Journal
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
Volume 55, Issue 3, Pages 1018-1034Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2017.09.011
Keywords
End-of-life care; environmental design; interior design; architecture; palliative care; terminal illness; hospice
Funding
- National Institute on Aging of the National Institutes of Health [P30AG022845]
- Lawrence and Rebecca Stern Family Foundation through the Translational Research Institute for Pain in Later Life (TRIPLL)
- Edward R. Roybal center (in the Bronfenbrenner Center for Translational Research)
- Cornell Institute for Healthy Futures
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Context. The environment in which end-of-life (EOL) care is delivered can support or detract from the physical, psychological, social, and spiritual needs of patients, their families, and their caretakers. Objectives. This review aims to organize and analyze the existing evidence related to environmental design factors that improve the quality of life and total well-being of people involved in EOL care and to clarify directions for future research. Methods. This integrated literature review synthesized and summarized research evidence from the fields of medicine, environmental psychology, nursing, palliative care, architecture, interior design, and evidence-based design. Results. This synthesis analyzed 225 documents, including nine systematic literature reviews, 40 integrative reviews, three randomized controlled trials, 118 empirical research studies, and 55 anecdotal evidence. Of the documents, 192 were peer-reviewed, whereas 33 were not. The key environmental factors shown to affect EOL care were those that improved 1) social interaction, 2) positive distractions, 3) privacy, 4) personalization and creation of a home-like environment, and 5) the ambient environment. Possible design interventions relating to these topics are discussed. Examples include improvement of visibility and line of sight, view of nature, hidden medical equipment, and optimization of light and temperature. Conclusion. Studies indicate several critical components of the physical environment that can reduce total suffering and improve quality of life for EOL patients, their families, and their caregivers. These factors should be considered when making design decisions for care facilities to improve physical, psychological, social, and spiritual needs at EOL. (C) 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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