Thesis (doctoral)--Universität zu Köln, 1981. / Includes bibliographical references (p. 281-304).

BACKGROUND: When a person becomes unwell and develop an illness, they become vulnerable and more sensitive to the surrounding of the environment. The importance of health care has long been seen as a factor for well-being. The Nursing role as a caregiver is central and paramount and must have a holistic approach to care. AIM: The purpose was to describe the aspects of the healthcare environment that affect well-being. METHOD: A general literature study based on 21 articles with quantitative data was researched. RESULTS: The analysis process of data resulted in the emergence of two main themes with additional SUB themes. The senses- light, sound, smell. Physical environment that includes spaces, technical equipment, garden and design. CONCLUSION: It appears in our literature review, that different aspects of the healthcare environment can have both positive and negative effects in patients, close relatives and nurses' well-being. It is very important to quickly identify which aspects promote well-being and implement it in the healthcare environment to prevent that which leads to adverse effects. IMPLICATIONS: Nurses should have knowledge of the health care environment's effects in order to implement it in their work. By introducing these aspects, it is possible to create a better healthcare environment for patients, close relatives and nurses. More research into the roles of nurses in hospital is required. / SAMMANFATTNING BAKGRUND: När en människa utsätts för sjukdom blir den sårbar och mer känslig för stimuli från omgivningens. Vårdmiljöns betydelse har länge sett som en faktor för välmående. Sjuksköterskans roll som vårdare är centralt och bör ha holistiskt förhållningssätt vid vårdandet. SYFTE: Syftet var att beskriva de aspekter i vårdmiljön som påverkar välmående. METOD: En allmänlitteraturstudie baserad på 21 artiklar med kvantitativa data. RESULTAT: Analysprocessen av data resulterade till uppkomst av två huvudteman med tillbehörande SUB teman. Sinnen- ljus, ljud, lukt. fysisk miljö som innefattar utrymmen, teknisk utrustning, trädgård och design. SLUTSATS: Det framkommer i vår litteraturöversikt att olika aspekter i vårdmiljön kan ha både positiva och negativa effekter i patienter, närstående och sjuksköterskors välmående. Det är av stor vikt att snabbt identifiera vilka aspekter som verkar främjande för att implementera det i vårdmiljön och förhindra det som leder till negativa effekter. IMPLIKATIONER: Sjuksköterskor bör ha kunskap om vårdmiljöns effekter för att kunna implementera det i sitt arbete. Genom att införa dessa aspekter kan det skapas en främjande vårdmiljö med bättre välmående för patienter, närstående och sjuksköterskor. Det krävs mer forskning gällande sjuksköterskans roll vid planlösningar av sjukhus.

Made available in DSpace on 2015-05-08T14:47:26Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1747620 bytes, checksum: 88c9e140809a78996b2a6663c3d19fc2 (MD5) Previous issue date: 2011-03-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Childhood cancer is a chronic disease that, when diagnosed implies on major repercussions on the child and his family lives. The outpatient chemotherapy is an alternative to minimize damages relating to impaired family links, since the child is replaced by the possibility of receiving the proposed treatment and be released to return home after few hours. In pursuit of excellence in health care, it has been recently appointed that the influence of physical space on the different actors in the hospital environment, such as patients, staff and carers, is of growing importance. The Instituto de Pediatria e Pericultura Martagão Gesteira built a new area for the chemotherapy room which was remodeled and decorated based on the movie Finding Nemo, known now as Aquário Carioca (Carioca Aquarium). Therefore, this study aimed to investigate the influence of environment of the Carioca Aquarium in the perception of the child in relation to the context of the care and well being of the same during the sessions of chemotherapy. This is a qualitative, exploratory and descriptive research. The subjects were seven children of school age who had or were undergoing chemotherapy at the Carioca Aquarium. Data collection was performed in May 2010, using an adaptation of the story-drawing technique for the production of empirical data. To interpret the speech of children followed by the thematic analysis. Emerged from an empirical category: hospital ecology in Carioca Aquarium. The subcategories were: the process: from diagnosis to survival; the Carioca Aquarium environment; care in the aquarium. The results showed that cancer brings much suffering to children and their families at different stages from diagnosis to survival. However, the physical environment was significant and representative for adherence to treatment and was a significant tool for coping with the child and his family in childhood cancer. The children enjoyed playing around the place, even when their presence was not needed in the room. Moreover, stories and personal relationships created and experienced in that hospital ecology were essential to minimize the negative impact of cancer and its treatment in child development. Children, even in cancer chemotherapy, did not perceive themselves as sick, only when there was exacerbation of symptoms or troublesome toxicities. The games made a bridge between the professional and the child by providing a closer approximation, therefore the creation of links, through a careful and sensitive listening. The hospital ecology of the Carioca Aquarium initiatives strengthens the host of the professionals in the child and his family, providing the production of humanized and comprehensive care. It is recognized that the Carioca Aquarium can be a powerful therapeutic environment. / O câncer infantil é uma doença crônica que quando é diagnosticada traz repercussões para a vida da criança e de sua família. A quimioterapia ambulatorial é uma alternativa para minimizar danos relacionados à quebra de vínculos familiares, uma vez que a criança passa a ter possibilidade de receber o tratamento proposto e ser liberada para retornar ao lar após algumas horas. Na busca pela excelência na atenção à saúde, tem sido apontada recentemente a influência que o espaço físico tem sobre os diferentes atores no ambiente hospitalar, tais como os pacientes, o corpo técnico e os acompanhantes. O Instituto de Puericultura e Pediatria Martagão Gesteira destinou uma nova área para a sala de quimioterapia que foi reformada e decorada baseada no filme Procurando Nemo, denominada Aquário Carioca. Este estudo objetivou investigar a influência do ambiente do Aquário Carioca na percepção da criança em relação ao contexto do cuidado e bem estar da mesma durante as sessões de quimioterapia. Trata-se de pesquisa de abordagem qualitativa, exploratória e descritiva. Os sujeitos foram sete crianças em idade escolar, que fizeram ou estavam fazendo quimioterapia no Aquário Carioca. A coleta de dados foi efetuada no mês de maio de 2010, utilizando-se uma adaptação da técnica do desenho-estória para produção do material empírico. Para interpretação dos discursos das crianças seguiu-se os fundamentos da análise temática. Emergiu uma categoria empírica: Ecologia hospitalar no Aquário Carioca. As subcategorias foram: o processo: do diagnóstico à sobrevivência; o ambiente do aquário carioca; o cuidado no aquário carioca. Os resultados apontaram que o câncer traz muito sofrimento para a criança e sua família nas diferentes fases, desde o diagnóstico até a sobrevivência, contudo o espaço físico foi representativo e expressivo para a adesão ao tratamento e constituiu-se em ferramenta significativa para o enfrentamento da criança e sua família frente ao câncer infantil. As crianças gostavam de ficar brincando no local, mesmo quando não era necessária sua presença na sala. Ademais, as histórias e relações pessoais vividas e criadas nessa ecologia hospitalar foram imprescindíveis para minimização do impacto negativo do câncer e seu tratamento no desenvolvimento da criança. As crianças, mesmo em quimioterapia antineoplásica, não se percebiam como doentes, apenas quando havia exacerbação de sintomas ou toxicidades incômodas. O lúdico fez uma ponte entre o profissional e a criança proporcionando uma maior aproximação, portanto a criação de vínculos, por meio de uma escuta sensível e atenta. A ecologia hospitalar do Aquário Carioca fortalece as iniciativas de acolhimento dos profissionais frente à criança e sua família, possibilitando a produção do cuidado integral e humanizado. Reconhece-se o Aquário Carioca como um ambiente terapêutico.

“Förlossningsvården behöver i ännu större utsträckning än idag även bestå av känslomässigt stöd och trygghetsskapande omvårdnad.” Citatet ovan finns i boken Trygg förlossning (2017) och är vägledande i mitt examensarbete. Idag är det säkert att föda i Sverige och mödra- och barnadödligheten är bland den lägsta i världen. Trots detta lider många av förlossningsrädsla. Studier, bland annat från Socialstyrelsen, visar att platt ryggläge är den förlossningsställning som är mest ofördelaktig, för både föderska och barn. När föderskan rör på sig och om hen dessutom har en upprätt förlossningsställning kan den upplevda smärtan minska, eftersom utsöndringen av endorfiner ökar. Trots detta har de flesta en liggande ställning under förlossningen. Det finns uppenbarligen glapp mellan den medicinska kunskapen och förlossningspraktiken. Därför undersökte jag befintliga hjälpmedel och produkter inom förlossningsvården, som dessutom inte är utvecklade för ett förlossningsarbete, utan inlån från andra sjukvårdsavdelningar. Jag har utvecklat ett designförslag som ska uppmana till upprätta förlossningsställningar för en tryggare förlossning. / “Maternity care needs to be comprised of emotional support and reassuring nursing practices, even more so than it does today.” This quotation, from the book Trygg förlossning (2017), has been a big influence in my degree project. Today, it is regarded as safe to give birth in Sweden with maternal and child mortality being amongst the lowest in the world. Despite this, many suffer from a fear of childbirth. Studies from Socialstyrelsen, amongst others, show that a back-lying position during childbirth is disadvantageous for the mother and child. If the mother moves and has an upright position, the perceived pain may decrease as the release of endorphins increases. Despite this, most people continue use a back-lying position during childbirth. There is obviously a gap between medical knowledge and childbirth practice. Therefore, I have investigated existing aids in maternity care, many of which are not developed for childbirth, but borrowed from other healthcare departments. I have developed a design proposal that will encourage an upright childbirth position for a safer delivery.

Made available in DSpace on 2014-12-17T15:39:04Z (GMT). No. of bitstreams: 1 LucianaM.pdf: 457840 bytes, checksum: bf4b3acdf176b25088129393a942d019 (MD5) Previous issue date: 2004-10-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The creation of the Humanization Program of Hospital Care and the increasing number of academic works and journal articles that discuss more humane practices in the health care services express the emphasis given to the theme in Brazil. In these discussions, however, it is not usual to find reference to architecture as a relevant factor in the humanization of hospitals, even though it is known that the physical structure of the building may help the recovering of the patients; elements such as gardens, the use of colors and open spaces may soften the impact caused by the hospital routine on patients. Considering the contribution the architectural project may bring to the humanization of hospitals, the aim of this study was to verify how the architects perceive the hospital humanization process. Besides having searched for subsides in informal interviews with health professionals, in visits to hospitals and in related seminars, the study was based on semi-structured interviews with architects of Natal, Rio Grande do Norte, who are specialists in this kind of projects. The content analysis of the interviews showed that physical space and attendance are essential to the humanization process. Those professionals see two humanization tendencies: while private hospitals have the structural physical appearance considered as humanized, public hospitals emphasize the humanization in attendance, fact that illustrates the contradictions in Brazilian health system. The interviewees consider the post-occupancy evaluation of the building as a learning exercise that contributes to new projects, but surprisingly they do not mention the patients opinion as part of it. Two annoying facts have emerged from the interviews, as also seen in preliminary stages of the study: rare are the works that focus on the person-environment relationship, and the definition of humanized hospital environments is still broad and inaccurate. This suggests the need of new studies in order to better understand how the two factors shown in this study attendance and physical space interact towards a true hospital humanization / A cria??o do Programa de Humaniza??o da Assist?ncia Hospitalar e o n?mero crescente de artigos e teses que discutem pr?ticas mais humanas no atendimento em sa?de expressam a ?nfase dada ao tema no Brasil. Nessas discuss?es, entretanto, n?o costuma haver refer?ncia ? arquitetura como fator relevante para a humaniza??o hospitalar, embora j? se saiba que a estrutura f?sica do edif?cio pode auxiliar no restabelecimento dos pacientes; elementos como jardins, uso de cores e espa?os abertos podem amenizar o impacto causado pela rotina hospitalar sobre os pacientes. Considerando a contribui??o que o projeto arquitet?nico pode trazer para a humaniza??o de hospitais, o objetivo deste estudo foi verificar a percep??o dos arquitetos acerca do processo de humaniza??o hospitalar. Al?m de ter buscado subs?dios em entrevistas informais com profissionais de sa?de, em visitas a hospitais e semin?rios sobre o assunto, a pesquisa foi baseada em entrevistas semi-estruturadas com os arquitetos de Natal, Rio Grande do Norte, especialistas neste tipo de projeto. A an?lise do conte?do das entrevistas revelou que espa?o f?sico e atendimento s?o essenciais ao processo de humaniza??o. Para aqueles profissionais, h? duas tend?ncias de humaniza??o: enquanto hospitais privados t?m a apar?ncia f?sica de sua estrutura considerada como humanizada, hospitais p?blicos enfatizam a humaniza??o do atendimento, num contraste que refor?a as contradi??es do sistema de sa?de do pa?s. Os entrevistados consideram a avalia??o do edif?cio depois de entregue ao uso um exerc?cio de aprendizagem que contribui para novos projetos, mas, surpreendentemente, n?o contemplam a opini?o dos pacientes. Confirmam-se duas inquieta??es decorrentes dos levantamentos preliminares: raros s?o os trabalhos que focalizam as rela??es pessoa-ambiente, e a defini??o de ambiente hospitalar humanizado ainda ? abrangente e imprecisa. Isso sugere a necessidade de novas pesquisas para compreender melhor como os dois fatores apontados neste estudo atendimento e espa?o f?sico interagem para uma verdadeira humaniza??o hospitalar

Even if one is confident that the staff provide the bestpossible treatment, being admitted into hospital is still astressful situation. In recent decades, architecturalresearchers have elaborated on aspects of the patient'sperspective where the design of the physical environment maypositively enhance the healing experience. The emergingunderstanding reveals that this is not an issue to be solvedsimply by decorative design, for it entails the spatialinterpretation and integration of broader and deeper facets ofhuman response, within which suffering, empathy andprofessional care are embraced. This thesis elucidates the patients' use of space accordingto their cultural perceptions in two inpatient wards in aregional hospital in northwestern Namibia. The study appliescase study methodology with the focus on the interactionbetween patients, visitors and nursing staff in relation to thephysical environment. The theoretical basis within medical anthropologyconceptualises sickness as a cultural event in the dual notionillness and disease, signifying two ways of understandingsickness, the individual and the professional interpretations.The Foucauldian theory on discipline and space suggests thatthe biomedical discipline is spatially represented by themodern hospital, from which aspects of illness areexcluded. The results show that circumstances in the physicalenvironment highly influence the patients' illness experienceby possessing certain qualities or by the activities renderedpossible by spatial conditions. The two wards possess manymodern qualities adding to an enclosed and restrictingenvironment. Patients come from a culturally dynamic andchanging context where new approaches to healthcare andhospital physical space are generated. Whereas patients haveintegrated hospital-based biomedicine as a medical alternative,modern hospital space cannot accommodate certain patient needs.Patients, visitors and nursing staff negotiate space in orderto overcome spatial weaknesses. Family members' overnightaccommodation in the hospital, as well as their voluntarycontribution to patient care, are two important aspects whichare not spatially incorporated. An alternative ward design is suggested in which patients'and family members' active participation in the healing processis encouraged, with support from the nursing staff. The higherflexibility the design offers caters for the spatialintegration of future hybrid processes.

<p>Even if one is confident that the staff provide the bestpossible treatment, being admitted into hospital is still astressful situation. In recent decades, architecturalresearchers have elaborated on aspects of the patient'sperspective where the design of the physical environment maypositively enhance the healing experience. The emergingunderstanding reveals that this is not an issue to be solvedsimply by decorative design, for it entails the spatialinterpretation and integration of broader and deeper facets ofhuman response, within which suffering, empathy andprofessional care are embraced.</p><p>This thesis elucidates the patients' use of space accordingto their cultural perceptions in two inpatient wards in aregional hospital in northwestern Namibia. The study appliescase study methodology with the focus on the interactionbetween patients, visitors and nursing staff in relation to thephysical environment.</p><p>The theoretical basis within medical anthropologyconceptualises sickness as a cultural event in the dual notionillness and disease, signifying two ways of understandingsickness, the individual and the professional interpretations.The Foucauldian theory on discipline and space suggests thatthe biomedical discipline is spatially represented by themodern hospital, from which aspects of illness areexcluded.</p><p>The results show that circumstances in the physicalenvironment highly influence the patients' illness experienceby possessing certain qualities or by the activities renderedpossible by spatial conditions. The two wards possess manymodern qualities adding to an enclosed and restrictingenvironment. Patients come from a culturally dynamic andchanging context where new approaches to healthcare andhospital physical space are generated. Whereas patients haveintegrated hospital-based biomedicine as a medical alternative,modern hospital space cannot accommodate certain patient needs.Patients, visitors and nursing staff negotiate space in orderto overcome spatial weaknesses. Family members' overnightaccommodation in the hospital, as well as their voluntarycontribution to patient care, are two important aspects whichare not spatially incorporated.</p><p>An alternative ward design is suggested in which patients'and family members' active participation in the healing processis encouraged, with support from the nursing staff. The higherflexibility the design offers caters for the spatialintegration of future hybrid processes.</p>

Thesis--University of Oklahoma. / Bibliography: leaves 50-53.

Made available in DSpace on 2015-05-08T14:47:49Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1264878 bytes, checksum: 5cf01f944124654dcbc396847b5b4a86 (MD5) Previous issue date: 2015-12-05 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The diagnosis and treatment of childhood cancer brings much suffering for the child and his family. For some people, cancer is seen as an indication of approaching death. The nursing care, occur in this reality. The search for the humanization of the hospital environment can help to minimize the suffering of children, their caregivers and nursing staff. Florence Nightingale said that one of the defining of a person's health status and disease is the environment around them, their conditions and influences. We aimed o analyze the influence of a playful outpatient setting on the vital power of children in chemotherapy, their caregivers and nursing staff. This is a qualitative study conducted in a children's outpatient chemotherapy service (Aquário Carioca), between May and June 2010 and October 2013. The subjects were 10 caregivers of the children attending the outpatient chemotherapy and 9 members of the nursing staff working in the Carioca Aquarium. We used the in-depth interview for the production of empirical material. Followed the principles of thematic analysis for interpretation of the material produced. The concepts described in Environmentalist Theory, along with literature, substantiate the results and discussion. We were create three empirical categories. The first: Vital Power of children in playful environment for chemotherapy; with two sub-categories: external environment to children with cancer and internal environment to children with cancer. The second: playful outpatient chemotherapy of child and the vital power of the caregivers, with two subcategories: favoring the vital power and weakening of the vital power. The third: care in child chemotherapy room: vital power of the nursing team, with three sub categories: environmental context for child care in outpatient chemotherapy; principle of operation in child chemotherapy room; feelings of nursing staff in the care of everyday. Empirical data from field research support the contention that a playful and proper care environment for the child outpatient chemotherapy, humanizes nursing care and influences the vital power of children with cancer, caregivers and nursing staff. / O diagnóstico e tratamento do câncer infantil traz muito sofrimento para a criança e sua família. Para algumas pessoas, o câncer é visto como uma indicação de morte próxima. É nesse cenário que a Enfermagem precisa cuidar; portanto, a busca pela humanização do ambiente hospitalar pode contribuir para minimizar o sofrimento das crianças, dos seus acompanhantes e da equipe de enfermagem. Florence Nightingale afirmava que um dos definidores do estado saúde-doença de uma pessoa é o ambiente ao seu redor, suas condições e influências. Objetivou-se analisar a influência de um ambiente ambulatorial lúdico sobre o poder vital de crianças em quimioterapia, de seus acompanhantes e da equipe de enfermagem. Trata-se de uma pesquisa qualitativa, realizada em um serviço de quimioterapia ambulatorial infantil (Aquário Carioca), no período de maio e junho de 2010 e outubro de 2013. Os sujeitos foram 10 acompanhantes das crianças que frequentavam o ambulatório de quimioterapia e 9 membros da equipe de enfermagem que trabalhavam no Aquário Carioca. Utilizou-se a entrevista em profundidade para produção de material empírico. Foram seguidos os princípios da Análise Temática para categorização do material produzido. Os conceitos descritos na Teoria Ambientalista de Florence Nightingale, junto com a literatura pertinente, fundamentaram os resultados e a discussão. Foram criadas 3 categorias empíricas. A primeira: Poder vital das crianças no ambiente lúdico para quimioterapia; com duas subcategorias: ambiente externo à criança com câncer e ambiente interno à criança com câncer. A segunda: Ambulatório lúdico de quimioterapia infantil e o poder vital dos acompanhantes, com duas subcategorias: favorecimento do poder vital e fragilização do poder vital. A terceira: Cuidado em sala de quimioterapia infantil: poder vital da equipe de enfermagem, com três sub categorias: Contexto do ambiente para o cuidado à criança em quimioterapia ambulatorial; Modo de trabalho na sala de quimioterapia infantil; Sentimentos da equipe de enfermagem no cotidiano de cuidado. Os dados empíricos da pesquisa de campo comprovam a tese de que um ambiente lúdico e propício ao cuidado, durante a quimioterapia ambulatorial infantil, humaniza a assistência de enfermagem e exerce influência sobre o poder vital de crianças com câncer, acompanhantes e equipe de enfermagem.

Orientador: Andre Munhoz de Argollo Ferrão / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil / Made available in DSpace on 2018-08-04T00:26:18Z (GMT). No. of bitstreams: 1 Fernandes_AdhemarDizioli_M.pdf: 5897291 bytes, checksum: 53dd194d71c80c76c31e185fba8a5632 (MD5) Previous issue date: 2003 / Resumo: O hospital converteu-se em instituição social através dos séculos, transformouse em um edifício complexo, abrigando especialidades e equipamentos médicos múltiplos que refletiram na sua concepção e projeto. Neste trabalho descrevem-se as transformações arquitetônicas e construtivas do edifício público de saúde na cidade de São Paulo, principalmente, a partir da segunda metade do século XIX, com o desenvolvimento da cultura cafeeira, o advento da República e a estruturação do Serviço de Saúde Pública. Especificamente, identificam-se as intervenções físicofuncionais e técnico-construtivas ocorridas no período de 1998 a 2002, em uma série de hospitais públicos, construídos a partir de uma mesma tipologia, na Região Metropolitana da Grande São Paulo. Os resultados mostram que esses hospitais, concebidos em 1986, continuam atuais diante das alterações e reestruturações implementadas no seu espaço físico, visando abrigar novas unidades funcionais e equipamentos, possibilitando a execução de novos procedimentos médico-hospitalares / Abstract: Throughout the centuries the hospital has turned into a social institution, becoming a complex building, sheltering specialties and multiple medical equipment that is reflected in its conception and design. In this paper the architectural and constructive transformations of the public health building are described in the city of São Paulo, mainly, from the second half of the XIX century, with the development of the coffee culture, the coming of the Republic and the structuring of the Public Health Service. Specifically identified are the physical-functional and technical-constructive nterventions that happened from 1998 to 2002, in a series of public hospitals all built from the same typology in the Metropolitan Area of Great São Paulo. The results show that those hospital buildings, conceived in 1986, continue to be updated due to the alterations and restructuring implemented in the spitals, seeking to shelter new functional units and equipment, making possible the execution of new medical/hospital procedures / Mestrado / Edificações / Mestre em Engenharia Civil