Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Batch: 2013
Date: 11/21/2016
ABSTRACT
Winston Churchill concisely expressed the effect of architecture and our surroundings with the
comment that: We shape our buildings and later they shape us.
The intent of this dissertation is to explore how architecture can inform healing or provide spaces
and events where healing can take place. We as human beings have an inner connection with our
environment by physical, mental, emotional and spiritual means. Healing cannot be understood in
isolation from the factors that operate in the dynamic life of an individual. These include the self,
the family, the community, the environmental context within which life is carried forth, and the
world of spirit or essence.
Furthermore, the arts and art therapy have, over the years, been used to heal different aliments
such as cancer, mental illness, aids, addiction and the elderly have been successful in doing so as
it heals across all ages and race. The question I pose is can architecture do the same? Besides,
can architecture play a superior role in healing? In our built environment we often interact with the
buildings themselves without knowing the fact of relationship between building and surroundings.
Can we create those interactions by evidence based design methods? This dissertation
summarize the principals of life enhancing role of architecture and planning in the healing process.
Through a theoretical approach including the history of healing architecture and the introduction of
architectural and anthropological theories, the project defines four main parameters that should be
included in the design of future spaces for social support: Functions that reect the everyday life,
materials & textures with a homely atmosphere, importance of daylight in hospitals and details
with interior design in the human scale.
The study also comprises of case studies of two hospital which lies in Delhi NCR, india (1.
Medanta hospital , gurgaon 2. Fortis hospital , gurgaon ). Both the hospitals are multi specialty
in nature. This study includes the innovative solution for healing environment inside and outside
the hospital building through site planning , building planning , interior of the room , views, social
spaces such as waiting areas, atrium , corridors, food court , healing gardens , etc.
ACKNOWLEDGEMENT
The Research Paper presented here would not have been possible but for the guidance &
support of
Ar. Tanya Gupta, HOD, School of Architecture for extending her support & valuable
guidance whenever wherever required.
DIPESH ANAND ,Guide & mentor for her/his relentless pursuit of high academic
standards, the can-do attitude & imbibing professional ethics have helped this project meet
high academic standards & professional working.
My parents who have taught me to strive for perfection in everything I do.
Any other person
And also my friends & colleagues who were always around to help me.
Appreciation & gratitude is owed to them.
DIPESH ANAND
Student
(_2016_)
Batch
Date - 12th december 2016.
PAGE NUMBER
1. Introduction
11
12
15
15
19
2.1 Introduction
20
22
22
34
50
51
53
57
59
60
61
4.1.1 introduction
62
72
73
73
of coherence factor
B. Evaluation model in relation guidelines set through
88
TABLE OF CONTENT
PAGE NUMBER
92
4.2.1 introduction
93
94
99
99
of coherence factor
4.3 Analysis / interviews
110
4.3.1 interview
4.3.2 analysis
5. Conclusion
114
6. Bibliography
7. glossary
The overall
1. INTRODUCTION
1.
INTRODUCTION
aim of this research is to study the life
architecture which increases the healing property of a building through architecture and
planning guidelines. The goal of such healing spaces are they can reduce fear , stress ,
tension and give relief for some time which actually results in healing of the patient. The
study has also been carried out to acknowledge the critical experience of patient , staff
For detached spectators it seems obvious that, when building and planning hospitals, the
architectural environment surrounding patents, families and sta , should support the
considered the direct cause to stress, anxiety, frustration and generally longer
hospitalization due to the unsuited facilities and environments in todays health care
system.
architecture
This dissertation is done to have a clear and comprehensive information on how to create
a healing environment in light of growing healthcare demand in India. The aim is to have
a humanizing architecture that can positively contribute to the healing process. It should
make the patient enjoy the best of bioclimatic comfort. Healthcare Design must also
satisfy professional requirements.
The physical environment of the healthcare facility should firstly do no harm and secondly
facilitate healing process.
1.1 Preamble :-
Objective - The aim of this research paper is to obtain an in-depth understanding of the
physical aspects in hospital design and how these physical aspects play important roles in
creating a healing environment. Other objectives of the present paper are:
To acknowledge the critical experiences of patients, staff and visitors in hospital
buildings,
Importance of daylight in hospital architecture,
To outline the physical aspects in healing environment,
To investigate the previous and current research available on the subject of health and
environment, design for healing and the effect of day lighting on human beings,
To examine the elements of physical aspects of existing project brief of public hospitals,
To study the need for social support during hospitalization,
Scope - The scope and the intention behind the design concept healing architecture is,
as described, not a new way of thinking, but is rather a continuation of earlier assumptions
that the surrounding environment, daylight, nature views and access, etc., had a healing
aect on patents.
This research focus on recovery of the patient which reduces the rehabilitation time which
in turn reduces the stay time in hospitals. The research intends to change the mind of the
designer and improve the designing techniques used by the architect in designing a
hospital.
Thus we have explained an equation that says the importance of architecture in hospitalization
which reduces the healing period through its various examples given below:1. Homely atmosphere or hermitage Authentic healing modalities
Individual process
Spiritual guidance
Hermitage club spa - anti stress
Hermitage workshops
Yoga centre
Meditation centre in nature
Architecture of hermitage should be in relation to natural built environment.
2. Connection to nature Nature window views
Garden accessible to patients
Nature art : no abstract at
Daylight factor
Internal courtyard connected to ward , patient room
Quiet in the ccu (coronary care unit)
Music during minor surgery
Air quality
Landscaped courtyard
Floor to ceiling windows
Therapeutic benefits
Landscaped setback
Front porch - (overhang may scale down the size of the building)
Entry garden
Plaza(include trees, shrubs, overall is not of green image , but of a paved urban plaza).
Roof terrace( potentials for expansive views).
Viewing/ walk in garden
Sound of water and attraction of birds to the fountain are particularly appreciated ( roof
garden)
Roof garden for mood change
Wide walkways outside patient rooms provide a buffer from garden activities.
A covered patio style coffee shop provide and shelter for an outdoor eating area within a
garden.
10
In the 17th and 18th centuries, the dual emergence of scientific medicine and Romanti- cism
fortuitously combined to encourage the re-emergence of usable outdoor spaces in hospitals.
The intention behind the concept of healing architecture seems immediately obvious and
straightforward, and it seems rather strange that not all hospitals are based on these concepts
of integrating the architectural environment as support for the medical treatment. However, the
idea of a beneficial effect on patients healing process sup- ported by well designed
surroundings is not a new concept. In fact, these ideas may be traced back to thoughts and
ideas evolved in the 18th century. At that time, leading doctors and nurses proposed changes
in the layout and design of hospitals in order to reduce the danger of contamination by
designing smaller wards and increasing ventilation. Later these theories are followed by
Florence Nightingale, who in Notes on Hospital from 1859 published her philosophies and
thoughts of the supporting effect of aesthetic environmental settings for the patients physical
and psychological condition. In Denmark, the first public hospital is planned by request of king
Frederik V in 1752. At that time, the medical knowledge was underdeveloped and the
experience of building health care settings were naturally lacking. In the 17th and 18th
centuries, the dual emergence of scientific medicine and Romanticism fortuitously combined to
encourage the re-emergence of usable outdoor spaces in hospitals. The notion that infections
were spread by noxious vapors spawned designs that paid special attention to hygiene, fresh
air, and cross-ventilation. The so-called pavilion hospital became the predominant form
throughout the 19th century. Two- and three-story buildings linked by a continuous colonnade
and ventilated with large windows marked the design of the influential Royal Naval Hospital at
Ply- mouth, England. Recommendations for hospital garden de- sign written by German
horticultural theorist Christian Cay Lorenz Hirschfield at the end of the 18th century uncannily
foreshadow the findings of researchers such as Roger Ulrich at Texas A & M University, who
documented in one study the healing benefits of a view onto vegetation for patients recovering
from surgery (Ulrich, 1984).
11
Reduce staff stress and fatigue and increase effectiveness in delivering care
2.
3.
4.
A basic requirement for the architect and the design team is to study or examine perfectly
the research data to have relevant and use of EBD results in a specific building project
followed by a re-contextualization before implemented in a project (Hamilton 2003 and
Hamilton 2004).EBD this way not giving answer related to hospital planning it just
documenting the influential factor of architectural environment ,which have a great influence
on our mind.
Evidence based design in healthcare architecture is not solely capable of ensuring future
well-designed hospitals even architects and planners play a crucial role in evolving the
process. as a requirement in current world and expectation by decision - makers , its an
obvious task for designer to explore more on this field to create future healing environment
for patients , staff and visitors.
12
1.6
Present
and future of
healing
architecture
The idea behind
the
concept
of
healing
architecture
not
is
new
concept
but
is
rather a earlier
explanation
more
in
advanced
techniques
the
that
surrounding
environment,
daylight, nature ,
views
and
patients.
todays
in
planning
of new modern
hospitals
THE ARCADE AT FOTIS HOSPITAL , GURGAON
has
shifted to patientcentered
care
and
well-
being
the
of
the
13
14
I believe that this is the time to stop counting patients as number treat them as humans and
patients, like everyone else , having social attraction and basic need for encouraging social
interaction. otherwise, we will simply build the same hospitals again and again.
The fight against the cancer is not solely doing research in medicinal treatments , but it is
required that what cancer does to a human being , its physical and psychological conditions.
Especially through several course of disease it is essential to have social interaction with
their closeness to feel safe and comfort in hospital environment.
some cases directly related to the social and emotional support. (Zachariae & Christensen
2004) The human is generally a social creature, and our relationship with other people our
social relations is a central aspect of our life. The amount of social support that cancer
patients is experiencing, and especially the possibilities to discuss ones disease and
treatment with other cancer patients, is considered very helping in the stressful periods of
the disease. (Zachariae & Christensen 2004)
The diagnose of cancer generally cause depression , stress , tension , anxiety among the
cancer patient and their families. the risk of developing a profound depression is increased
due to isolated social spaces and lack of control over the situation. the patients are
experiencing upturn process of adaption in order to accept and understand the disease,
changed prospect, various treatment., etc. at that point of time social support is much more
of need to conquer depression and stress.
15
may are from different places, but they communicate in same language at that time
( Rasmussen 2003).
The solidarity with other patients may range from intense intense conversation and social
support to inspiration of other patient activities and actions. that's why patient don't feel left
alone with their disease. particularly at time of changed treatments social support from other
patient is proven useful.
1.7.4 Patients and their families
A serious disease cancer not only affect the patients but solely the entire family. Partners,
parents, children, close relatives are also implicated by the disease and long period of
treatment. As it is important that families facing same situation get socially interacted with
each other at equal status. in these forums , families can talk about the problems facing
them without influencing the patients. Families to cancer patents are experiencing a tough
psychical stress, but their well-being is rarely in focus. Depression, confusion, anger,
sadness and other negative feelings and emotions are often unavoidable consequences for
the relatives to a cancer patient, which may be overcome or reduced with increased social
support to the families themselves. (Hansen & Thastum 2005)
1.7.5 Social support in future oncology ward
Though we have stated that social support is very much of importance in treatment of
cancer in order to satisfy their mental condition. the main focus in designing phase there will
be patients themselves and the need of their families will be taken into considerations. there
will be such living areas in single patient room for the social interaction of their families so
that they do not feel that they are totally in medical staff .
16
17
18
contrary the social space may seen as intersection between a public space and a homely
environment. Usually our everyday activities are performed with our family and friends,
while in the hospital these simple familiar activities suddenly are occurring with unknown
people in a semi-public space.
If we improved these social spaces then the healing power will also get increased and may
even considered as an influential elements in regard to healing architecture. There are,
however, not found any specific EBD research that define detailed aspects in regards
to design and physical planning of these spaces. (Ulrich et al 2008) Instead, the project is
stating the thesis that by introducing architectural and anthropological theories, a more
thorough understanding of the human perception of space and even specific transferable
architectural aspects There are, however, not found any specific EBD research that define
detailed aspects in regards to design and physical planning of these spaces. (Ulrich et
al 2008) Instead, the project is stating the thesis that by introducing architectural and
anthropological theories, a more thorough understanding of the human perception of space
19
and even specific transferable architectural aspects may be defined and incorporated when
designing social spaces with inviting, attractive and sensory aspects in future hospitals.
Social support during hospitalization is experienced in various levels of intensity. The need, the promotion and finally the
development of social interaction is the main essential steps towards the potential social support.
Lobby of American
hospital in Dubai
University Hospital
20
21
mentally ill persons have a larger bubble of personal territory. But the places created must
still make people feel encompassed and secure.
In pune "Mukthangan De-addiction centre" observed that patient rooms are placed near the
amphitheatre
space
near
the
natural
elements
like
trees,
sunlight
and
gentle wind to heal their agitation. The language of making public activity inside the private
spaces are done also in Mukthangan rehabilitation centre with the help of well lit
amphitheatre space in the centre enclosed by rough wall to give those agitated people a
sense of protection.
social participation and elective
seclusion
successive
expansion
personal
of
the
sphere
and
publicity
are
either
alone
or
in
22
binding
connection
with
others. The social contact on the low intensity scale is therefore an evident and important
possibility for persons to interact with others on a casual level, and perform as transition
between various kinds of contact. (Gehl 2003). The establishment of such common
attractive and inviting social spaces are very much required for day meeting to interact
socially patient with equal status for social support which enhances their knowledge about
such situation.
2.2.3 Activities in the public zones
In regards to activities in the public space, Gehl (2003) defines three types; essential
activities, optional activities and social activities all with di erent demands to the physical
environments.
The
essential
the
medical
treatment.
The optional activities are
common facilities,
23
in his
psychiatric ward
apparently patient wee talking less to each other after such change in arrangement of
furniture in such a sociopetal arrangement, the social interaction increases in that same
ward. When designing future hospitals we should keep in mind the statement of Edward
T.Hall
and change can be made through such small arrangements which can change
24
sociofugal spaces to sociopetal spaces. Layout of furniture plays a very crucial role in
enhancing the social interaction suppose if the chairs are placed back to back then the place
automatically turned into sociofugal spaces. however, if the layout of the chairs are
immediately changed they are face to face then the place changes to sociopetal spaces.
In some occasions the sociofugal setting would be preferable, for instance when studying or
reading, and what is considered sociofugal in one context might even be sociopetal in
another situation depending on the occurring activity and the people involved.
The challenge for the architect is consequently to design spaces with accordance between
the physical space and intended function and to maintain diversity between the
dierent spaces in order to give people the choice for social interaction or privacy depending
on the circumstances and their own state of mind.
25
Through other studies of human behavior in public spaces, Gehl (2003) argues, that the
social activities has its own self-prevailing effect, where human actions attract attention and
thereby more people. These studies show an instance , that the use of benches are
depending upon their orientation , where those situated where more human activities are
done neither in quite green environment. (Gehl 2003) As well as the sizes of furniture the
orientation and layout also have significant importance in regards to use and social
interaction.
26
Finally, the placement of furniture in the room is noticeable, where seating environments
along with the inner facades of common open spaces or in the transition zone between two
areas usually are preferred. In these places ones individual exposure is limited, and it is
easier to create an overview of the surroundings and to feel comfort in these situations.
(Gehl 2003)
furniture
27
28
As concluded, my research is that spaces for social support in future hospital environments
is defined as an intersection between the public space and physical environments with a
comfortable, homely atmosphere - a social place, where patients engage meetings and
social interaction, thus enabling social support.
The first step towards social support is consequently for the patients to meet each other,
which may include the theories of Gehl (2003 and 2010) and Hall (1973), described in the
previous chapter The public space - how to promote social interaction. The next step is to
develop this initial social interaction to intense level, and this process is believed to require
specific demands of the physical environment. In our daily life these levels of superficial
conversations are usually performed with our families or close relatives in safe and familiar
surroundings. (Rasmussen 2003) When hospitalized, the family contact may be reduced
(Ulrich et al 2008) and the environment today is often characterized by institutional settings
far from familiar and well-known. Hence, the two aspects that form the basis of this social
interaction and support in our everyday life are apparently not present today.
From architectural point of view it is very difficult to raise the visits in patients room. instead,
other patient and staff can act as a family member at that point of time may be even for
better social support in some health related issues.
In hospitals patient are confined to such environment where the general freedom of choice,
is strictly limited. However, the things concerning the social interaction and the allocated
social spaces do not necessarily have to be so di erent from the spaces we recognize from
our daily life and our own homes. By changing the design of hospital dayroom of patient to
an inviting , familiar and homely environment recognizable for the patients leads to better
social support.
29
Finally,
arrangement
the
details
and
of
30
is
believed
to
be
the
materials
and
textures
of
the dayrooms. Today these rooms are often marked as institutional and are often
decorated and furnished as the bedrooms, hence the distinction between the dayroom
and the rest of the hospital are often immaterial. The materials used in todays hospitals
(wood, fabrics, textiles, colors, etc.) May be the same as we use in our own home but the
way they are used have very dierent conceptions. Textiles are for instance a material
that is used rather carelessly, and does not derive the potential as we experience in our
domestic environment. At homes the textiles are applied for curtains, cushions,
blanket,.etc all adding a tactile perception to the material, which imply comfort and
coziness to the space and experience. Today this critique may be noticed in many
hospitals, as the high restriction in regards to hygienic and durability demands have
excluded nearly all tactile materials, including textiles, from many applications. However,
recent research and development in smart
textiles is improving the potential use of textiles
in new recognizable ways in future hospital
environments, where the use of tactile and
sensory materials, like textiles, would be possible
to implement with great beneficial value. Finally,
the details and arrangement of furniture should
reect a homely environment. The size of the
A private space in the sun at Maggies
London
room,
furniture
orientation
and
the
room
31
Summary
The homely atmosphere in future hospitals may be difficult to define, as our home is
usually very personal and individual and therefore impossible to transfer directly to
a health care environment. However, it is the research of this project, that by
implementing three fundamental characteristics of our home and everyday life, including
functions; materials and textures and details, it is possible to create a more homely
atmosphere in the social spaces, than we experience today. This atmosphere is
considered beneficial for the more developed levels of social interaction and social
support, as the conversations in safe, comfortable and homely environments are
believed to be more outspoken and emotional than the acquaintances in the regular,
standardized and clinical dayrooms we experience today.
32
maker, urban planners and anthropologists if the environment is not providing possibilities
for social activities, there will not be any interaction between patients-hence no social
support. The architectural eects described in the previous chapters, will in this chapter be
compiled in three guiding subjects, including functions (1); materials and textures (2)
and details (3), and through a translating description, their aspects are defined in
regards to the context of hospitals. This theoretical approach will define the main visionary
guidelines for the design phase of this project as well as form the basis of the evaluation
model used in the later following case studies.
The theory described by Gehl(2003) and T.Hall (1973) states that people attracts
people, if the social area remains unattracted then physical environment remain
empty all the time. When patents or their families have engaged social interaction,
maybe through the attractive functions, they should develop these contacts, which call for
spaces recognizable from their own home, partly achieved through a mix of functions
reecting the everyday life.
anthropologists, the materials and textures should overall assist in creating a familiar,
sensory and homely atmosphere. The final aspect considered as one of the main
guidelines for future social spaces are the details and interior planning in human scale,
concerning scale, personal distances and sociopetal spaces. Often small details change
the
way
we experience a room, and some of the main physical elements in todays hospitals, like
acoustic ceiling sheets, integrated artificial lightning, vinyl ooring, etc. are only
supported by the details of for instance co ee serving, greenery, arts and furniture, all
together defining the social space as institutional, inhuman and basically unfit for social
interaction.
2.4.1 FUNCTIONS
REFLECTING THE EVERYDAY LIFE
We often see uninspiring and unattractive spaces in hospital which is not used by
the patient. Above all , patient should have choice between social and private
space, ideally a gradual transition between them. Private spaces may appear in
single room but a new concept is needed to get complete framework of common
spaces and dayrooms in the future should appear social. This social aspect may derive
33
from inviting, attractive and socially obvious functions performed by patents and their
families in the common areas of the patent ward.
Accordingly, the specific programming of the common spaces in future hospitals is
essentially important to design very deliberate. Firstly, the patients should engage
acquaintances, through a process that may be compared to the human interaction in
public spaces or the small talks with our neighbor in the front yard. In a future patent ward
these informal meetings may occur in the common dayroom or even in natural ow
intersections and recesses along the hallway. Secondly, the patents should develop these
initial relationships, through deeper conversations and social interaction, which may cause
for more recognizable and familiar settings, reected in the patents everyday life. When
considering functions in the common spaces, these might actually be quite parallel to the
activities performed in our daily life and the planning of a patient ward may
even be compared to a regular single-family house having rooms for: conversations and
drinking coee in the living room, relaxing in the lounge area; dining around the kitchen
table; simple cooking in the kitchen; entertaining around the television, etc. By introducing
these social activities in new-designed patent wards, and by making them optional and
inviting for both patients and their families, spaces for social interaction and support are
believed to have improved conditions in future hospitals.
34
35
Besides reecting the everyday life through planned activities and programming of the
social spaces, materials and textures also have significant inuence on the way we feel,
act and interpret the room, and should reect the familiar and homely environments we
are
accustomed
to
from
our
own
house.
A deliberate choice of materials for any room, i.e. the visual surface and the tactile
perception, are often under prioritized in many projects, and in health care architecture,
the high demands for hygiene, cleaning and durability are usually decisive factors when
considering materials in both bed rooms and common areas. Consequently, the
spaces often appear clinical and institutional, with standard equipment and furniture,
acoustic ceilings, white plaster walls, etc. As regards to social interaction, these spaces
are predicted to limit the potential, as the patients will adapt their behavior to the
institutional surroundings with no conclusive benefit for engaging social interaction and
social support. Today human qualities are competing against hygienic standards and
general call for durability, and the predominant challenge for the health care architect is
therefore to balance between the homely expression and the rational clinical demands,
keeping in mind that the close compromise may determine the success or failure of the
spaces for social interaction.
36
37
2.4.3 DETAILS
INTERIOR PLANNING IN HUMAN SCALE
"In context of EDWARDT.HALL(1973)and GEHL(2003)"
Small details may change our use and perception of any space rapidly, and if only
prioritized by the architect, spaces for social support may be improved significantly in
future hospitals. First of all, the overall scale of the room should be familiar in size and
easy to overview if more personal conversations should take place, and even in regards
to dimension of the furniture, Halls (1973) theories regarding social distances may be
implicated. Smaller tables will for instance force patents to sit within their intimate
distances (0,45 1,30 meter), which may be advantageous for deeper conversations and
social support. However, if the patients do not know each other yet, the small table and
intimate distance may be an unconscious limitation for patients to join an occupied table,
and the patients will then never engage important initial contact. The design of details and
furniture should therefore contemplate the intended social concept in the common areas.
In this regard, Gehl (2003) is furthermore describing how the placement and orientation of
furniture in public places inuence the specific use. Seating environments along the
perimeter of the room is usually preferred, where the individual exposure is limited, and it
is possible to create a comfortable overview of the surroundings. Details in the orientation
of the furniture may even define the social status of the room, where a face-to-face layout
facilitates a sociopetal behavior and the back-to-back arrangement is creating a
sociofugal, private space. Ideally the patent ward should provide both private spaces
(sociofugal), passive observational spaces and social spaces (sociopetal) - although not
necessarily in the same room. (Hall
1973). Today, details like light fittings,
acoustic
regulators,
blankets,
homely and
inspiring
atmosphere
promoting
social
38
39
In order to visualize the substance of the parameters (functions, materials and textures,
and details), defend in the previous chapter, three various case studies will in the following
chapter be described and evaluated based on the analysis form stated below. The overall
thesis of this project defining the future spaces for social support as an intersection
between the public space and the homely atmosphere is the overall basis for
choosing three individual cases for analysis and comparison. Secondly, the cases are
selected depending on the patents/persons motivation for attendance, which follow the
three guiding needs defined in Maslows hierarchy pyramid (Poston 2009). The basic needs
as exemplified in a hospital (case 1), the psychological needs is exemplified in a cancer
caring centre (case 2), and finally the self-fulfillment needs which is exemplified in a highend gourmet restaurant (case 3). To summarize the chapter of the wide-ranging case
studies, a concluding compilation will define the common relevant guidelines for the design
phase.
40
41
CASE 2- HEJMDAL
CASE 3 - RESTAURANT
GERANIUM
EMERGENCY
DEPARTMENT
42
Lund University Hospital is placed in Skne, Sweden as one of the larger regional hospital
with 980 beds. The basis for this case study is the surgical emergency department
(KAVA) with 24 beds and 4-500 patients per year hospitalized for 48 hours in average.
Patents in this ward may be compared to oncology patients in regards to medical/surgical
treatment and their general physical condition and mobilization. The ward consists primarily
of multi bedrooms, where the beds are separated with curtains. When this specific ward is
chosen as hospital case, it is due to the recent modernization and remodeling performed a
few years ago in connection with transferring the ward. Here one of the focal points, among
others, was new arrangements of social spaces. The recent buildings are constructed in
1968 and is today causing problems with the physical surroundings in regards to patient
treatment and human healing condition. When the ward was chosen to move to another
oor, sta was given the possibility to rethink the interior layout and organization of the
ward without changing the main construction. Nurses and other members of sta initiated a
process, where future requirements, visions and ideas were discussed and planned for the
new settings. The intention of improving the social spaces was strong, and the fact that it
was even a focal point in the nurses vision for a future ward shows appreciated awareness
of its importance. The base in the new dayroom is the sta operated ward kitchen, where
the meals to the entre ward are finalized (after being brought to the ward precooked from a
central). Sta is consequently always present in the room performing a homely activity (in
regards to cooking and not the method), and brings life and atmosphere to the space.
Concurrently, the kitchen oers snacks and drinks directly from the kitchen counter, and
mobilized patients can always get something to drink and eat directly from the kitchen like
in their own home.
The general use of
materials
and
textures indicates a
clinical environment
with
institutional
furniture,
vinyl
are
single
Dayroom in the KAVA ward (Surgical emergency department). The social space is
placed at the end of the blind corridor leading to the patent bedrooms.
elements
like a fruit basket, freshly brewed coee, biscuits served in glass jar and blankets in the
43
lounge
area
that
attempt
to
drag
the
room
towards
more
homely
atmosphere. Along with the kitchen function these small details actually do support the
domestic feeling of the dayroom with added features that may revive memories from
the patients everyday life. However, the first impression and the overall experience of the
dayroom as clinical and institutional is still predominantly. The intention of making the social
space homely is noticeable although it lacks in completion of the commenced ideas, and a
deliberate holistic approach towards creating social spaces in future health care
environments are still needed for perfection.
FUNCTIONS
What are the options for residence?
The dayroom is considered the primary place
for residence outside the bedroom, although
there
are
some
smaller
furniture
What
are
the
optional
functions?
the
primary
activity
is
the
to
time
of
participation?
observation
(between
44
breakfast
and
lunch),
periods.
There
was
dining
table
entertainment
in
and
the
TV
lounge
simply
seems
be
to
there
moderate
and
short
description
of
used
grayish
vinyl
and
to
hygienic
demands
and
45
materials,
textures,
furniture?
consistent
and
deliberate?
The
furniture
in
the
lounge
area,
accentuate
any
stories
in
the
dayroom
between
various
deliberateness
in
the
DETAILS
HEALING ARCHITECTURE IN HOSPITAL DESIGN
46
kitchen
area
and
dining
is
consequently
Other details?
Specific details are worth mentioning as room accessories
including a fruit basket and containers with biscuits in the
kitchen area, as well as the blankets in the lounge. The intention of making a homely
47
environment is remarkable,
although not quite succeeded.
The overall impression of
the room is due to the general
use of materials still significantly
institutional and it takes more
than just small details to define
attractive and welcoming social
spaces.
CONCLUSIVE REMARKS
Lund University Hospital is a
case
illustrating
the
good
intention of improving the social spaces in the existing hospital wards. It is a significant
progress just to call attention to the problem of unfulfilled common areas, and with the
enhanced focus from the sta, some hospitals are taking the lead and in Lund with
various success. The fact that a fair amount of square meters are dedicated to the dayroom
is positive, and the room even has some small elements, where the intersection between
the homely atmosphere and the public space is combined - although not convincingly
enough.
The
room
is
still
experienced
quite
institutional, especially expressed by the overall materials like vinyl ooring and acoustic
ceiling sheets, and the lack of tactile and sensory elements. The idea of letting the kitchen
be a central part of the room is in general good and even recognizable from our own home,
but the fact that it is closed o from the patients may instead work as an amplified reminder
of hospitalization? The kitchen table towards the patent area, is however a self-service are,
which share familiar elements, although the freshly brewed coee, which is chosen for
its homely character, instantly turn institutional when being served in 3 liter coee pot with
stacked industry cups. The small details could easily have been better thought through, and
why should the patients not have access to a smaller part of the real kitchen themselves?
In general the dayroom in Lund meets many of these adversative examples, where the
intention lacks completion due to small details that easily could have been improved
if they were only in focus. The room is therefore experienced as institutional even though
48
some positive elements do exist, and the future design of these spaces needs a
more holistic approach towards material use and the general perception of space.
Compared to the other dayrooms experienced in Lund University Hospital, the KAVA ward
is indeed a consolation. On the oor below the dayroom is a 15 m2 room in the middle of
the building envelope with no windows and natural lightning, and consequently it seems to
be empty most of the day. The spaces for social support in future hospitals should, in
regards to design and planning, be more holistic and well considered, than it is experienced
in Lund.
3. SALUTOGENIC DESIGN
MODELS
3.1 Antonovskys Theory of Salutogenesis
3.2 Alan dilani - psychosocially supportive design
3.3 Roger ulrich - theory of supportive design
3.4 Jan goelbiewski - neurology of supportive design
49
50
51
This includes the designers and developers, as well as the doctors, staff and possibly the
patients and their families. If the entire team understands the impact that design has on a
sense of coherence and in turn on the success of a project, they may be more likely to
support the design process and to encourage the upkeep of the facilities. The organization
should measure the sense of coherence; the staff should comprehend it and act on it
52
One of the conditions for health promotion in hospitals is to create an organization that
provides the major parts of care services as close to the patient as possible, within the
patients familiar environment. An emphasis on patient-focused care presupposes a
different building structure, as it requires a decentralization organization. Instead of the
traditional grouping structure the new model for RIT 2000 (University Hospital in
Trondheim), in Norway, has been organized around the patient and his/her disease. The
planning for RIT 2000 has broken important new ground by integrating and extending
concepts such as a patient-centered care philosophy and environmental design, and multi
disciplinary care teams.
Traditional wards where the staff is based somewhere in a room far away from
patient rooms will disappear. In modern wards, there will no longer be a nurse
station but a centrally placed workstation, which is easy to reach, and where the
staff is always available.
From there, the staff should be able to survey and watch a group of patients within a very
short walking distance. This arrangement is called a cluster. A ward can consist of two or
three clusters which can easily be coordinated and flexibly used depending on the patients
demand for care. Communication and contact between staff and patients is made easier in
this way, creating a feeling of security for both staff and patients.
Research has shown that access to nature, daylight and other wellness factors like art and
music can result in the patient using fewer drugs and spending less time in the hospital.
Nature can affect our emotions positively. It can easily catch a persons attention or interest
and in turn can stop or reduce anxiety while bringing about desirable psychological
changes. It can reduce blood pressure, ease pain and stimulate our senses positively.
An increase in the consideration of wellness factors within design could have beneficial
effects on well being and health processes and thereby creates environments that are not
only functionally efficient but also highly psychosocially supportive.
53
54
55
56
CURRENT EXAMPLE:The Khoo Teck Puat Hospital (KTPH) in the city / state of Singapore is setting new standards
for incorporating nature into the design and layout of the health facility. Tim Beatley in UVA
Design describes it as arguably the greenest, most biophiliac hospital in the world.
Using the principles of biophilic design, and incorporating natures influence into the
design of healthcare facilities has numerous positive benefits.
Interfaces Essence range has been designed using natural patterns and hues to create
spaces that echo nature; helping hospitals become places of rejuvenation and healing
rather than decline and sickness.
57
58
59
60
4.1.1 INTRODUCTION
Location : sector 44, Gurgaon
Site area : 43,303 sq. m.
Built up area : 65,961 sq.m.
FAR : 1.52
Principal Architect : Ar. Rajinder kumar,
Rajinder Kumar Associates, New Delhi
It has 430 functional beds, with a further planned increase in beds to 1000.
FMRI is accessible easily by road, It can also be reached using Delhi Metro, as
the hospital is located opposite to the HUDA city metro station
DEPARTMENTS
Plastic Surgery
Ophthalmology
Pulmonology
Plastic Surgery
Dental Sciences
Internal Medicine
Invasive Cardiology
Paediatrics
C-DOC
Neonatology
Radiation Oncology
Radiology
Rheumatology
61
ENT
LOCATION :-
62
NIEGHBORHOOD CONTEXT :-
63
64
65
66
There are tremendous reason for choosing this hospital , main aim to create
an environment which should not give a sense of boring hospital. The design
philosophy behind this hospital to provide the health and well being of the
people they serve through integrated, innovative, and compassionate care,
also creates spaces that allow for privacy, rejuvenation, choice, humanistic
scale, feel and experience, communication, and collaboration. The Hospital
should incorporate new trends like wellness, technology and creates a Gen
Next Medical Center which sets new standards for healthcare focusing on
healing & nurturing robust health. At the south corner is a quiet & sun-filled
healing garden for patient, recuperation & areas of respite for staff and
families. All major areas in the hospital will have natural light for healthy and
sustainable environment.
The architecture of this hospital considered the healing source, although
factors like daylight, room atmosphere, sound, music, art and optional privacy,
altogether are believed to assist in creating carefully designed environments
that affects and supports the psychological and physical healing of the
patients.
With acceptance of the architectural inuence on human healing aspects, it is
even more obvious that healing architecture should be incorporated in the
planning of future hospitals.
67
of
ones
sense
of
coherence
is
determined
by
three
key
factors:
1. WAY FINDING
Modular planning of clinical floors to optimizes flexibility and
improves way finding.
Clear organization and simple circulation system within medical
areas eases patient and sta use.
Flexible floor plates provide shared practice space, systems, and
amenities for various clinical modules and sub-specialties.
Ward layouts in older hospitals generally provide long corridors organized
around a central nursing station, where medication and charts are
located. Research has shown that nurses spend much of their time
walking up and down halls increasing fatigue and stress and sharply
cutting the time available for observing patients and delivering direct
care.
Common console for cathlabs , MRI, X-RAY , AND ICT decreases the
circulation pattern proves efficient for patient and sta.
68
PATIENT USE.
69
70
71
2. PERCEPTION
The experience already starts when guest or patient enters the lobby area , where an
welcoming fountain sculpture and reception welcomes the visitor with a holistic experience.
In a beautiful designed combination between the functional space and interior decoration ,
the holistic experience make you feel forget where you really are. When focusing on the
lowest levels of Maslows pyramid of needs, the physical and psychological, respectively,
the high-end hospital
the visitors, and Fortis is accordingly providing a holistic experience, where design and
atmosphere is united in a multiple sensory expression.
72
3. LANDMARK
While entering the central courtyard we see a white sculpture titled Loveable Curious Child
a baby with a stethoscope plugged into the ground, creates a landmark of the hospital
building. Around this sculpture many people take selfie and sit together, seems to be an
vital part of the hospital social space.
73
4. PLEASURE
It also accommodate a small cinema name as " FORTIPLEX", for visitors it is a recreational
hall where visitors can watch a cinema for several time, so that they will get some
relaxation and stress free time
74
75
person is in control of his or her environment and life circumstances is very fortifying the
feeling that you are totally out of control is absolutely disempowering
1. AESTHETIC ELEMENTS
2. NATURAL LIGTH
Survey question
Considered sunlight to be a nuisance
Considered sunlight to be pleasurable
Considered sunlight to be calming
Considered sunlight to be unfavorable
Patient
Staff
2%
55%
91%
33%
95%
1%
37%
18%
The study found that these patients subsequently required less narcotic pain medication,
experienced a shorter hospital stay, and had fewer negative evaluative comments in
nurses notes.
76
77
All major areas in the hospital will have natural light for healthy and
sustainable environment. Skylight at the roof transmitting natural light
into the most common & waiting areas.
The integration of natural physical environments into treatment for human sufferers has
always proven to be an effective course of action. Elements in nature emulate qualities of
calmness and serenity that are necessary for a healing environment. There are two
benefits of windows: one is daylight and the other is view.
3. GREEN ENVIRONMENT
78
among themselves. it also provide a sense of supportive design for patient as plants
represents
life
growth
and
hope.
they
can
provide
interest
and
diversion.
1. SOCIAL SUPPORT
79
ARRANGEMENT
MATERNITY
OF
FURNITURE
WAITING
AREA
IN
FOR
80
Patient Based Art Programs include artwork that is selected based on the unique needs of
each patient groups (such as Cancer, Pediatric, Geriatric, Women, Heart, ICU, Rehab and
Psychiatric). Patient Based Art helps to deinstitutionalize the clinical setting while illustrating
a sensitivity to location and patient demographics. Patient based artwork can also aid in way
finding by helping to visually identify areas.
A successful healthcare art program consists of a coordinated series of visual elements
placed in public and private spaces throughout the facility. The selection of these elements,
as well as their size and placement, is crucial to the success of the program.
If photographs and slides of nature are viewed positively and reduce stress, it is probable
that artwork that replicates nature would also have this effect. Research on adult patients
suggests that by infusing art into the healthcare setting, patient-focused design may foster
improved moods or reduce stress that would impact the negative thoughts that could impede
the healing process.
81
ALL
PHOTOGRAPHS
ARE
CLICKED
BY
82
3. VIEWS
stays,
had
DIRECTION.
fewer
scores
for
negative
minor
complications
comparatively
therapeutic
evaluative
postsurgical
natural
scene
had
influences,
it
83
largely
featureless
brick
wall.
B.1 FUNCTIONS
What are the options of residence ?
The living area in suit room considered as primary place for visitors , where visitors always
remain close to the patient. Although looking at the furniture arrangements in the living
room looks almost like you are in such a homely atmosphere, which ultimately increases
the sense of coherence among the patient. The
lighting in the room sets a relax mood of patient
and visitors both , which changes the pathogenic
place to Salutogenic place.
84
can
watch
television
as
welcoming
the
guest
accommodatingly
and
friendly
85
List
The
which
power
and
aside.
How is
the
is
the
are
86
B.3 DETAILS
Scale and partition of the room ?
The main suit room is large in scale
through with specially defined partition
with door accessibility and the room is
experienced personalized in scale.
The living area in this category divide
the room into two. The patient area is
kept quiet institutional and a living area
is non institutional.
the
multiple
seating
options
sofa
is
placed
along
the
Other details ?
Specific details such as flower pot
at the window bay as well as lamp in
the living area arouses a feeling that
a patient is in his/her home. t is done
to define attractive and welcoming
social space.
87
88
4.2.1 INTRODUCTION
Medicity will be a world class 1,200 bed hospital with 10 super specialties, 40
high-tech, air-conditioned surgical amphitheatres equipped to perform robotic
surgery, and much more. On its campus, there will be a medical college and a
paramedical college, as well as a diagnostics and research and development
facility.
Area: 43 Acres
Built Up Area: 15, 00,000sq ft
Client: Global Health Pvt. Ltd. (The Institute of Integrated Medical Sciences & Holistic
Therapies)
Architect: cardinal hardy architects / jodoin lamarre pratte architects / group arcop
Cost: 900 Crores Rs. (Approx)
Status: Design Development
Departments : Division of Endocrinology and Diabetes
89
There are enormous reason for choosing this hospital , The prestigious
Medicity project, a state-of-the-art institute of integrated medical sciences and
holistic therapy, will, for the first time in the history of medicine, combine
different
streams
of
medical
science
such
as
allopathy, Ayurveda,
humanistic
scale,
feel
and
experience,
communication,
and
collaboration.
The architecture of this hospital considered the healing source, although
factors like daylight, room atmosphere, sound, music, art and optional privacy,
altogether are believed to assist in creating carefully designed environments
that affects and supports the psychological and physical healing of the
patients. This is a project that is very close to our heart. The Trehan family,
who formulated the vision and encouraged a detail-oriented execution of the
project, were wonderful people to work with. We wanted to create an uplifting
and happy space far removed from how we generally see hospitals. It was a
tremendous opportunity to create a difference, especially amongst people who
were unwell and recuperating.
90
MEDANTA HOSPITAL
91
5th floor level plan :- Green color represent healing garden , as it is enclosed
between the buildings, which acts as a central green court or we can say a healing
garden for the patient to increase common activity aoruses the sense of coherence
among the patientand the staff.
92
93
The language of forms in architecture also has a correlation to the feeling one
obtains from the space. For example the natural environment has soft edges, but no
right angles (Red stone). However, the right angles in our everyday life are endless
in the built environment. The architecture of a healing environment can take on the
qualities of natural conditions through imitation in form. While one might feel
constrained and boxed in rectilinear spaces, the uidity of an organic space creates
no such feeling. Without right angles, the spaces become seemingly less harmful
and comforting to the human eye. "It is not the rectangle which is the problem, but its
life-sapping characteristics. Where materials, textures, colors, light, living line and
94
human activity can reinvest such forms and spaces with life, the ly None the less, in
general, one feels on much safer ground with non-rectangular, or shape-moderated
spaces.-RogerUlrich
2. Colors
As the color of the ceiling and walls are mainly white , slightly change in bedrooms but
although it is kept as
View showing the texture and colors of waiting areas and private rooms
95
3. Nature
Medanta come up with the design solution to give natural views to visitors waiting area and
lounge area through floor to ceiling windows. It is evidence that visitors having a view of nature
remain calm and peace. Outside the building there is also an assembly area for the visitors
where visitors walk and talk with each other, in term increase the social support among them.
96
4. Pleasure
There is a provision of lounge area for visitors with a capacity of 20 recliners and 15 sofa set
with center table, so that visitors find relax when they are tired or in stress. They can also
watch television and read magazine, it is 24 hrs open for the visitors.
The furniture used in lounge area have leather covered cushions ,recliners and general design
of these are luxury.
View of the lounge area for the visitors for night stay.
A.2 MANAGEABILITY
1.Natural light
Survey question
Considered sunlight to be a nuisance
Considered sunlight to be pleasurable
Considered sunlight to be calming
Considered sunlight to be unfavorable
97
Patient
Staff
2%
45%
89%
35%
91%
1%
32%
12%
As the orientation of the building is north -south oriented, building has two big bed tower
which is interconnected with one central arm. The two bed tower enclosed an green area in
between which is having shaded area due to south-east block. While talking about the
interior space of bedroom , The bedroom on outer side of south-east block get ample
amount of daylight while the inner face is in shaded region , on the other side north-west
block getting the west sun in the inner side while the outer side is in shaded region. Other
areas like food court and waiting lounges are getting ample amount of daylight. Some
areas like waiting areas in OPD section on above floors are not getting daylight , seems to
pathogenic in that case , which increases the stress level among the patient and visitors.
98
daylight.
2. Green environment
Healing landscapes have long been an important aspect of human life. When people first
began erecting dwellings, healing places could be found within nature through sacred
groves, special rocks and caves . With same approach of Roger ulrich , medanta also
accommodates a healing garden or we can say a therapeutic garden on the fifth floor level
for the patient use only.
HEALING GARDEN
99
100
Above figure shows the spatial assessment of Medicity based on the green approach, shows
the arrangement of bedrooms along the healing garden which increases the physical
interaction between the nature and patient helps in reducing the stress level among the
patient , ultimately enhances the coherence factor, makes Medicity as a Salutogenic model.
There has been provide such access control for the visitors , only patient are allowed in
healing garden with nurse in daytime. There is a department name as "PANCHKARMA"
based on Indian therapeutic surgeries, utilizes healing garden for the rehabilitation or healing
of patient in some case.
A.3 MEANINGFULNESS
1. Art
When I was in hospital, the photographs on the corridor walls kept my mind off
thermometers and at Gurgaons multi-specialty hospital Medanta, the sculpture at the
entrance is very soothing to relatives of patients. Titled the Trees of Life or the Mannat
(wish fulfilling) Trees and made by Rajasthani artist Ruchur Tiwari, the sandstone
structures are 21 feet each in height and stand tall, inviting visitors across religions. On
the base of the tree is a beautiful cluster of mauli, the sacred red thread that relatives tie
while praying for recovery of their loved ones. Not only is the artwork helpful for the
patients but it also touches on the work life of doctors and technicians who work in the
stressful environment. If I go to a room with a painting, I do look at it and appreciate it.
Its not only aesthetic but also has an impact on your behavior and provides an
environment that is not sterile in terms of thought, says Dr Randhir Sud, chairman of
the Medanta Institute of Digestive and Hepatobiliary Sciences. Anything that helps any
patient
illness is a
huge help.
101
The Trees of Life installation at the Medanta hospital, Gurgaon, created by Rajasthani artist Ruchit Tiwari.
2. Views
While visiting the inner wing of bedroom tower , view from the transparent glass window
seems to be pleasant and green. For persons experiencing anxiety or stress, studies
indicate that certain types of nature scenes rather quickly foster more positive feelings,
and promote beneficial changes in physiological systems for instance, lower blood
pressure. Those patients assigned a landscape with
trees and water experienced less anxiety, and
required fewer strong pain doses, than control groups
assigned no pictures. Positive distractions are a small
subset of environmental-social phenomena that are
distinguished by their capacity to quickly and
effectively promote restoration from stress (Ulrich,
1999).
102
3. Positive distraction
There are lots of positive attraction in the hospital which make
institutional place such as food court , healing garden , luxury lounge area , small
cafeteria , green lawn at the entrance of hospital, etc. Such positive attraction distract
the mind of patient and visitors to a relax mode , thus reduce stress n anxiety among
them. The great majority of patients prefer representational art depicting serene,
spatially open natural environments having scattered trees and/or no turbulent water
features--but consistently dislike abstract art. Although designers, artists, and some
healthcare staff react positively to abstract images, or to art having a sense of
"challenge" or ambiguity, there is evidence that such properties in pictures can
negatively affect patient stress and worsen other outcomes.
103
4. Patient experience
104
105
106
107
108
4.3.2 Analysis
109
5. CONCLUSION
The ability of architecture to heal the mental and physical illness with the different planning
parameters and the elements that can enhance healing has been explored. Without
compromising on the need, the ability of all patients to be outdoors in a good environment is, in
my view, the absolutely greatest strength in the design of this caring environment. The
spontaneous process of making architecture, its almost as if we formulate our own abstract
ideas of what we envisage a space to be, through special images from memory we assemble
architecture to be a part of the real world. It not only seems that art is inherent in all of us, it is
also possible that architecture is inherent in all of us. As an act of healing it is symbolic of our
perseverance as a species to live a fulfilled existence. In exploring art as healing, architecture as
an art and lastly, architecture as a healing space, I can deduce that the common bond between
them is that art does have healing qualities and it can be said that such healing qualities provide
therapeutic harmony in all of us. I believe its effects may be limitless in measuring the benefits to
the Self. The journey of healing through art seems to be a process of retrospection, Self growth
and Self discovery. This investigation has brought about key design objectives that may be
crucial in space making concepts for my healing architecture in healthcare design.
The purpose of creating a green oasis which patients can retreat to unescorted by staff, in my
opinion, has to be achieved. Even in a number of problems where the outdoor environments are
concerned, everyone agrees that the existence of the gardens and light courts is something
absolutely positive and something that is very good for the patients. It is also clear that being
allowed out in the gardens is perceived as conferring an opportunity of greater sovereignty. In
this way I think the aim of increasing normalcy has been achieved.
Patients often experience different needs from time to time, and so the architect should
consciously design the place or the environment so as to facilitate the process which recovery.
In the design process, the architects should consciously reduce the institutional ambience and
create such Salutogenic design which will shift the pathogenic approach . As I see it, there is
scope for the patients to use different parts of the environment, both indoors and outdoors
depending on the stage of the recovery process they have come to. Outdoor spaces are always
with lusting green and the sound of water to heal their agitation. Indoor is more towards the
sunlight that enhance the healing and the ventilation to give the patient high level of
conformability.
110
With the aid of my detail study and the precedents I have concluded four connections that has
to be consciously addressed while designing.
1. The connection with the personalized environment - Healing begins when one is in a
space of Homely atmosphere. The physical space however is one that must be comfortable and
a reflection of oneself. The physical environments have great inuence on our social behavior
and the possibilities for patents to engage social activities promoting social support. The
common spaces should provide more than just the possibility for patents to form this basic
contact.
2. The connection to sensory experience : The integration of all the senses helps complete
the highest potential of an environment to allow for healing to emerge. As, Human beings cannot
live without natural surroundings. The symbiotic relationship that exists between the two is one
that has to be nurtured. A physical and visual link with nature has positive beneficial qualities
that help in healing and health in general.
3. The connection with Light: Natural sunlight kills harmful bacteria and cleans air. Apart from
these obvious natural benefits of sunlight, natural light - when controlled - gives a space
character that is sensual so giving a space an emotive quality which can be felt by the end-user.
Light is also a symbol of growth and life as it benefits the natural world in that way.
4. The connection with the City: The city environment is harsh and busy and tends not to offer
many places or spaces of retrospection and contemplation. The site should be a part of the city
but detached from the fast pace. The end user should be able to arrive conveniently with public
transport to the site to allow a large catchment of people seeking a place for healing. The site
should also be in a place that is not difficult to navigate and find.
111
8. BIBLIOGRAPHY www.hindustantimes.com/brunch/art-is-finding-an-unusual-home-in-indian-hospitals/storyyk6GAHLQvEFfJYd46rWCVN.html
timesofindia.indiatimes.com/life-style/health-fitness/de-stress/music-therapy-to-heal-cancerpatients/articleshow/51921616.cms?from=mdr
kgd-architecture.com/portfolio_page/fortis-hospital-gurgaon-i-healthcare-4/
soundofarchitecture.com/blog/architectural-healing-how-the-built-form-changes-lives
archinect.com/firms/project/14168405/medicity-medanta/60103380
Salutogenic Places: Designed to Thrive. Farrow Partnership Architects. YouTube
Golembiewski, Jan A. "Start Making Sense Applying a Salutogenic Model to Architectural
Design for Psychiatric Care." Facilities
Golembiewski, Jan A. "Salutogenic Design: The Neurological Basis for Healthcare
Design" World Health Design Journal.
Dilani, Alan. "Psychosocially Supportive Design." World Health Design Journal
Dilani, Alan. A new paradigm of design and health in hospital planning. World Hospitals and
Health Services, 41.4
About Maggies. Maggies Centres. The Maggie Keswick Jencks Cancer Caring Centres
Ulrich, R. S. (2000). Environmental research and critical care. In D. K. Hamilton (Ed.), ICU 2010:
Design
for the Future. Houston: Center for Innovation in Health Facilities, 195-207.
Ulrich R S (2004) The role of the physical environment in the hospital of the 21st century: a
once-in-a lifetime opportunity. New York: Robert Wood Johnson Foundation.
Ulrich, R. S., Lundn, O., and J. L. Eltinge (1993). Effects of exposure to nature and abstract
pictureson patients recovering from heart surgery. Paper presented at the Thirty-Third Meetings
of the
Society for Psychophysiological Research, Rottach-Egern, Germany. Abstract published in
Psychophysiology, 30 (Supplement 1, 1993): 7.
Ulrich, R. S., Simons, R. F., Losito, B. D., Fiorito, E., Miles, M. A. and M. Zelson (1991). Stress
recovery during exposure to natural and urban environments. Journal of Environmental
Psychology 11:
201-230.
Ulrich R, Zimring C, Quan X et al (2006) The environments impact on stress. In S Marberry
(Ed.), Improving healthcare with better building design. Chicago: Health Administration Press,
37-61.
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GLOSSARY Environment: that which environs or surrounds; surrounding conditions, inuence, or forces, by
which living forms are inuence and modified in their growth and development.
Heal: to restore or be restored to health
Health: the general condition of the body or mind with reference to soundness and vigor
Well-being: a good or satisfactory condition of exis tence; a state characterized by health,
happiness, and prosperity
Psychology: the scientific study of the human mind and its functions, esp. those affecting
behavior in a given context.
Flexibility: responsive to change; adaptable
Meditation: a stylized mental technique... repetitively practiced for the purpose of attaining a
subjective experience that is frequently described as very restful, silent, and of heightened
alertness, often characterized as blissful
Urban: Characteristic of the city or city life.
Evidence-based: entails making decisions about how to promote health or provide care by
integrating the best available evidence.
Therapeutic: having or exhibiting healing powers.
Spirit: the principle of conscious life; the vital principle in humans, animating the body or
mediating between body and soul.
Body: the physical part of a person
Mind: the element of a person that enables them to be aware of the world and their experiences,
to think, and to feel; the faculty of consciousness and thought.
Habitat: the natural home or environment of an ani mal, plant, or other organism.
Sequence: a set of related events, movements, or things that follow each other in a particular
order.
Sequence: a set of related events, movements, or things that follow each other in a particular
order.
salutogenis -Salutogenesis is a term coined by Aaron Antonovsky, a professor of medical
sociology. The term describes an approach focusing on factors that support human health and
well-being, rather than on factors that cause disease (pathogenesis).
pathogenesis -The pathogenesis of a disease is the biological mechanism (or mechanisms)
that leads to the diseased state. The term can also describe the origin and development of the
disease, and whether it is acute, chronic, or recurrent.
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