Abstract

Dina A Bakir
The Psychological Well-being of Users and the Design of Physical Rehabilitation Centers :A Phenomenological Investigation of users' Lived Experience.
THE TRADITIONAL APPROACH TO THE DESIGN OF HEALTHCARE FACILITIES TENDED TO FOCUS ON FUNCTIONALITY and THE EFFECTIVENESS OF THE CARE DELIVERY. IT TENDED, HOWEVER, TO IGNORE THE PSYCHOLOGICAL WELLBEING OF USERS. SINCE THE 1980’S A GROWING AMOUNT OF RESEARCH EVIDENCE HAS SHOWN THAT DESIGN CHARACTERISTIC HAVE AN IMPACT ON THE PSYCHOLOGICAL WELLBEING OF USERS IN HEALTHCARE ENVIRONMENTS. IN TURN, IMPROVED PSYCHOLOGICAL WELLBEING WAS SHOWN TO INFLUENCE HEALTH OUTCOMES. IMPROVING THE DESIGN OF HEALTHCARE FACILITIES IS A PRIME PRIORITY FOR DEVELOPING COMMUNITIES. AMONGST THESE FACILITIES ARE REHABILITATION CENTERS. IN EGYPT PARTICULARLY, ABOUT FOUR-HUNDRED THOUSAND PATIENTS ANNUALLY ADMIT TO HOSPITALS DUE TO SKELETAL and NEUROLOGICAL PROBLEMS. THE FULL RECOVERY OF THESE ILLNESSES NECESSITATES PHYSICAL REHABILITATION. THE REHABILITATION PROCESS COVERS MENTAL, PSYCHOLOGICAL and SOCIOLOGICAL ASPECTS, IN ORDER TO ACHIEVE FULL RECOVERY. WHILE PSYCHOLOGICAL HEALTH IS RECOGNIZED TO BE VERY IMPORTANT TO HEALING IN THE PHYSICAL REHABILITATION PROCESS, TO DATE, VERY FEW STUDIES HAVE LOOKED AT THE RELATIONSHIP BETWEEN DESIGN and THE PSYCHOLOGICAL WELLBEING OF USERS IN THE CONTEXT OF PHYSICAL REHABILITATION CENTERS. THIS THESIS AIMS TO CONTRIBUTE TO THE BETTER UNDERSTANDING OF THE RELATIONSHIP BETWEEN PHYSICAL CHARACTERISTICS OF PHYSICAL REHABILITATION CENTERS and THE PSYCHOLOGICAL WELL-BEING OF USERS and CONTRIBUTE TO THE KNOWLEDGE NEEDED FOR AN EVIDENCE-BASED DESIGN OF HEALING ENVIRONMENTS. THE THESIS PRESENTS FIRST A REVIEW OF THE RESEARCH THAT HAS INVESTIGATED THE IMPACT OF PHYSICAL DESIGN ON THE WELLBEING OF USERS IN HEALTHCARE ENVIRONMENTS ALONG WITH EXAMPLES ILLUSTRATING HOW THE FINDINGS OF THIS RESEARCH STARTED TO INFLUENCE DESIGN. THE THESIS PRESENTS THEN AN ARGUMENT FOR THE NEED FOR HERMENEUTIC PHENOMENOLOGICAL RESEARCH TO DEEPEN THE UNDERSTANDING THAT CAN ULTIMATELY BETTER INFORM THE EVIDENCE-BASED DESIGN OF HEALING ENVIRONMENTS. THE ARGUMENT DETAILS THE CHARACTERISTICS and THE POTENTIAL BENEFITS OF SUCH A RESEARCH APPROACH. THE THESIS ALSO DISCUSSES THE DIFFERENT ASPECTS OF PHYSICAL REHABILITATION CARE, THE DIFFERENT TYPES OF PHYSICAL REHABILITATION CENTERS and THEIR FUNCTIONAL ORGANIZATION, and THE PARTICULARITIES OF THE THREE MAIN TYPES OF USERS IN PHYSICAL REHABILITATION CENTERS: (1) PATIENTS, (2) RELATIVES, and (3) STAFF. THIS DISCUSSION CONFIRMS THE IMPORTANCE OF INVESTIGATING THE IMPACT OF DESIGN CHARACTERISTICS ON THE PSYCHOLOGICAL WELLBEING OF USERS IN THE PARTICULAR CONTEXT OF PHYSICAL REHABILITATION CENTERS. IT ALSO CONFIRMS THE RELEVANCE OF THE PHENOMENOLOGICAL RESEARCH APPROACH FOR SUCH AN INVESTIGATION. FINALLY, AN EMPIRICAL STUDY WAS CONDUCTED USING A HERMENEUTIC PHENOMENOLOGICAL RESEARCH APPROACH TO EXPLORE THE LIVED EXPERIENCES OF USERS IN PHYSICAL REHABILITATION CENTERS IN ORDER TO INVESTIGATE THE RELATIONSHIP BETWEEN PHYSICAL CHARACTERISTICS and PSYCHOLOGICAL WELLBEING. THE STUDY RELIED ON SEMI-STRUCTURED IN-DEPTH INTERVIEWS WITH PATIENTS, RELATIVES, and STAFF IN THREE PHYSICAL REHABILITATION CENTERS IN CAIRO. DATA COLLECTION ALSO INVOLVED A PHYSICAL INSPECTION OF THE THREE CENTERS THROUGH PHOTOGRAPHS and FIELD NOTES. THE QUALITATIVE INTERPRETIVE ANALYSIS OF THE INTERVIEWS PERMITTED TO IDENTIFY TEN THEMES: (1) SPATIAL VARIATIONS, (2) SAFETY and SECURITY, (3) AUTONOMY and CONTROL, (4) PRIVACY, (5) MEANINGFUL ACTIVITIES, (6) HOME-LIKE ENVIRONMENT, (7) POSITIVE DISTRACTION, (8) APPROPRIATE EXPRESSION OF SOCIAL IDENTITY, (9) ENVIRONMENTAL COMFORT, and (10) ERGONOMIC and ANTHROPOMETRIC DESIGN. THESE EMERGENT THEMES CAN BE VIEWED AS IMPORTANT EXPERIENTIAL DIMENSIONS OF DESIGN QUALITY TO CONSIDER FOR THE BETTER DESIGN OF PHYSICAL REHABILITATION CENTERS. KEY WORDS: HEALING SPACE, SPATIAL QUALITIES, REHABILITATION CENTRE, PHENOMENOLOGY, EVIDENCE-BASED DESIGN