Mother Nature Takes A Peek Into Medical Facilities
While the tendency to seek connections with nature and other forms of life, has been a part of the human experience since the genesis of man himself, the idea of incorporating natural light, natural views, and vegetation into the modern world’s built environment is still a fairly new concept.
Although the concept of biophilic design is relatively new, I’d like to make a case for the health and wellbeing potential of incorporating biophilic design attributes into the built environment, and, in particular, into healthcare spaces.
Biophilia. What is it?
The term ‘biophilia’ was first coined by psychologist Erich Fromm in 1964, then later popularized in 1984 by American biologist Edward O. Wilson. In his book, Biophilia, he describes biophilia as humanity’s innate affinity for the natural world; the pleasure that comes from being surrounded by living organisms. Biophilia notes the benefits humans derive from connecting with the natural environment. We are drawn to nature. Humans have evolved in nature and, even now, find ways to recharge by evoking our senses and connecting to the natural world. This is especially important for healthcare environments.
Biophilic design is the result of this idea. For it’s a design philosophy that encourages the use of natural features and processes in the built environment.
Because human evolution manifested in the natural environment, we are genetically inclined to respond, and be in tune, with our natural surroundings. It wasn’t too long ago when hunting and gathering was humanity’s primary and most successful method to obtaining food, occupying at least 90 percent of human history. As a result, human development is ingrained by it’s innate familiarity with nature, and it’s sensory interaction with the natural landscape. Only recently has the shift towards urbanization isolated man from a continual interaction with land and nature. Subsequently, human interaction with nature is often lacking in modern day societies. Thus, the idea behind biophilic design then is to incorporate natural features and systems into the built environment in order to provide human beings with their much-needed exposure to nature [1].
The design philosophy appreciates that we have an intuitive and deeply ingrained attraction to nature, and a biological need for contact with the natural world. It takes the concept that stems directly from the philosophy behind biophilia and incorporates nature in design. Recently, hospitals have been getting in on the action thats is biophilic design. And the results are something we can all get excited about.
The reflection on the principles of biophilic design is particularly interesting when it is applied to healthcare facilities. This is not only due to the high rate of critical and stress factors in hospitals for patients, their families as well as healthcare professionals, but also because the hospital and the city are two separate but interconnected systems, which are visited and used by the same individuals. According to several studies, the humanization of healthcare spaces and contact with nature can empower the patient and have a positive impact by reducing stress and pain and improving emotional wellbeing. In modern times, however, “the built space has been conceived and designed by giving nature a role that is not only marginal, but also irrelevant to the health and happiness of individuals [2]. Moreover, there have been a growing number of studies that show evidence of the advantages of human interaction with nature. Research proves that it can improve productivity, lower stress levels, enhance learning comprehension, and increase recovery rates from illness. As a result, the philosophy behind biophilic design has seen increasing interest and recognition from building industries and scientific communities. It’s being implemented in workspaces and commercial centers across the world at increasing rates. And medical centers are among the locations seeing the most benefit from the practice. Why? Because hospitals can be stressful — For everyone involved — From nurses and doctors, to patients and family members. By their very design, they are there for people when they are having some of their worst moments. A greater understanding of biophilic design could help create more efficient medical facilities with better results.
Applying the benefits of biophilic design to hospital design.
In 1839, the Lexicon Medicum mentioned the “healing powers of nature”, arguing that many illnesses could be cured without the help of medicines, simply by paying attention to air, food, rest, physical activity, and state of mind. Therefore, the environment was considered therapeutic and capable of affecting the health of individuals and helping their recovery.Though the approach has changed and evolved over time, this awareness has remained valid since then.
In the 20th century, these assumptions have been supported. There is a growing body of research which confirms the benefits of interacting with nature in hospital settings. The results of such studies have helped to better define a new approach to built design that benefits both the psychophysical well-being of individuals and their health.
Hospitals today often offer little or no access to nature, but this wasn’t always the case. In ancient china, the sick would travel to remote natural areas where monks built temples in which they provided treatment and palliative care. Monasteries in Europe in the middle ages contained elaborate gardens designed to soothe the ill who came to the monks for medical care. Ayurveda, an ancient healing tradition of India which is still widely practiced today, views the mind and body as a unified system and takes a holistic approach to healing, believing that balance in the mind is essential for health in the body. What happened to modern hospitals?
When the image of a hospital comes to mind, most envision a similar setting: fluorescent lighting, various mechanical noises, white tile floors, eggshell painted walls and the smell of disinfectant. For some visitors, these environmental components can evoke feelings of unease and even anxiety [3]. Modifying hospitals’ design by humanizing spaces and especially through reconnecting with nature offers a therapeutic support that can positively impact on the patients’ psychological and physical well being. It can also improve their ability to recover.
The first well controlled empirical test of this hypothesis was published in 1984 by Roger Ulrich, which measured the influence of natural and urban sceneries on patients recovering from gallbladder surgery. He simply compared recovery rates of surgical patients in rooms with or without outside views. Some patients were provided with views to nature, whereas others looked at brick walls. All patients had the same kind of surgery, with the two different view groups matched for age, gender, and general health conditions. Ulrich found that patients with the tree view used less narcotic and milder analgesics, indicating lower pain experience. They also stayed in the hospital for a shorter time period and had a more positive post-surgical recovery overall than did patients who had the view of the brick wall. On average, patients whose windows overlooked a scene of nature were released after 7.96 days, compared with the 8.71 days it took for patients whose views were of the hospital’s exterior walls to recover sufficiently to be released — a decrease of 8.5% [4]. Similar studies have found that daylighting in patient rooms increases recovery rates and decreases the use of pain medications. Artwork of natural scenes reduces anxiety, and healing gardens at hospitals promote health, social connectivity, and pleasurable memories in patients. Incorporating nature and natural elements into the design of healthcare facilities has also been shown to benefit visitors and healthcare-facility staff, mitigating stress and increasing job performance and satisfaction.
Likewise to Ulrich’s study, researchers at Texas A&M University mimicked the hospital study over a decade long time period. They found that subjects who are exposed to a stressor recover faster and better if they are shown nature scenes or urban scenes with nature, rather than urban scenes devoid of natural elements. Interestingly, subjects viewing the completely natural scenes did the best overall, with the greatest and quickest reduction in physiological stress, and noticeably enhanced attitudes and general moods. [5]. Among others, these findings and Ulrich’s work is important because it has shown that contact with nature can be significantly beneficial, whether that contact is real or simulated. In fact, in many environments, such as windowless spaces, simulations may be the only way to create beneficial experience. A study of windowed and windowless offices by Heerwagen and Orians supports this conclusion. They found that people in windowless spaces used twice as many natural elements, particularly posters and photos, to decorate their office walls than those who had window views to natural areas outdoors [6].
A look at Hospitals with biophilic Design in Action…
Can we change our approach regarding patients’ health by considering a new vision of medicine, healthcare and healing environments? The answer to this question will be among one of the many global health challenges of the 21st century. To see a real change in healthcare facilities, a new way of thinking and a modification in the design of healthcare services, through an approach that considers the needs of human beings, will be required. Though this time, not in a therapeutic sense.
Rather, a sense that will embrace an environment that’s oriented towards the physical and emotional reconnection of man with nature. Doing so can minimize stress factors most commonly felt by patients. Such as, the inability to control their surroundings, the lack of privacy, the presence of unfamiliar and often disturbing sounds and noises, artificial lighting with a low comfort level, and intense environmental smells, which are often familiar due to the association in the lives of most people with the experience of illness. A place that’s anticipated to be relaxing, welcoming, aesthetically pleasing, and recognizable generates a greater sense of trust. Especially in hospital settings, which are too often perceived as a frightening and intimating places. This transformation, nonetheless, could be accomplished by implementing biophilic design in healthcare facilities around the world.
Biophilic design encourages the use of natural elements and processes as design inspiration in the built environment. According to the Biophilia hypothesis, these positive effects of exposure to nature originate in a biological bond between humans and the natural world. The idea is that exposure to natural environments and attributes have positive effects on human health and wellbeing. Therefore, in order to provide human beings with their much-needed exposure to nature, the idea behind Biophilic design is important to take into consideration when designing healing environments. And although nature based design in healthcare is still a developing field of study, it holds great promise for benefiting patients, families, physicians, nurses, and other healthcare employees, as it could be advantageous for everyone involved to incorporate natural features and systems into the built environment.
I suppose we don’t need peer-reviewed scientific research to tell us that nature in itself is a big healer. We feel good in nature. Humans have an innate connection with it. And more importantly, our physical and mental well-being depends on it. Thinking forward, it will be interesting to see the many different ways we continue integrating nature, through biophilic design, into our built environment and everyday lives.
References
- Gillis, Kaitlyn, and Birgitta Gatersleben. “A Review of Psychological Literature on the Health and Wellbeing Benefits of Biophilic Design.” MDPI, Multidisciplinary Digital Publishing Institute, 25 Aug. 2015, www.mdpi.com/2075-5309/5/3/948/htm.
- Totaforti, Simona. “Applying the Benefits of Biophilic Theory to Hospital Design.” SpringerLink, Springer Berlin Heidelberg, 2 Mar. 2018, link.springer.com/article/10.1186/s40410–018–0077–5.
- Choo, Felicia. “Hospitals That Seek to Heal with Nature.” The Straits Times, 1 Jan. 2018, www.straitstimes.com/singapore/health/hospitals-that-seek-to-heal-with-nature.
- Ulrich, R.S. 1984. View from a window may influence recovery from surgery. Science. 224(4647): 420–421.
- Campbell, Lindsay K., and Anne Wiesen. Restorative Commons: Creating Health and Well-Being through Urban Landscapes. USDA Forest Service, Northern Research Station, 2011.
- Heerwagen, J.H.; Orians, G.H. 1986. Adaptations to windowless: The use of visual décor in windowed and windowless offices. Environment and Behavior. 18(5): 623–629.
- Kellert, S.R. Dimensions, Elements, and Attributes of Biophilic Design. In Biophilic Design: The Theory, Science, and Practice of Bringing Buildings to Life; Heerwagen, J., Mador, M., Eds.; Wiley: Hoboken, NJ, USA, 2008.
