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Article
Publication date: 28 June 2013

Jan A. Golembiewski

350

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Facilities, vol. 31 no. 9/10
Type: Research Article
ISSN: 0263-2772

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Article
Publication date: 2 March 2010

Jan A. Golembiewski

This paper aims to look into the significance of architectural design in psychiatric care facilities. There is a strong correlation between perceptual dysfunction and psychiatric…

2464

Abstract

Purpose

This paper aims to look into the significance of architectural design in psychiatric care facilities. There is a strong correlation between perceptual dysfunction and psychiatric illness, and also between the patient and his environment. As such, even minor design choices can be of great consequence in a psychiatric facility. It is of critical importance, therefore, that a psychiatric milieu is sympathetic and does not exacerbate the psychosis.

Design/methodology/approach

This paper analyses the architectural elements that may influence mental health, using an architectural extrapolation of Antonovsky's salutogenic theory, which states that better health results from a state of mind which has a fortified sense of coherence. According to the theory, a sense of coherence is fostered by a patient's ability to comprehend the environment (comprehensibility), to be effective in his actions (manageability) and to find meaning (meaningfullness).

Findings

Salutogenic theory can be extrapolated in an architectural context to inform design choices when designing for a stress‐sensitive client base.

Research limitations/implications

In the paper an architectural extrapolation of salutogenic theory is presented as a practical method for making design decisions (in praxis) when evidence is not available. As demonstrated, the results appear to reflect what evidence is available, but real evidence is always desirable over rationalist speculation. The method suggested here cannot prove the efficacy or appropriateness of design decisions and is not intended to do so.

Practical implications

The design of mental health facilities has long been dominated by unsubstantiated policy and normative opinions that do not always serve the client population. This method establishes a practical theoretical model for generating architectural design guidelines for mental health facilities.

Originality/value

The paper will prove to be helpful in several ways. First, salutogenic theory is a useful framework for improving health outcomes, but in the past the theory has never been applied in a methodological way. Second, there have been few insights into how the architecture itself can improve the functionality of a mental health facility other than improve the secondary functions of hospital services.

Details

Facilities, vol. 28 no. 3/4
Type: Research Article
ISSN: 0263-2772

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Available. Content available
Article
Publication date: 27 January 2012

355

Abstract

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Facilities, vol. 30 no. 1/2
Type: Research Article
ISSN: 0263-2772

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Article
Publication date: 28 June 2013

Jan Golembiewski

Psychological and epidemiological literature suggests that the built environment plays both causal and therapeutic roles in schizophrenia, but what are the implications for…

966

Abstract

Purpose

Psychological and epidemiological literature suggests that the built environment plays both causal and therapeutic roles in schizophrenia, but what are the implications for designers? The purpose of this paper is to focus on the role the built environment plays in psycho‐environmental dynamics, in order that negative effects can be avoided and beneficial effects emphasised in architectural design.

Design/methodology/approach

The approach taken is a translational exploration of the dynamics between the built environment and psychotic illness, using primary research from disciplines as diverse as epidemiology, neurology and psychology.

Findings

The built environment is conceived as being both an agonist and as an antagonist for the underlying processes that present as psychosis. The built environment is implicated through several means, through the opportunities it provides. These may be physical, narrative, emotional, hedonic or personal. Some opportunities may be negative, and others positive. The built environment is also an important source of unexpected aesthetic stimulation, yet in psychotic illnesses, aesthetic sensibilities characteristically suffer from deterioration.

Research limitations/implications

The findings presented are based on research that is largely translated from very different fields of enquiry. Whilst findings are cogent and logical, much of the support is correlational rather than empirical.

Social implications

The WHO claims that schizophrenia destroys 24 million lives worldwide, with an exponential effect on human and financial capital. Because evidence implicates the built environment, architectural and urban designers may have a role to play in reducing the human costs wrought by the illness.

Originality/value

Never before has architecture been so explicitly implicated as a cause of mental illness. This paper was presented to the Symposium of Mental Health Facility Design, and is essential reading for anyone involved in designing for improved mental health.

Details

Facilities, vol. 31 no. 9/10
Type: Research Article
ISSN: 0263-2772

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Article
Publication date: 28 June 2013

Amy Wagenfeld, Connie Roy‐Fisher and Carolyn Mitchell

Providing veterans diagnosed with post‐traumatic stress disorder (PTSD), their families, and staff opportunities to experience physical and mental restoration in outdoor…

2644

Abstract

Purpose

Providing veterans diagnosed with post‐traumatic stress disorder (PTSD), their families, and staff opportunities to experience physical and mental restoration in outdoor environments designed based on evidence is important. The purpose of this paper is to explore the relationship between evidence‐based collaborative design of outdoor environments and their potential capacity to contribute to a veteran's journey to wellness.

Design/methodology/approach

There is no existing precedent in the peer‐reviewed literature linking positive health outcomes associated with outdoor environments to veterans with PTSD. This review of the literature is conceptualized as a means to extrapolate these benefits to this unique population.

Findings

Access to nature improves physiological and psychological health outcomes. A collaborative design approach ensures that design outcomes meet specific populations' needs.

Practical implications

Many service‐members are reluctant to seek traditional treatments for PTSD, fearing threat to future military service and limited available resources. Alternative treatments, access to sensitively designed outdoor environments and/or a re‐examination of traditional treatments and the environments in which they are provided supports best practice approaches to ameliorating the debilitating effects of this disorder.

Social implications

An integrated design approach blending the skills of landscape architecture and occupational therapy is key to achieve design outcomes that support the healing process to meet the needs of this vulnerable population.

Originality/value

An inter and/or trans‐disciplinary team approach to design and programming of outdoor environments for veterans with PTSD blends landscape architecture with occupational therapy to ensure both form and function are achieved, thus positing positive health outcomes.

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Article
Publication date: 28 June 2013

Evangelia Chrysikou

Patients' movement in mental health facilities is frequently compromised for reasons quite apart from real physical incompetence. Accessibility within mental healthcare facilities…

1551

Abstract

Purpose

Patients' movement in mental health facilities is frequently compromised for reasons quite apart from real physical incompetence. Accessibility within mental healthcare facilities is a more complex issue than universal accessibility standards generically allow for. The purpose of this paper is to critically question the adequacy of universal design aids as the main way to deal with accessibility in facilities for the adult mentally ill in the community.

Design/methodology/approach

Several community mental healthcare units (in both Great Britain and France) are reviewed and analysed while they are occupied and running. The focus of the study is on restrictions of movement and the use of universal accessibility devices. The data are part of a broader exploratory study of facilities for mental healthcare, which used empirical, comparative and user inclusive methods.

Findings

Mental health facilities are rarely designed for the model of care and staffing regimes which they will house. This discordance between the physical and organizational milieu inevitably compromises accessibility, even though patients tend to be physically able. Outdoor access, vertical circulation and the accessibility of bathrooms are particularly affected.

Research limitations/implications

Models of care, management and staffing requirements, therapeutic needs of patients and interpersonal relationships should be considered for accessibility during planning, in addition to traditional accessibility devices and design. Furthermore, more research is needed to address the ways that accessibility devices need to be altered to comply with the psychosocial elements.

Originality/value

This paper readdresses the traditional view of accessibility, suggesting the paradigm needs to be better developed and nuanced for mental healthcare facilities.

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Article
Publication date: 28 June 2013

Nathan H. Perkins

Participation by patients, staff and visitors in healthcare design and planning offers multiple benefits in addressing the complex challenges of creating salutary environments for…

557

Abstract

Purpose

Participation by patients, staff and visitors in healthcare design and planning offers multiple benefits in addressing the complex challenges of creating salutary environments for hospital patients, staff and visitors. The purpose of this paper is to present the benefits of participatory design and design imperatives to facilities architects and landscape architects.

Design/methodology/approach

The paper describes three case studies in which participatory methods were used to engage users in decision making over 15 years and creates a framework using “design imperatives” that has been successful in the design of outdoor settings.

Findings

Nine design imperatives can be used to design facilities that achieve a range of therapeutic benefits for patients, staff and visitors.

Research limitations/implications

The research limitations of this paper are those of using case studies in general. The implications suggest that papers such as this can be used in future hypothesis‐driven research.

Practical implications

Designers do not have the luxury or ability to base myriad design decisions on experimental research findings, as almost all design is unique and a hypothesis waiting to be tested. The result is that guiding principles, or design imperatives based on participatory methods, can form the basis for design decision making.

Social implications

The social implications are that some form of participatory decision making in facilities design has benefits to multiple constituencies, specifically, patients, staff and visitors.

Originality/value

Although this paper refers to many existing studies and places the results and conclusions within a context that is supported by the literature, much of the value is because the results are based on practice. More than a dozen projects form the basis for concluding that general principles of design, person‐environment interactions and participatory methods lead to desirable and beneficial outcomes.

Details

Facilities, vol. 31 no. 9/10
Type: Research Article
ISSN: 0263-2772

Keywords

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Article
Publication date: 28 June 2013

Ana Paula Baltazar, Silke Kapp, Augustin de Tugny and Juarez Pereira Furtado

The purpose of this paper is to report on the point of view of architecture of an interdisciplinary research on housing and social integration of people with severe mental…

449

Abstract

Purpose

The purpose of this paper is to report on the point of view of architecture of an interdisciplinary research on housing and social integration of people with severe mental disorder (SMD) in Brazil after deinstitutionalization. It first aims to present the need for a qualitative evaluation of the way people with SMD deal with their living spaces (house and city); then to describe the method adopted to approach people living under control – in therapeutic residential services (SRTs) proposed by the State as the only alternative model for those leaving psychiatric institutions – and people living alone – with little psychiatric assistance and no dwelling support provided by the State. It aims to conclude with a discussion of the observed dwellings pointing towards the need to accommodate differences in any housing model adopted by the State.

Design/methodology/approach

The qualitative evaluation enabled the focus of participant observation on the way people interact with each other and with their living space. The authors followed the routines of chosen people with SMD in three different cities in Brazil and provided reports for the whole group to analyze them.

Findings

It was found that those living in SRTs are much more obstructed by institutional control than those living alone. Despite the difficulties and fragilities of those living alone because of the lack of support, they end with more possibilities for autonomy and social integration.

Originality/value

Most research on the subject approaches objective housing issues focusing on statistical results. This research evaluates qualitative dwelling issues, summarizing little pointers for future health policy on housing for people with SMD.

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Article
Publication date: 1 May 1995

Martin Fojt

This special “Anbar Abstracts” issue of the Personnel Review is split into six sections covering abstracts under the following headings:Career/Manpower Planning and Recruitment;…

211

Abstract

This special “Anbar Abstracts” issue of the Personnel Review is split into six sections covering abstracts under the following headings: Career/Manpower Planning and Recruitment; Health and Safety; Industrial Relations and Participation; Pay, Incentives and Pensions; Performance, Productivity and Motivation; Work Patterns.

Details

Personnel Review, vol. 24 no. 5
Type: Research Article
ISSN: 0048-3486

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Article
Publication date: 1 May 1992

Editorial This special issue of Industrial Management & Data Systems is a huge departure from our usual journal/ monograph style. This is an additional issue to the year's volume…

1442

Abstract

Editorial This special issue of Industrial Management & Data Systems is a huge departure from our usual journal/ monograph style. This is an additional issue to the year's volume — a bonus in fact.

Details

Industrial Management & Data Systems, vol. 92 no. 5
Type: Research Article
ISSN: 0263-5577

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