impact of the architectural design of hospital built...

Impact of the Architectural Design

of Hospital Built Environment on the

Behaviour & Psychology of Cancer

Patients

Dissertation Submitted by Manishankar Datta

Reg No: 070901160

B. Arch IX Semester ‗A‘

Manipal School of Architecture and Planning

Manipal University

November 2011

Impact of the Architectural Design of Hospital Built Environment on the Behaviour &

Psychology of Cancer Patients

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DISSERTATION ARC-411 | MSAP MANIPAL | MANISHANKAR DATTA | B.ARCH SEMESTER IX ‗A‘

CERTIFICATE

We certify that the Dissertation entitled “Impact of the

Architectural Design of Hospital Built Environment on the Behaviour

& Psychology of Cancer Patients”, that is being submitted by

Manishankar Datta (Reg No. 070901160), in the IXth Semester of

B.Architecture undergraduate programme, Manipal School of

Architecture and Planning , Manipal University, Manipal is a record

of bonafide work, to the best of our knowledge.

------------------------------ -----------------------

Dr Nandineni Rama Devi Dr. N. K. Garg

Faculty in charge Director



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Acknowledgements

I would like to thank Dr Nandineni Rama Devi my guide for this dissertation.

I would like to acknowledge the contribution of the following people:

Sanghamitra Roy, Associate Professor, Manipal School of Architecture and

Planning

Deepika Shetty, Associate Professor, Manipal School of Architecture and

Planning

Dr. Gautam Bhattacharya, Oncologist, Cancer Centre Welfare Home and

Research Insitute

Anjan Gupta, Design Principal, Anjan Gupta Architects

Dr. Donald J Fernandes, Professor and Head of Department of Oncology,

Shirdi Sai Baba Cancer Hospital, A constituent of Kasturba Hospital, Manipal

Doctors at Shirdi Sai Baba Cancer Hospital, Manipal

Doctors at Cancer Centre Welfare Home and Research Institute, Kolkata

The Medical Superintendant and Administration of Kasturba Hospital, Manipal

for permission and co-operation in conducting the Case-Study.

Prof (Dr.) Garg Director, MSAP for his support.



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Abstract

The main aim of this research paper is to establish the criteria for designing an

environment targeted at the patient‘s psychology that helps them feel

comfortable and at home while combating a debilitating disease like

Cancer. This study is directed at the contribution of architects in reducing

stress in patients and influences their psychology in a positive way.

Cancer is a dreadful disease that affects millions of people all over the world.

Cancer knows no political, religious, caste, colour, race boundaries. It affects

people from different economic segments and a varied age group. Cancer

patients spend a lot of time at hospitals depending on the severity of their

disease. Cancer treatment affects essentially three groups: The doctors,

patients and their loved ones.

The two pronged study mainly consisted of a Medical Opinion on the topic

and an academic one. There lies a gap between Academic practises and its

direct impact on the patients which they may not be aware of which doctors

can bridge.

The research approaches adopted in this dissertation are Photographs,

observations, interview and questionnaires.

However it must be noted that Human Psychology is a dynamic concept and

has various interpretation. In a public space such as a hospital there are

people from various backgrounds, ethnicity, opinion, mental state etc. that

visit and the design solution should be a neutral one which is prevalently

accepted however certain other inputs may be appreciated by a few while

neutral to others.

This dissertation has been limited to the elements of the built environment.

Design considerations in the basis of space planning have not been

addressed. It is the unquantifiable elements of the built environment that



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have been looked into. Further studies on the effect of the psychology of the

patient on the space planning of the built environment can be looked into.

The research aims at developing a concrete relationship between built-

environment with the reactions of cancer patients. The reduction of stress of

this disease through different architectural treatments and principles is the

main goal. The stress has an impact on the recovery of such patients.

Palliative care is also an important study aspect making it comfortable for

terminal patients in their last days.

The findings from this research provide evidence that there is a clear link

between cancer patient‘s psychology and the built environment. The main

conclusions that I seek to draw from this dissertation is attempt to establish the

elements of the built environment that can influence a cancer patient‘s

psychology and come to a design criteria for such an environment.



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Table of contents

Page no.

List of Tables 7

List of Figures 8

Chapter 1: Introduction 9

Chapter 2: Literature Review 12

Chapter 3: Methodology 27

Chapter 4: Analysis of Data 40

Chapter 5: Conclusions 44

Appendix 47



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List of tables

Page No.

Table 4.1 Comparison of Data Collected 1 40

Table 4.2 Comparison of Data Collected 2 41

Table 4.3 Analysis of Data Collected 1 42

Table 4.4 Analysis of Data Collected 2 43



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List of figures

Page No.

Fig 2.1- Maggie's Centre in Dundee by Frank Gehry 12

Fig 2.2: Pictures from Circle Bath by Foster and Partners 15

Fig 2.3 Maggie Centre Fife designed by Zaha Hadid 16

Fig 2.4 Atrium at a Hospital 16

Fig 2.5.1Social Determinants of Health and Environment Health

Promotion.

26

Fig 3.1 Figure Representing Methodology. 27

Fig 3.2 Figure Representing Method of Data Collection 28

Fig 3.3 Site Plan (Source: CCWHRI, Kolkata) 30

Fig 3.3 Photograph of Landscape Areas at CCHWRI 31

Fig 3.4 A Campus Of Colours Shapes And Forms 31

Fig 3.5 A Campus Of Colours Shapes And Forms Atrium With

Fountain And Dome

32

Fig 3.6 A Atrium 32

Fig 3.7 and 3.9 Diagnostic Areas 33

Fig 3.10 Toy Train Line on Campus 33

Fig 3.11 View of Doctors Room 34

Fig 3.12 View of Waiting Area (From Collections of Author) 34

Fig 3.13 View of Main Atrium 35

Fig 3.14 View of Diagnostic Facilities 35

Fig 3.15 and 3.16 View of Diagnostic Facilities 36

Fig 3.17 View of Waiting Area 36

Fig 3.18 View of recreation at Waiting Area 37

Fig 3.19 and Fig 3.20 View Building and meditation Center 37



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CHAPTER 1: INTRODUCTION

1.1 Background

The World Health Organisation has projected that there could be 50 million

new cancer patients by 2020 (WHO, Cancer Repor-2010). In India there are

25 lakh cancer patients as of 2009 (Financial Express, 2005), the government

hospitals that have cancer treatment facilities tend to pay no attention to the

quality of spaces and the impact it makes to the human psychology.The

funds crunch all over has resulted in a severe ignorance towards the quality

of life of cancer patients. Children who are afflicted by this disease are

perhaps those who attract the maximum sympathy from all over.

Palliative care1 is an important aspect that a lot of cancer care facilities do

not pay much attention to. It is important for us to address patients who have

been diagnosed as terminal and make their environment comfortable for

them to spend their last days. Malignant tumours resulted in 56 million deaths

in the year 2000. Thus, there is strong statistic pointing out the need for

Palliative care facilities. Studies have shown, 58% of terminally ill cancer

patients wish to be euthanized. This is perhaps a result of lack of care facilities

of such patients.

1.2 Definition of Terms

The term built environment refers to the structures, and infrastructure, that are

made by man. This can include everything from simple housing to entire

cities, and even man-made outdoor environments. The Macmillan Dictionary

defines built environment as ―all the structures people have built when

considered as separate from the natural environment‖ The United States

1 Palliative care is defined as the care given to those patients that have been

declared as terminally ill and cannot be cured. Palliative care seeks to medicate

through pain killers and make the last few days for these patients as comfortable as

possible.



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Bureau of Reclamation further goes on to define Built Environment as Human-

modified environment, e.g. buildings, roads, and cities.

Cancer Patient is termed as a person suffering from some form of cancer.

Cancer Patients can be of two types- terminal and non-terminal. Cancer

Patients are categorized in stages in terms of the progression of cancer in

their system.

Patient Psychology is the study of the mind and mental processes, especially

in relation to behaviour and study of the soul. The Latin word psychologia was

first used by the Croatian humanist and Latinist Marko Marulić in his book,

Psichiologia de rationeanimaehumanae in the late 15th century or early 16th

century.

The term positive way implies to the betterment of an individual from both the

person‘s perspective and also others.

1.3 Aim

Designing an environment targeted at the patient‘s psychology that helps

them feel comfortable and at home while combating this debilitating

disease. This research is directed at the contribution of architects in reducing

stress in patients and influence their psychology in a positive way.

1.4 Research Question and Statement

The main question put forth by this research paper is:

„How can architects treat the built environment to affect the

psychology and behaviour of Cancer patients in a positive

way?

The research statement reads:

„The architectural design of a built space and its various aspects

of that design can have a positive impact on the psychology

and behaviour of cancer patients.‟



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1.5 Objectives

The objectives is mainly to establish the following:

To explore the different aspects of the built environment.

To study the impact of these aspects on patient psychology.

To determine the indicators of positive impact on patient psychology

with respect to the design of the built environment.

To study the behaviour of cancer patients in hospitals.

To investigate the architectural factors affecting behaviour of cancer

patients in hospitals.

To find and analyse the relationship between the architectural design

of the hospitals and the psychology and behaviour of the cancer

patients.

The next chapter will cover the existing research and information

regarding the topic of my dissertation. I shall be reviewing excerpts from

various literary sources from journals, books and articles to derive

relationships in regard to the objectives of the dissertation.



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CHAPTER 2: LITERATURE REVIEW

2.1 Maggie's Centres: can architecture cure cancer?

Maggie‘s Co-founder Charles Jencks2 believes Cancer care doesn't have to

mean grim hospital wards he further adds that uplifting buildings benefit both

body and soul. However may feel that it is an Architectural Placebo.

Fig 2.1- Maggie's Centre in Dundee by Frank Gehry, an example of making an impact

through expressive architecture. Breaking the monotony of a cancer patients life through

dynamic architecture. Photograph: Murdo Macleod

Here Jencks does not claim that architecture could replace chemotherapy,

but argues that can make a difference to cancer patients.

All six existing buildings have a lengthening list of high-profile designers:

Richard Rogers, Frank Gehry, Zaha Hadid, Rem Koolhaas. But Jencks has

come has come under fire from both the scientific community, who question

2 Charles Alexander Jencks (born 21 June 1939) is an American architectural theorist,

landscape architect and designer. In the mid-sixties Jencks moved to Scotland where he lived with his late wife Maggie Keswick Jencks. His late wife, Maggie Keswick Jencks, was the founder of Maggie's cancer caring centres, for which Jencks has designed gardens, and the author of a book on Chinese Gardens.



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the validity of his claims (or media distortions of them); and the design

community, who wonder if Maggie's Centres aren't injecting more

architecture into small healthcare facilities than they strictly need.

“Jencks is not advocating some deterministic equation

between architecture and health – as if the sight of a well-

detailed staircase could somehow zap away a malignant

tumour – but he does believes in what he calls an

"architectural placebo effect". "A placebo is a phoney cure

that works," he explains. "This is very hard for the medical

profession to get their teeth around because they hate

placebos but scientifically, placebos work in about 30% of

cases that are psychogenic diseases. You have to believe in

a placebo or it won't work, but if it works it's obviously

working in some indirect way, through feedback in the

immune system, let us say, or in the willpower of the patient

to take a more strenuous exercise in their own therapy.”

Jencks goes on to say "You can imagine all sorts of ways in which architecture

adds to the placebo effect," he continues, "and in that sense it's impossible to

measure. Here's a funny insight: in a way, the carers are more important than

the patients. Because if the carers are cared for, they turn up, they enjoy it

and you create this virtuous circle, this mood in a Maggie's Centre which is

quite amazing. So architecture helps do that because it looks after the carers.

There's a lot of people who would quite rightly attack that notion, and I don't

want to claim that we can yet prove it, but we hope to."

In his book The Architecture of Hope, Jencks presents his case and asks the

reader the question ―So is there an architecture that helps you live?‖

Jencks argues it is not to be found in the modern hospital. He describes the

space in which Maggie herself received her weekly chemotherapy as a form

of "architectural aversion therapy" – a windowless neon-lit corridor of



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Edinburgh's Western General Hospital. Many of us are familiar with similar

spaces. In the industrial age, the design of healthcare buildings has been

dictated by the demands of hygiene and efficiency: hard, sterile surfaces;

bright, white spaces; long corridors; artificial ventilation systems. The template

has been updated a little in the PFI age with atrium lobbies and toothpaste-

coloured cladding, but these places are still overwhelmingly alienating.

Dutch academic Cor Wagenaar, believed that modernism created a rupture

in the long, intimate relationship between architecture and health. That history

stretches back to ancient Greece, where temple complexes such as

Epidauros were about healing the spirit as well as the body, and even

Stonehenge, which recent findings suggest may have been a hospital. Its

modern roots lie in the Enlightenment, when it was first proposed that good

design of the built environment could do more for public health than the

medical profession could. In a way, Maggie's Centres reconnect with this

"secret tradition", says Jencks. Yes, we need medical environments to cure us,

but we also need to feel like people again, rather than patients. He is not

alone in this.

The Circle group's recent hospital in Bath, designed by Foster and Partners,

which feels more like a boutique hotel. They, too, are recruiting architects

such as Richard Rogers and Michael Hopkins to rethink hospital design on a

more human scale. Or there's the AHMM's bright, fresh Kentish Town Health

Centre, also nominated for last year's Stirling prize, or Gareth Hoskins's civic-

minded health centre designs. Things are changing.



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Fig 2.2: Pictures from Circle

Bath by Foster and Partners

where the changing times

of hospital architecture has

shown down. They too

have started recruiting

established architects to

give a new colour and

landscape to hospital

architecture.(Source:

Architect‟s Website)

There's no great architectural secret at work in the design of Maggie's

Centres. They are defined by inarguably positive qualities: light, space,

openness, intimacy, views, connectedness to nature – the opposite of a

standard-issue hospital environment. They are domestic in scale, centred

around the kitchen, a place where you can make yourself a cup of tea and

have an informal conversation. In Jencks's words, they are buildings that hug

you, but don't pat you on the head. It's not just about giving people

architecture, he argues – it's also providing information, relief; psychological,

emotional and even financial support – all of which contribute to the urge to

go on living. Nor is there any set of instructions for architects as to how to

achieve these goals. Frank Gehry's building, for example, combines a crinkly-

roofed fairytale aesthetic with a serene view over Dundee on one side and a

garden maze on the other. Zaha Hadid's outlet in Fife has been compared to

a Stealth bomber – sharp and black on the outside, but mercifully calm and

light inside. More recently, Richard Rogers's London Maggie's Centre shut out

the city behind rhubarb-pink walls and opened up an oasis of intimate,

domestic-scaled spaces, all capped by a protective roof.



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Fig 2.3 Maggie Centre Fife

designed by Zaha Hadid.

A clear example of

blending the environment

into the architecture of a

hospital, showing a clear

deviation from the

modular drab

architecture of hospitals at

present (Source:

Architect‟s Website)

Thus Maggie’s Centres are clearly an indication of changing times and they

have gone on to inspire others to follow suit. They believe in a strong link

between making people comfortable in a hospital environment which

directly impact on their mental state. It has often been said that the extra mile

can be covered by Architecture, however the basis of treatment remains in

medicine.

2.2 Playing upon patient psychology in hospital environment

Fig2.4 Atrium- Sharp corners or

unfinished ends in a room depict or

even force a visualization of

impending danger. The shapes have

In another article in a healthcare news

daily, Jyothiram Gajendran, who is an

Architec"t at Apna House of Design

Chennai writes “the singularity of a hospital

environment stems from the fact that it

hosts people of various hues and

backgrounds, held together by a single

common misfortune of their ill health. And

this makes the hospital a melting point of a

myriad of emotions, at times very

uncharacteristic of the principal factors.”



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to have easy-rounded corners,

leading into larger areas

The architect goes on to state that the challenge is identified by the needs of

the patient who looks forward to some amount of comfort and familiarity to

lessen his pain and anxiety. The ambience of a hospital plays an important

role in the psychology of a patient. A patient entering the hospital is at first

apprehensive and confused at the best. He would like to be attended to

immediately or to least find his way around without much trouble. The access

has to be wide; the movement has to be logical to avoid crisscrossing; and

the arrangement of various spaces has to be non-interfering with each other.

It provides the comfort of a home-away-from-home. The patient is made to

feel that he is in a well-cared-for place and is primarily diverted from the

anguish of pain, helplessness and an anxiety over a host of issues. It is

necessary to not have intimidating structures like complex machinery or

convoluted steel structures etc in the direct and open contact of patients.

Also the spaces itself is filled with lot of greens, a symbolism for life and

energy, as a replacement to cold concrete which becomes impersonal and

distant. It is for this reason that landscaping becomes an important feature in

hospital architecture. People entering the hospital, are affected by the

innocuous things and every detail assumes a larger meaning.

The shapes they encounter in any room they enter play hard on their

subconscious. Sharp corners or unfinished ends depict or even force a

visualization of impending danger. Seen along with the layout that is not

chaotic, the shapes have to have easy-rounded corners and leading into

larger areas or spaces. However, care is taken that the spaces are not too

large and devoid of proper sound absorption materials as any sort of echo

would create hallucinations very easily in an already disturbed mind. Also

very large spaces with little objects filled in and with very high ceilings are

imposing and make a very disturbing atmosphere. A patient feels more

comfortable in cosy and snug environs. Colours could be classified into cool,



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warm and neutral shades. A hospital would be effective with cool colours

with soft hues like blue, grey etc. However most of the hospitals is painted

white, as it is a neutral colour. Also white will make a small room airy and

seem bigger. As bigger rooms are a strict no-no, even smaller rooms create a

claustrophobic feeling. Hospitals should be well ventilated so that all the bad

odours are lifted away and a draft of fresh air hangs loose.

Good cross ventilation, apart from its known uses for hygiene,

also acts on the moods of the patients. A small dark room with

little or no ventilation and painted in dark, warm, colours will

increase the ambient temperature and would lead to

hypertension of the patients who are vulnerable to such attacks

on mildest of provocation.

The most unassuming feature of the design of a hospital is the materials and

its finishes. Generally materials that are easy to maintain, non-reflective,

smooth but not shiny and with good grip and non-slippery are preferred.

Apart from the fact that these are functional necessities, they also provide

patients with a feeling of comfort and warmth.

It is generally recognised that half the battle against the disease is won by the

patients’ mind. It, therefore becomes very much imperative that the patients

are goaded into a feeling of well-being and provided with a comfort of

being in expert care. This is partly taken care by the human elements in a

hospital, but various aspects of architecture are effectively used to alleviate

the pain of the truant mind after when the pain of the disease could be

tackled with the cold precision of a doctor‘s skill. The psychology of the sick

and their near ones are well documented and are routinely non-complex. An

architect thus uses this knowledge to provide the doctors with an atmosphere

that is most conducive to an effective treatment. An intelligent juxtaposition

of design features from an astonishingly wide selection makes a hospital

aesthetic and functional both in literal and in a sublime manner.



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This article ties together various aspects of Hospital architecture including

space planning, volumes, colours, odours, finishes and others and establishes

a direct link between these factors and impact on patient psychology.

2.3 Therapeutic Environments

An article in Therapeutic Environments Forum, AIA Academy of Architecture

for Health, Ron Smith (AIA, ACHA, Senior Associate, HOK ) and Nicholas

Watkins, (Ph.D., Director of Research and Innovation, HOK) writes some

interesting insights into therapeutic environments.

This article states that “Healthcare facilities are designed not only to support

and facilitate state-of-the-art medicine and technology, patient safety, and

quality patient care, but to also embrace the patient, family, and caregivers

in a psycho-socially supportive therapeutic environment. The characteristics

of the physical environment in which a patient receives care affects patient

outcomes, patient satisfaction, patient safety, staff efficiency, staff

satisfaction, and organizational outcomes. The effects can be positive or

negative. No environment is neutral.”

A healthcare environment is therapeutic when it does all of the following:

Supports clinical excellence in the treatment of the physical body

Supports the psycho-social and spiritual needs of the patient, family,

and staff

Produces measurable positive effects on patients' clinical outcomes

and staff effectiveness

Therapeutic Environment theory stems from the fields of environmental

psychology (the psycho-social effects of environment),

psychoneuroimmunology (the effects of environment on the immune system),

and neuroscience (how the brain perceives architecture). Patients in a

healthcare facility are often fearful and uncertain about their health, their

safety, and their isolation from normal social relationships. The large, complex



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environment of a typical hospital further contributes to the stressful situation.

Stress can cause a person's immune system to be suppressed, and can

dampen a person's emotional and spiritual resources, impeding recovery and

healing.

Healthcare architects, interior designers, and researchers have identified four

key factors which, if applied in the design of a healthcare environment, can

measurably improve patient outcomes:

Reduce or eliminate environmental stressors

Provide positive distractions

Enable social support

Give a sense of control

Research on completed projects by organizations including the Center for

Health Design, Texas A&M University's Center for Health Systems Design, the

Academy of Neuroscience for Architecture, and by a growing number of

architectural firms and their clients shows measurable benefits to patient

outcomes, safety, and quality of care, from such factors.

The application of these factors has been focused on the patient and

patient's family. However, there are also recognized potential benefits for

staff and caregivers in terms of satisfaction, effectiveness, and staff retention,

from environmental factors such as:

Noise reduction

Same-handed patient rooms

Access to daylight

Appropriate lighting

Providing 'off-stage' areas for respite

Proximity to other staff

Appropriate use of technology

Decentralized observation, supplies, and charting



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The benefits staff receive from these environmental factors may impact the

quality of care patients experience.

In general, Therapeutic Environments have been proven to be cost-effective

by improving patient outcomes, reducing length of stay, and by enhancing

staff satisfaction, recruitment, and retention of staff.

2.4 Colour In Healthcare Environments

In a study published in a healthcare magazine, an attempt was made to

establish relationships between Colour and various aspects of Healthcare

Environment. The purpose of this study was to review the literature on colour in

healthcare environments in order to separate among common myths and

realities in the research and application of colour in healthcare design.

Colour is a fundamental element of environmental design. It is linked to

psychological, physiological, and social reactions of human beings, as well

as aesthetic and technical aspects of human-made environments. Choosing

a colour palette for a specific setting may depend on several factors

including geographical location, characteristics of potential users (dominant

culture, age, etc.), type of activities that may be performed in this particular

environment, the nature and character of the light sources, and the size and

shape of the space.

The evidence-based knowledge, however, for making informed decisions

regarding colour application has been fragmented, sporadic, conflicting,

anecdotal, and loosely tested. Many healthcare providers, designers and

practitioners in the field have questioned the connections between colour

and behaviour of people, suspected the value of colour as a

psychotherapeutic aid, and searched for empirical reasoning for the various

colour guidelines in healthcare settings.



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The results of the critical review of the pertinent literature produced no

reliable explanatory theories that may help to predict how colour influences

people in healthcare settings.

Regrettably, much of the knowledge about the use of colour in healthcare

environments comes from guidelines that are based on highly biased

observations and pseudo-scientific assertions. It is this unsubstantiated

literature that serves colour consultants to capriciously set trends for the

healthcare market.

1. There are no direct linkages between particular colours and health

outcomes of people. No sufficient evidence exists in the literature to the

causal relationship between settings painted in particular colours and

patients‘ healthcare outcomes.

2. Specifying particular colours for healthcare environments in order to

influence emotional states, or mental and behavioural activities is simply

unsubstantiated by proven results.

3. There are demonstrable perceptual impressions of colour applications

that can affect the experience and performance of people in particular

environments. There are indications in the research literature that certain

colours may evoke senses of spaciousness or confinement in particular

settings. However, the perception of spaciousness is attributed to the

brightness or darkness of colour and less by its hue. The sense of spaciousness

is highly influenced by contrast effects particularly brightness distinctions

between objects and their background.

4. While studies have shown that colour-mood association exists, there is

no evidence to suggest a one-to-one relationship between a given colour

and a given emotion. In spite of contradictory evidence, most people

continue to associate red tones, for example, with stimulating activities, and

blue tones with passivity and tranquillity. Clearly, colours do not contain



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inherent emotional triggers. Emotional responses to colours are caused by

culturally learned associations and by the physiological and psychological

makeup of people.

5. The popular press and the design community have promoted the

oversimplification of the psychological responses to color. Many authors of

color guidelines tend to make sweeping statements that are supported by

myths or personal beliefs. Likewise, most color guidelines for healthcare

design are nothing more than affective value judgments whose direct

applicability to the architecture and interior design of healthcare settings

seems oddly inconclusive and nonspecific. The attempt to formulate universal

guidelines for appropriate colours in healthcare settings is ill advised. The

plurality, or the presence of multiple user groups and subcultures, and the

complexity of the issues of meaning and communication in the environment

make efforts to prescribe universal guidelines a futile endeavour. Consider, as

an example, the issue of weak communication in the context of colour

specification in present healthcare settings: designers may attempt to endow

the settings with cues that the users may not notice. If the users notice the

cues, they may not understand their meaning, and even if they both notice

and understand the cues they may refuse to conform as predicted.

6. The study of colour in healthcare settings is challenging because it

occurs in the context of meaningful settings and situations. When people are

exposed to a colour in a certain setting, their judgment is a result of a

reciprocal process that involves several levels of experience. Thus, if the

healthcare setting is too noisy, or too cold, or the place is cluttered with an

array of medical equipment and bad odours, the aesthetic experience of an

individual‟s response to its colour will be affected, regardless of its “objective”

meaning. In addition, the response is influenced by the person‘s role in the

settings (whether he or she is a patient, a staff member or a visitor to the

facility). Furthermore, a large host of internal forces are involved in the act of

reaching aesthetic conclusions. Among them are the person‘s physical



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condition (whether he or she feels sick or suffers from pain, how tired he or she

is, whether he or she lays in bed or works out as part of their physiotherapy,

etc.) as well as the person‘s psychological state (whether he or she is aware

of his or her surroundings or he or she is under the influence of drugs, or

anxious about medical procedures, or suffers from dementia, etc.).

The suggestions of the Article were the following:

“In conclusion, we want to reiterate that currently the use of color in

healthcare settings is not based on a significant evidence-based body of

knowledge. Second, we suggest that the attempt to formulate universal

guidelines for appropriate colors in healthcare settings is ineffectual. The

multiple user groups and subcultures, and the complexity of the issues of

meaning and communication in the healthcare environment make the

efforts to prescribe universal guidelines an unproductive undertaking. Our

efforts need to concentrate on the particular through the formulation of

explanatory theories and empirical studies with the aim to give attention to

specific and concrete problems rather than abstract and universal

questions.”

Clearly, the research of color in healthcare environments is an important

endeavor. Yet, the subject matter is complex and multifaceted. Furthermore,

mastering this knowledge for the application of research findings in

healthcare settings requires caution and sensitive creativity is paramount.

The relation of colour to well-being is distorted. However departing from

traditional customary hospitals colours, so as to speak, helps the patients who

have over time have attributed the overall climate of a hospital to those

colours. A deviation from the standard colour scheme keeps the patient open

to a new experience at this hospital. However its strong planning principles

and understanding of interrelation of spaces that can help break the overall

perception of a patient’s hospital experience.



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2.5 A Conceptual Framework For Understanding The Connections Between

The Built Environment And Health

None of the natural environment per se remains in cities, since even the parks

and waterways have been created—or at least significantly modified—by

people, and are therefore part of the built environment.

Nonetheless, the natural environment is essential to all life, including urban

dwellers. Thus, while we consider the natural environment to be a

fundamental determinant of health and well-being (see Figure2.5.1), in the

context of our joint urban planning and public health framework it is

background, while the built environment is foreground.

Mary Northridge recently collaborated with Amy Schulz, a University of

Michigan sociologist, to delineate the various mechanisms and pathways

through which social, political, and economic processes interface with the

physical configurations of cities to affect the health and well-being of urban

populations.

The conceptual model we jointly devised is presented in Figure 1. Figure 1 was

adapted from a conceptual model for understanding racial disparities in

health that was developed by Dr. Schulz and her colleagues at the University

of Michigan, and draws upon a joint urban planning and public health

framework for use in health impact assessment that our group at Columbia

University previously introduced.

The model posits that three domains—the natural environment (including

topography, climate, and water supply), macrosocial factors (including

historical conditions, political and economic orders, and human rights

doctrines), and inequalities (including those related to the distribution of

wealth, employment



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Figure

2.5.1Social

Determinants

of Health and

Environment

Health

Promotion. Aj

Schutz and ME

Northridge(20

03)

Thus using the various literatures available in relation to the dissertation, the

various factors of design, the stressors in healthcare environment have been

established. We have also managed to establish the best practices in those

factors. The next section will cover the methodology in which I wish to go

about my dissertation including mode of data collection, method of analysis

and drawing inferences.



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CHAPTER 3: METHODOLOGY

After collecting the background on the dissertation like the factors involved in

the topic it gave a guideline in which further studies could be conducted.

Also helped frame the methodology to be followed. This chapter establishes

the method of data collection. It establishes various stages of this dissertation

and the methodology followed to come to the final conclusion.

3.1 Figure Representing Methodology. A clear understand of the various stages of

dissertation can be established from this chart and the organization structure.

Formulation of Research Question

Literature Review

Formulation of Questionaire and documentation

techniques

Case Study 1 Case Study 2

Categorization of data collected in similar format as

Case Studies

Tabulation and analysis of data

collected

Interpretation and conclusion



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3.1 Tools of Data Collection

There were various ways in which the data was collected. The data itself can

be categorized into primary data, secondary data and data collected from

literature review. The chart below shows the various categorizations of data

collected.

Figure 3.2 Figure Representing Method of Data Collection

Data Collection

Primary Data

Observation Questionaire

Doctors/Nurses

Patients

Relatives

Experts

Behavioural Survey

Mapping of Circulation

Visual Analysis

Secondary Data

Internet based data collection

Literature Review

Journals

Articles

Books



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3.1.1 Interview Schedule

The various forms of data collection were included in this dissertation. The

questionnaires mostly comprised of Likert‘s Scale3 type questions which allow

maximum data collection with least effort.

The questions were aimed at deriving a link between the patients feeling

better in regard to the architectural features present at the hospitals. Also

open ended questions were included when questionnaires were filled by

relatives and architects so that more input could be obtained.

The questionnaire target group were four- Doctors, Patients, Relatives and

Architects. This allowed for a wholesome view from all the important user

groups of a hospital and the Architects who designed them.

For further information see Appendix.

3 A Likert scale is a psychometric scale commonly involved in research that employs

questionnaires. The scale is named after its inventor, psychologist Rensis Likert.



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3.2 Case Studies

The case studies mainly encompassed two major hospitals. The 250 bedded

Cancer Care Welfare Home and Research, Kolkata and the 300 bedded

Shirdi Sai Baba Cancer Hospital, Manipal. After establishing the criteria of

observation based on the literature study, a careful analysis was made of

these existing hospitals.

3.2.1 Cancer Care Welfare Home and Research Institute

CASE STUDY I: CANCER CENTRE WELFARE HOME AND RESEARCH INSTITUTE (CCWH&RI)

LOCATION: THAKURPUKUR, KOLKATA, WEST BENGAL

NO. PICTURE OBSERVATION

1. SITE PLAN

Fig 3.3 Site Plan (Source: CCWHRI, Kolkata)

The sprawling

campus features

a lot of

architectural

elements.

Spread of 15

acres the entire

campus has a

toy train track, a

series of ponds,

lots of

landscaping and

also and

amphitheatre.

The campus has

all the modern

technologies in

cancer care.



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2. AN INTERACTIVE CAMPUS FROM END TO END

Fig 3.4 Photograph of Landscape Areas

Upon entering

one cannot

ignore the

campus

screaming out to

the soul. The lush

green spaces

and the geese

present on the

campus do not

give you an

option but to

interact with the

open spaces.

3.

Fig 3.5 A CAMPUS OF COLOURS SHAPES AND FORMS

Architect Anjan

Gupta explains

that this campus

features the use

of a variety of

colours and

shapes and

forms that help

the penetrate

into the patients

psychology and



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4.

Fig 3.6 A CAMPUS OF COLOURS SHAPES AND FORMS

ATRIUM WITH FOUNTAIN AND DOME

Fig 3.7 A Atrium

The three floor

high fountain

penetrates the

atrium spaces of

the child care

centre, making

in a de-stressing

element for the

inhabitants of

the building. The

fountain is

capped by the

giant dome that

sprinkles light into

the atrium and

helps keep the

patients

attached to

natural light

even in their

ultra-clean

artificial world of

their wards.



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DIAGNOSTIC AREAS

Fig 3.8 and 3.9 Diagnostic Areas

Here an

architect cannot

help but block

out natural light

due to radiation

and other

climatic controls,

however by the

use of artificial

lighting in an

intelligent way

along with music

we are able to

de-stress a

patient and

make them feel

comfortable.

Fig 3.10 Toy Train Line on Campus

The toy train

dedicated to

the children

ensures that in-

spite of staying in

a hospital

environment

they do not miss

out on their

childhood and

they are able to

relate to the

hospital in a nice

manner and do

not dread or

regret the days



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they spend their.

3.2.2 Shirdi Sai Baba Cancer Hospital, Manipal

CASE STUDY II : SHRIDI SAI BABA CANCER HOSPITAL AND RESEARCH INSTITUTE

LOCATION: MANIPAL, KARNATAKA

NO. PICTURE OBSERVATION

1. SITE PLAN

Fig 3.11 View of Doctors Room

The doctors rooms

here are definitely

well planned for the

amount of natural

light entering,

however the vista is

nothing to write

home about.

Perhaps better

campus planning

would have

prevented this.

2.

Fig 3.12 View of Waiting Area

The Waiting facility

at diagnostic areas

and the doctors

rooms lack natural

light. The white

fluorescent tube

lighting gives a very

cold feeling to the

area.



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3.

Fig 3.13 View of Main Atrium

The main atrium has

enough space and

light, however again

the white light gives

it a cold feel.

4.

Fig 3.14 View of Diagnostic Facilities

The Diagnostic

Facilities are

comfortable and

well lit. however

there is a clear

absence of

entertainment and

mood lighting.



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Fig 3.15 and 3.16 View of Diagnostic Facilities

The areas leading to

diagnostic areas

have presence of

intimidating medical

equipment that can

demoralise a

patient.

Fig 3.17 View of Waiting Area(Source: Author)

The waiting areas in

the campus have

lack of natural light.

They are spacious

but lit poorly or by

cold lights. The

sources of

recreation in the

campus is few and

far between.



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Fig 3.18 View of recreation at Waiting Area

Fig 3.19 and Fig 3.20 View Building and meditation

Center

There is a distinct

lack of privacy of

the meditation

room. Meditation

rooms should be

neutral towards

religion as there a

variety of users.

Both these cancer hospitals showed contrast in terms of built environment. The

Cancer hospital in Manipal had great space constraints hence not much attention is

paid to the environment outside. The hospital also lacks funding for interior

environment and the old structure when design, many modern day practises such as

double height atriums were not present. The Cancer Hospital in Kolkata had the

luxury of space, and hence the campus could spread horizontally rather than

vertically making the quality of space both inside and outside quite different and

pleasurable for patients.



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3.2.3 Interview Data of Key Informants

The key informants comprised of various people from different backgrounds.

The Professors and doctors at the Cancer Hospitals were crucial in giving

feedback of architectural elements from the medical perspective. The

relatives of patients were also key in notifying the troubles of a cancer patient

and the relatives. Architects gave insight on modern day practices in hospital

architecture and the various constraints in such an environment.

3.2.3.1.Dr. Piyush Saxena, Professor, Department of Oncology, KMC Manipal.

He was very detailed on the kind of colours that patients are considered

apprehensive due to their relation with treatment, hospital environment and

bodily fluids. He went on to say that Red, Brown, Yellow were colours that

should be avoided. Patients directly respond to friendly relaxed and open

hospital staff. Perhaps a way to passively influence the patients is to keep

those who work at the hospitals happy and their environment open inviting

and stress free. Painting are a good idea as long as they are not too abstract

that patients would find them distracting to look at. Televisions should remain

on mute and hospital environment should be as neutral as possible due to the

wide strata and social standing of people coming to it. Public spaces are for

public! He felt that a clear circulation of patients and flow of patients from

area to area of hospital which is free from confusion helps them stay calm

and collected when in a hospital.

3.2.3.2 Dr. Donald Fernandes, HOD of Oncology KMC, Manipal

He was of the opinion that large landscape areas go a long way to keeping

the patients and the users of the hospital happy. Giving a source of

recreating during procedures and in the waiting hall is critical.

3.2.3.3 Deepika Shetty, Proffessor MSAP

She spoke from experience of getting treatment for a relative and spoke

about the importance of a clear and un-confusing flow of space. She was of

the view that patients must be introduced to large open spaces and

interesting elements only after the process of admitting and other formalities



39 | P a g e


are done. Distracting Architectural elements just prior to the admission areas

are perhaps a bad idea as the patients are here at the hospital for a purpose

and do not always enjoy the distractions in the moment of crisis. Further, the

quality of spaces at tertiary waiting areas is often not looked at. Architects

often concentrate on the main waiting halls and neglect other waiting areas

in front of diagnostic facilities or procedure rooms. Perhaps it is there that a lot

of the distractions are required. The organisation of waiting areas like a

railway stations pointing directly a television is perhaps a bad idea as it

discourages conversation. The plight of patients if shared between each

other will perhaps make it easier for them to cope. Hence more open and

interactive waiting spaces may be a better idea.

Thus after speaking to the doctors, relatives and architects the basic design

factors could be reinforced with statements from affected parties. The proof

of these co-relations could now be established through observations at the

hospitals, interviews with the doctors and talking to architects of such

healthcare environments. The next chapter will show the tabulation of the

data collected from various sources and the inference drawn from it.



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CHAPTER 4: ANALYSIS OF THE DATA

4.1 Observations and Inferences

Tab

le 4

.1 C

om

pa

rison

of D

ata

Co

llec

ted

1



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Tab

le 4

,.2 C

om

pa

rison

of D

ata

Co

llec

ted

2



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Tab

le 4

.3 A

na

lysis o

f Da

ta C

olle

cte

d 1



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Tab

le 4

.3 A

na

lysis o

f Da

ta C

olle

cte

d 1



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4.2 Findings

The major factors of built environment in relation to the research question was

identified as landscape, light, acoustics, ventilation, colours, forms , vistas, art

and artefacts and interior open spaces. The psychological factors of patients

which are linked to the topic and in the purview of architecture were

identified as anxiety, stress, discomfort, homeliness and depression.It was

found that landscaped areas had an overall impact on all the psychological

factors and helped alleviate the patient‘s distress.

Light whether artificial or natural had a positive impact on a patient‘s well

being provided it was adequate controlled and positioned. Acoustics is

important in creating a sound buffer for patients and keeping them free from

irritation and mental uneasiness.

Natural ventilation was ideal wherever possible to keep patients connected

to nature and keep establishment costs low and treatment affordable.

Diagnostic areas have to be mechanically ventilated due to unavoidable

reasons should be monitored to keep patients free of discomfort.

Colours give a sense of vibrancy to an area and had a positive impact on

cancer patients if used judiciously and too loud colours were avoided.

Forms gave a sense of variation to the built environment and prevented a

sense of monotony in the patient‘s minds. Vistas help keep patients engaged

while they are in the hospital.

Art and artefacts create very dynamic components in a room and free from

becoming mundane as artwork has various interpretations. Hence replacing

TVs in a congregation area with some nice art work or artefacts have a

positive influence on the people.

Interior open spaces can create interest in a patient‘s mind keeping him

distracted from his health situation and keeping his or her spirits high.



45 | P a g e


CHAPTER 5: CONCLUSIONS

Upon conclusion of the data collection, analysis clear relations were

established between the patient psychology and the difference aspects of

the built environment. Though many of these conclusions cannot be

quantified, however many of them can be observed in practise. The direct

link between many of these may not be established, however through

secondary factors such as stress and mental well-being of the patient,

relations can be established.

5.1 Inferences

The predominance of Medicine in cancer treatment is un-doubted. However

the human touch through architecture goes a long way to going that extra

mile in patient care and treatment.

Thus a medical campus with massive buildings and mono-tone interiors can

intimidate patients and cause them to by psychologically depreciated

before even entering a hospital building. Hence it is seen that keeping an

open campus with lots of nature, human scale buildings, interesting

interacting architectural element can help patients feel at home even at a

hospital.

The architectural touch through the built environment has a truly positive

impact on patients. Landscaping, lights, acoustics, ventilation, colours, variety

in form, vistas, art and artefacts and interior open spaces can all contribute

towards impacting the patient‘s psychology in a positive way.

It is however cautioned that one must not go overboard with architectural

elements creating confusion in the organized structure of a hospital. A patient

or relative must have a direct and straightforward circulation; it is only at

waiting areas and other static areas that architects should make the

interventions. Often creating informal spaces in a hospital is obstructing, but

planning those spaces correctly can create the best distraction for patients



46 | P a g e


which is each other. The formal arrangement of spaces in a hospital prevents

patients from interacting with each other and cause patients to become

isolated in their own rooms.

5.2 Summary

Also a cautioning design guideline must be to keep the neutrality of the

design interventions. Music, lights and some architectural elements might

have a wide audience with different levels of discomfort or comfort

associated with them. Hence such elements should be programmed in a

neutral way to help keep the hospital environment open to people from

many different background and psychological states.

Overall we were able to establish links between the positive impacts on

patient psychology with the architectural factors of built environment such as

colour, light, landscape, acoustics, vistas, forms etc. Further studies are

possible on the individual architectural elements and the particular segments

of patient psychology that it affects. Through this paper thanks to

collaboration with doctors, architects, patients and relatives some concrete

links between the unquantifiable elements such as well being, positive impact

on a patient were linked to architectural elements of the built environment.



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CHAPTER 6: BIBLIOGRAPHY

1. Jencks, Charles&Heathcote, Edwin – The Architecture of Hope:

Maggie's Cancer Caring Centres – 2010

2. Mary E. Northridge, Elliott D. Sclar, and Padmini Biswas, December 5

2003, Sorting Out the Connections Between the Built Environment and

Health: A Conceptual Framework for Navigating Pathways and

Planning Healthy Cities, Journal of Urban Health: Bulletin of the New

York Academy of Medicine, volume 80 No. 4

3. Lynn Nesmith,Eleanor – Health Care Architecture: Designs for the

Future-1995

4. Jyothiram Gajendran, Architect, Apna house of Design, Chennai

http://www.expresshealthcaremgmt.com/20020131/architecture.shtml

on August 19, 2011.

5. http://www.who.int/mediacentre/news/releases/2003/pr27/en/ on

August 22, 2011

6. http://www.worldrtd.net/news/most-terminally-ill-cancer-patients-favor-

right-die on August 19, 2011.

7. http://www.financialexpress.com/news/25-lakh-cancer-patients-in-

india/445476/ on August 20,2011

8. http://www.cancercentrecalcutta.org/about-cancer/index.html on

August 19, 2011.

9. http://www.guardian.co.uk/artanddesign/2010/may/06/maggies-

centres-cancer-architecture on August 20, 2011.

10. http://www.wbdg.org/resources/therapeutic.phpon August 19, 2011.

11. http://www.healthcaredesignmagazine.com/article/summary-color-

healthcare-environments-critical-review-research-literature on August

19, 2011.



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APPENDIX

APPENDIX A- QUESTIONNAIRE FOR DOCTORS/NURSES

NAME:

OCCUPATION:

YEARS WORKED:

1: STRONGLY AGREE 2: AGREE 3: NEUTRAL 4: DISAGREE 5: STRONGLY DISAGREE

1. THE FACILITIES HERE IS OF HIGH CLASS:

2. THE INTERIOR ENVIRONMENT OF THE HOSPITAL IS GOOD FOR PATIENTS

3. THE PATIENTS HERE ARE NOT STRESSED DURING THEIR STAY

4. THE FACILITIES HERE ARE OF WORLD CLASS STANDARDS

5. DURING DIAGNOSTIC PROCEDURES MUSIC AND LIGHTS MAKE AN

IMPACT ON REDUCING PATIENT STRESS:

6. THE LANDSCAPE AREAS ARE MAINTAINED WELL

7. GOOD LANDSCAPE FACILITIES HELP PATIENTS REDUCE STRESS

8. THE WINDOWS OF THE HOSPITALS HAVE GOOD VISTAS.

9. THERE ARE SUFFICIENT SPACES FOR PATIENTS TO GO AND UNWIND.

In Your own words:

What do you think improves the mood of patients?

How are the palliative care facilities?

How do you think Architects can contribute to making the patients feel

better?



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APPENDIX B- QUESTIONNAIRE FOR PATIENTS












In Your own words:




better?



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APPENDIX C- QUESTIONNAIRE FOR RELATIVES OF PATIENTS












In Your own words:




better?



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APPENDIX D- QUESTIONNAIRE FOR EXPERTS












In Your own words:




better?



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APPENDIX E- QUESTIONAIRE FILLED BY SANGAMITRA ROY



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APPENDIX F- QUESTIONAIRE FILLED BY DEEPIKA SHETTY



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APPENDIX G- QUESTIONAIRE FILLED BY DR. SHARMA, SSCH,KMC, MANIPAL



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APPENDIX H QUESTIONAIRE FILLED BY DR. PIYUSH SAXENA, SSCH, KMC, MANIPAL



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APPENDIX I- QUESTIONAIRE FILLED BY ANJAN GUPTA,AGA

Scale to be followed: 1: STRONGLY AGREE 2: AGREE 3: NEUTRAL 4: DISAGREE

5: STRONGLY DISAGREE

1. DURING DIAGNOSTIC PROCEDURES MUSIC AND LIGHTS MAKE AN IMPACT ON

REDUCING PATIENT STRESS: 1

2. THE LANDSCAPE AREAS ARE MAINTAINED WELL 2

3. GOOD LANDSCAPE FACILITIES HELP PATIENTS REDUCE STRESS 2

4. A GOOD VISTA FROM A WINDOW GOES A LONG WAY TO HELPING DE-STRESS.

1

5. A PATIENT MUST BE DE-STRESSED BEFORE ENTERING A HOSPITAL BUILDING TO

HELP HIM OR HER BE MORE CO-OPERATIVE. 3

6. THERE MUST BE SUFFICIENT SPACES FOR PATIENTS TO GO AND UNWIND. 1

In Your own words:


The spatial quality, natural light, tranquilty, soothing music, pictures/painings of

natural scenery, human touch of Doctors, nurses and paramedics are of prime

importance to improve the mood of patients.

What are the architectural inputs possible on palliative care facilities?

Creating space of openness with privacy to be with their near and dear ones

alongwith views outside the windows to connect to the serene nature and thus

almighty in their last days of life.

How do you think Architects can contribute to making the patients feel better?

The architecture should be friendly at the same time reassuring in terms of creating

an image of latest technology for to boost their self confidence and mental well

being.

In your opinion, what are the ways in which a patient can de-stresses before entering

a hospital?



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This depends on the accompanying relatives or friends how they try to distress before

entering a hospital

Inside a hospital what are the elements that can reduce anxiety?

The overall ambience that blends architecture with surrounding serene nature

seamlessly. Also the proper organization of different spaces so that the patients can

go through a systematic way to their final destination without any confusion and

wasting anytime.

Patients and/or Doctors prefer Artificial Light or Natural Light?

Natural light is always preferred to artificial light in general. However, artificial lights

are required for clinical examination and other medical procedures.

Patients and/or Doctors prefer Natural Ventilation or HVAC?

Natural ventilation is always preferred to mechanical HVAC system. However,

considering the climatic condition of the region a proper HVAC system should be

there to provide human comfort controlling the temperature and the humidity.

Special ares like ICCU,ITU, BMT and the likes, a controlled HVAC is a must for the

prevention of any cross infections.

What elements can help the relatives or the patients?

Built form and open space should be blended well along with rational architectural

planning.

All the spaces inside and outside the building should be functional, soothing visually

to alleviate the agonies of the patients and their relatives. There should be spaces for

different kind of activities including recreational, library, cafeteria and other waiting

and sitting spaces with good natural landscaping, indirect lighting, artwork, fountain

and play areas for the child patients.

An auditorium plays a vital role in a hospital not only for scientific seminars and

conferences but also for the cultural/entertainment programs for the inpatients and

their relatives to take care of their psychological aspects especially when they are

suffering from the dreadful disease called ‗Cancer‘.



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APPENDIX J- QUESTIONAIRE FILLED BY DR. BHATTACHARYA, CCWHRI, KOLKATA

NAME: Dr GAUTAM BHATTACHARJEE M.D.

OCCUPATION: Radiation Oncologist

YEARS WORKED: 30 years

Scale to be followed: 1: STRONGLY AGREE 2: AGREE 3: NEUTRAL 4: DISAGREE 5:

STRONGLY DISAGREE

Questions

1. THE FACILITIES HERE IS OF HIGH CLASS: 2

2. THE INTERIOR ENVIRONMENT OF THE HOSPITAL IS GOOD FOR PATIENTS 1

3. THE PATIENTS HERE ARE NOT STRESSED DURING THEIR STAY 2

4. THE FACILITIES HERE ARE OF WORLD CLASS STANDARDS 3

5. DURING DIAGNOSTIC PROCEDURES MUSIC AND LIGHTS MAKE AN IMPACT ON

REDUCING PATIENT STRESS: 1

6. THE LANDSCAPE AREAS ARE MAINTAINED WELL 2

7. GOOD LANDSCAPE FACILITIES HELP PATIENTS REDUCE STRESS 1

8. THE WINDOWS OF THE HOSPITALS HAVE GOOD VISTAS.1

9. THERE ARE SUFFICIENT SPACES FOR PATIENTS TO GO AND UNWIND.1

10. A PATIENT WOULD BE EASIER TO HANDLE IF THAT PERSON IS DE-STRESSED

BEFORE ENTERING THE HOSPITAL. 1

11. COLOURS HELP DE-STRESS 1

12. ARCHITECTURE ELEMENTS SUCH AS FOUNTAINS, SCULPTURES, LIGHTING,

MATERIALS ETC HELP IN RE-DUCING STRESS 1

In Your own words:


I feel good lighting with lot of colours and good aroma improves the mood to a

large extent.




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They are reasonably good covering all issues of Palliative Care but we still need more

professional counsellors

How do you think Architects can contribute to making the patients feel better?

By good lanscaping , allowing more air and light to enter the rooms and spaces with

lots of bright colours and preferably soft music like the Buddhist Chants etc :-

Any other notable facility visited by you, and your observations:

Thakurpukur Cancer Hospital takes into consideration the patients needs to de-stress

and feel comfortable with oneself. It tries to augment the environment with good

lighting and colours which makes it bright and cheerful. Most of the patients coming

to this hospital are advanced cases which means they have limited liofe-span and

hence often anxious and depressed. Good environment tries to take away their

depression and elevate thie moods.

Being a Doctor and a user group of a Hospital what elements in a Hospital helps you

de-stress?

Lots of open space to walk around - the rooms are bright and well-lit and the water-

bodies makes us feel optimistic and healthy.

Which would you prefer-Artificial Light or Natural Light? Natural Ventilation or

Artificial?

Would surely favour natural light and natural ventilation if feasible.

impact of the architectural design of hospital built...

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