could be justifies and it can serve as a splendid identifier of the place if it is impeccably maintained. formal planting but the means of adequate maintenance is not usually available these days. SAFTEY ASPECTS Hospitals land does present the usual possibility of attack and assault on many people who use it. In springs. ALTERNATIVE USE OF COLOUR PLANTING The love of organized colors besides the available budget could be channeled instead into hanging baskets. RATIONAL FORMAL PLANTING We are not advocating that the hospitals hand no colorful. HEDGES. Money is a genuinely constrained. CREEPERS These are usually inherited from thoughtful gardeners who planted those decades ago and. Great trees and large shrubs might be the remains of the asylum parks. Garden formality has to be a manicured. To neglect their replacement is to I mperil our reputation with future generations. as such . the unstable and those with a grudge. TREES. besides the usual precautions of lit pathways and camera surveillance. especially trees need a steady regeneration to maintain the population. dozens of such baskets could be prepared. Shrubberies also tent to attract and accumulated rubbish underneath that trunked trees do not and the provisions of rubbish bins is another feature of environmental care. 2008BARC033 . 5th Year Architecture. 4. they er often taken for granted. Low value is placed on the aesthetics benefite for the patients and staff of the quality land usage. Psychiatric hospitals experience their fair share of attack both by and on patients and hospitals generally attracts voyeurs. Dense shrubberies of a height to offer concealment may be felt to present an avoidable hazard so lower growth and trees above the head are alternatives. SHRUBS. hedges may mark the edges of land ownership or have been planted simply for their aesthetics. fully planted. padded with moss and be ready for a summer’s display. Himanshu Tripathi. these established plants.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 22 3.

The poor capacity to actually accept and care for water features is a great pity. fountain or anything to do with water for two reasons: one is that they are never. it is better to accept theses determined footpaths and upgrade and pave them in some way. there is a great deal of landscape design expertise on the planning of minor road system and car parking. we are lugubriously warned. Then the worn earth has a bulge in it like a snake that has swallowed a goat. ever maintained and other is that they arouse frantic fears of danger amongst nurse. again and again. HARD LANDSCAPE The course of path We described earlier the need for a good system that works and has visual quality.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 23 WATER FEATURES Water features are always being requested but it is firmly advised never to install a pond. because water does prompt soothing reactions almost universally. When people have voted with their feet. flowers like snowdrops. Hard surfacing qualities Asphalts and concrete are unavoidable but they do not have to present unbroken sweeps. alyssum. alliums. Native. 5th Year Architecture. but the best way to designate paths for walking is to let people’s feet describe their course. award winning water gardens and so on but visualize them in ten years’ time after yet more reorganizationto the NHS and consider what their condition might be like them. There are good instances. the NHS has only to consult wisely and in time. Stepping stone slabs in the mown grass are a neglected variant and white flowers planted along the path edges give night guidance. If people are determined to take a short cut that is where the path will appear and for the estates department vainly to place no parking traffic cones on the path merely makes everyone step around them. in spite of in addition to lights. 2008BARC033 . Himanshu Tripathi. You cn drown in an inch of water. selfperpetuating or cheap. ransoms and so on traditionally lined the path to the outdoor privy to guide you in the dark and the same principles could be used to guide people to the car park.

If you have raised borders with inches high to two feet high. There is no reason why two or three colors of the same composite slab cannot be used. on a dim day there will be no variation in its appreances. probably light in tone and laid everyehere. which is cheapest to lay. is not difficult or even prohibitively expensive and it makes a dramatic difference. and it is usual to have one type of constituted stone slabs. Walls. 2008BARC033 . we shall understand the alternatives.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 24 Suppose you wish to create a concrete courtyard for the elderly. Gaps for low flowers do not impede wheelchairs if well placed. for variety. there will be thoughtful coordination about it from the whole image down to the details of handkerchief and shoes. even if they have not bought their whole outfit at the same time. Himanshu Tripathi. but the planting of large trees. LANDSCPAE BUILDING / FURNITURE / EMBELLISHMENT The well-dressed landscaped A classically well-dressed will have achieved that state by careful planning. nor do small areas of gravels.materials. even up to twenty feet high. On the sunny day the unrelieved slabbing will reflect light and heat directly up into old eyes. you will think in terms of pavings to allow wheel chairs. Any physiotherapist wills advice that variety is what humanity needs. softness and variety. Many courtyard have no relief in the form of large trees to interrupt visually the straight. hard engineering line of the surrounding roofs. zimmer frames. If we transfer this metaphor of classical and gipsy to the appointing landscape. and intersection in the ground of cobbles and brick make all the difference. An alternative is gipsy variety where assorted items are thrown together and given a sort of unity by the glamorous if eccentric style of their combination. 5th Year Architecture. as many slab as possible covering and controlling as much earth as possible. to take paving right up to a wall losses opportunity for planting climbers and softening the engineering harshness of the building . curbs and steps Walls to sit on. unsteady walking and an easy passage. Also. while a specialist job. The use of half nosed bull bricks is a much softer edges than an ordinary squares bricks. curbs and steps to steps off should have two features.

large areas are needed. These are a few suggestion of what can be done. brings in people and they can be regarded as unpaid supervision. However. the modern one in hi-tech way and trashy one’s in gaudy manner. birds and wild mammals. There are likely to be different designs of railings. and the screens stained greens covered with creepers. Colors washes on disparate buildings an unify them. It can be reasonably feared that thicker and lass obviously manicured vegetation may increase vandalism and likelihood of attack on the vulnerable. and other land uses.permanent wheeled bins can be parked behind trellis screens. sheds and huts are often interesting and reflect the hospital history. Semi. This should involve a fresh approach to planting and paving and painting abut. 2008BARC033 . for dog walkers. In a modern movement block the entire outside facing curtain colors can be handled like a huge abstract painting of colored. cyclist. The lining of window curtains can be used as color opportunity since they are what outside sees. Its features are to encourage self-seeding. doors can be painted to a scheme and nothing softens unsympathetic architecture like creepers. WILDLIFE GARDENS This is a more of an element than a specific place. bollards. not tiny Himanshu Tripathi. Community and specialist use of land Psychiatric hospitals have been working to take patient into the community. whatever it may be. the traditional items can be painted traditionally. these things are controlled when there are a lot of people around. Pavilion. above all organizing.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 25 The best thing to do is accept the varied and various existing items and combine them in a powerful design scheme. Several Russian vines and multiple other creepers can make a huge difference to a hospital site. but the community can also be encouraged to come into the psychiatric or any other hospital site and use its land. but a well-used open track. in the way caravans are hidden in a garden. it takes dedicated organization but this could transform a bleak building. 5th Year Architecture. horse riders. your gipsy solution. . noncultivated plants and so attract insects. seats. Organizing and painting Temporary rubbish skips are difficult to hide but they can be placed sensitively. it is the desolate car park with a few unsupervised cars that spells trouble. lampposts in a typically muddled site and some unity can be achieved by painting them in relating colors but in different ways to emphasize their designs.

as it is no use encouraging insects in one small patch when they are blitzed pesticides throughout the surrounding acres. There will also need to be agreement that estates or contract staff will not suddenly mow all the seeding flowers heads and remove them to a rubbish tip a mile away in order of someone who thinks anything wildlife is untidy. 5th Year Architecture. 2008BARC033 .PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 26 courtyard. PROVISION FOR CHILDERN There is a plenty of material available regarding playing fields for adolescents and adults. This will depend upon space expediency. Himanshu Tripathi. and playgrounds for children. The problem always arise whether such facilities should be available to the community generally or just the hospitalized and the staff.

Healing the hospital design – Sarah Hosking. www.org/research/psychiatry-behavioral/research-activity 2.ucsf.cancer.org/cancerpsychology 3.in/medical/departments/as/psychiatric. 2008BARC033 .edu/psycho-oncology Bibliography 1.gov.PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 27 References 1.christianacare. www.htm 4. www.mskcc. www.tmc. 5th Year Architecture. Liz Haggard Himanshu Tripathi.

5th Year Architecture. 2008BARC033 .PSYCHOLOGY IN CANCER HOAPITAL A discussion on built environment 28 Himanshu Tripathi.

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