healing environments in radiotherapy - Agnes van den Berg

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Healing Environments in Radiotherapy Project Report Disclaimer This report is produced by students of Wageningen University as part of their MSc-programme. It is not an official publication of Wageningen University or Wageningen UR and the content herein does not represent any formal position or representation by Wageningen University. Dit rapport is gemaakt door studenten van Wageningen Universiteit als onderdeel van hun MScopleiding. Het is géén officiële publicatie van Wageningen Universiteit of Wageningen UR. Wageningen Universiteit neemt middels dit rapport geen formele positie in, noch representeert het haar visie of mening in deze. Acknowledgements The consultancy team would like to express their gratitude toward everybody who helped to make this project possible. We want to thank the directors of the two radiotherapy departments that took part in this study, one of which commissioned this project. Both directors and their assistants provided invaluable input and ideas, and we are grateful for their cooperation in hosting the focus groups and interviews conducted during the project. Furthermore, we want to thank the experts on healing environments, dr. Roger Ulrich, drs. Gerrie van Lagen, drs. Fiona de Vos and Arnoud Kwint, who donated their valuable time to this project. We would like to thank all the patients and their relatives who participated in the focus groups, as well as the staff members who were interviewed at the two radiotherapy departments. Their invaluable input was essential to the success of this project. Finally, we want to express our gratitude to the teachers at Wageningen University who assisted us throughout in the process of working on this project. Special thanks to the team’s Content Expert dr. Agnes van den Berg, who provided very valuable comments on our work, and our Process Coach prof. dr. ir. Pim Brascamp, who helped us to reflect on individual learning goals. We also appreciate very much the assistance we received from the focus group expert dr. Astrid Hendriksen to optimise the design of the focus groups conducted at the commissioner’s radiotherapy department. We would also like to thank Anouk Brack for teaching us how to work in a team, and Erik Hijmans for guiding us in writing the project proposal. ii
Healing Environments in Radiotherapy Project Report Executive Summary This report is the final product of the academic consultancy project Healing Environments in Radiotherapy. The consultancy project aimed to provide the commissioner at a radiotherapy department in the Netherlands with general recommendations regarding healing environments for cancer patients, as well as more specific recommendations for improving the current non-optimal healing environment at the radiotherapy department. This aim was approached through a fourtiered data collection strategy. First, a review of academic literature regarding healing environments was conducted to uncover insights into the physical, and social and psychological elements of healing environments. Since specific literature on healing environments for cancer patients is rare, data collection efforts were extended to interviews with experts in the field, as well as desk research on good practice examples of healing environments in radiotherapy. Furthermore, a comparative case study was conducted to gain insights on how cancer patients and staff evaluate the healing environment at their radiotherapy department. Patient perspectives were investigated through focus groups with patients at the commissioner’s radiotherapy department, who had experienced a nonoptimal healing environment, as well as patients at a second Dutch radiotherapy department where principles of healing environment have been implemented. Staff perspectives were studied through semi-structured interviews with radiotherapy employees at both radiotherapy departments. The findings of the literature and good practice review were substantiated by interviews with four experts in the field of healing environments, including the most recognised academic in the field, prof. dr. Roger Ulrich. This revealed a range of elements that are important for healing environments. For instance, physical elements include lighting, fresh air, smell, access to outdoor nature, indoor nature, noise levels and music, the spatial layout, a homely atmosphere, art and positive distractions, and use of colour. Furthermore, social and psychological elements comprise feeling in control, privacy, access to information, being treated with respect, counselling and support groups, caring and compassionate treatment, and a functioning medical team. Importantly, it was found that social and psychological elements are equally important as physical elements of healing environments. Through the comparative case study, it was possible to make these findings relevant to the specific situation at the two radiotherapy departments involved in this project, which led to a range of general recommendations for improving healing environments in radiotherapy, with a specific focus on the commissioner’s department. Of course, the study presented here had some limitations regarding sampling method and data collection, which will be outlined at the end of the report. In spite of these limitations however, the study was able to argue for the importance of implementing evidence-based design principles to create healing environments in radiotherapy. Furthermore, the study points to several areas for future research, especially in the direction of staff appreciation of radiotherapy environments and the links between staff satisfaction and cancer patients’ recovery outcomes. iii
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