Light, noise, art: how patients feel

Evangelia Chrysikou is an architect and medical planner at UCL. She spoke to Katie Haylor about how hospital surroundings can be adapted to improve how patients feel while in hospital...

Evangelia - In my own research in psychiatric hospitals, fairly frequently patients complain about noise from doors. They are heavy. If you're in a ward you can hear many doors. People don't think very much of the surfaces. Surfaces are thought as an aspect for infection control. We don't consider for example, that it could be surfaces, that could absorb noise. We have these technologies, we do these things in other contexts. There are technologies that could be used, low tech and high tech.

Katie - So noise is one. What about light? Have there been studies done to assess how much light someone can tolerate if they need to go to sleep or anything like that?

Evangelia - Light is something that in general, it is relatively well-studied. Light can be positive or annoying depending also where the light source is. It can be managed by where we place the source of light, but also what type of light we have. If we can adjust for example elements in the room, like if a hospital room could have curtains that maybe the patient could control. If for example, we have the discussion about individual and shared patient rooms, where again, there is the control aspect can be different. If you give to the patient the opportunity to control the light, this is around the bed. But also where the light sources are in the corridors. For example, this was most frequent in the past that the hospitals would have the light in the middle of the corridor. And then you would have people looking at these lights when they were moved around the hospital. Now, this is something that designers take into better consideration, for example, but in general, it can have a therapeutic effect.

Also natural light, this is an area where we have very good evidence. There has been a study on recovery. And we have seen that patients who recover in the post-operation rooms, that they have windows with natural light, as opposed to people who are in dark rooms, artificially lit. The people who are in the natural light area, they have faster recovery. And this is very significant because it means that you need less pain medication for example, they occupy the bed of that area less time, but it's also very important for the patient to leave the hospital or specific areas of the hospital to move to more relaxed spaces, as soon as possible.

Katie - You've mentioned light and noise, but what about decorations in a room?

Evangelia - In all of this comes the element also of control and the ability of people to intervene in their environment. This has a positive effect when people can control their environment. We have evidence when they can control temperature, for example, or as I said, the light. But with decorations there was a study done in the US where they used the pictures of the Amazon catalogue. They classified the images according for example, images that were more abstract, more naturalistic, photographs of nature, sea views, or savanna. They looked at what healthy people liked when they live in their homes and what patients really liked when they are in the hospital. And they found that the two groups differ significantly. Patients in hospitals, they liked naturalistic images. They were not fond of abstract art. And they liked images of nature. Savanna was their preference, which is something that, of course you don't expect to see in people's home, where you have more variety and more different types of art. But this was a very good study, actually.

Katie - Are there any other really key areas where research suggests that designers can intervene to make the experience of being in hospital a bit better?

Evangelia - Yes, for me, the control is a very important element. When the patient enters the hospital, they lose a lot of things. And one of them is their choice and that personalisation. And a lot of decisions happen for them.

It's important to have a sense of control. This is something that is not only for patients. We have evidence for that for all people. But everything that's applicable to normative people is more applicable when people are not well.