CONTROL

In designing restorative spaces, serious consideration should be given to providing as much control over the environment as possible for those who will use the space. Music played in an entire space, for example, may raise issues of control for individuals, even if the music itself might have restorative properties.

Here are some commentaries regarding the stress-related effects of control and lack of control in (and beyond) healthcare settings:

Nurses and other healthcare staff experience stress and often burnout because their work is characterized by low control and high responsibility.  One sign of a poorly designed work environment is the lack of adequate lounge or break areas.  This shortcoming reduces the sense of control among staff and increases stress (and may contribute to higher turnover) by making it difficult to escape briefly from work demands. . . Psychologist Robert Simons and I conducted a study of a blood bank where the well-intentioned policy was to have a television, not controllable by blood donors, playing continuously in the waiting area.  For purposes of the study, the television was turned off on randomly selected days and played continuously on other days.  Donor stress in the waiting area proved to be higher during days when the television was on than during days when the television was off.”1


 

“It has been demonstrated that in all settings – not just hospitals – control reduces stress. When you know you have options, even in the most minimal sense, you feel better. The consequences for health facilities are enormous: patients who can control the temperature and lighting in their rooms, the amount of privacy they have, and the timing and content of meals will experience less stress and will likely heal more quickly.”2

“Several studies have shown across a variety of patient groups that pleasant music, especially when controllable, often can reduce anxiety or stress and helps some patients cope with pain.”3  [emphasis added]

Footnotes

[1] Ulrich, R.S. “How Design Impacts Wellness.” Healthcare Forum Journal (September-October, 1992) http://www.scenicflorida.org/lscwellness.html

[2] Malkin, J. in Bilchik, G.S. “New Vistas: Evidence-Based Design Projects Look into the Links Between A Facility’s Environment and Its Care” Health Facilities Management  (August, 2002): 19- 24 http://www.hospitalconnect.com/hfmmagazine/jsp/articledisplay.jsp?dcrpath=AHA/NewsStory_Article/data/
hfm0802FEA_design&domain=HFMMAGAZINE.  See also, Malkin, J. Hospital Interior Architecture: Creating Healing Environments for Special Patient Populations (New York: John Wiley and Sons, 1992).  http://www.amazon.com/exec/obidos/tg/detail/-/0471289760/qid=1062433978/sr=1-1/ref=sr_1_1/104-4426911-4541515?v=glance&s=books

[3] Ulrich, R.S. “Evidence-Based Environmental Design for Improving Patient Outcomes” http://www.muhc.mcgill.ca/healing/english/Speakers/ulrich_p.html  Citing Menegazzi, J. J., Paris, P., Kersteen, C., et al. (1991). “A randomized controlled trial of the use of music during laceration repair.” Annals of Emergency Medicine, 20: 348-350 and Standley, J. M. (1986). “Music research in medical/dental treatment: Meta-analysis and clinical applications.” Journal of Music Therapy, XXII: 56-122.

 
 
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