healing environments in radiotherapy - Agnes van den Berg

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Healing Environments in Radiotherapy Project Report Table of Figures Figure 4: Project Goals ............................................................................................................................ 5 Figure 5: Four-tiered data collection....................................................................................................... 6 Figure 7: Experts interviewed for the project ......................................................................................... 9 Figure 30: Chart of ‘Healing Colours’ used at Parrish Medical Center.................................................. 36 Figure 32: Goals and methods of the comparative case study............................................................. 46 viii
Healing Environments in Radiotherapy Project Report 1. Introduction This report is the final product of the academic consultancy project ‘Healing Environments in Radiotherapy’, which was conducted from March to mid June 2009 by seven Master level students from Wageningen University. The project was commissioned by the director of a radiotherapy department at a hospital in a major city of the Netherlands (henceforth the target hospital), and enjoyed substantial support from the director of a second radiotherapy department at a Dutch hospital (henceforth the control hospital). The project was concerned with evidence-based design of healing environments for cancer patients, and aimed to contribute to the vision of the target hospital to extend the efforts currently made to create a better healing environment in the radiotherapy department, and to base such efforts on relevant evidence. Before we outline the project goals and approach in more detail, the concepts of ‘healing environment’ and ‘evidence-based design’ will be explained, and advantages and disadvantages of creating healing environments in hospitals will be discussed. 1.1 Healing and healing environments When trying to understand what a healing environment actually is, it is important to first gain a clear understanding of the word healing. According to the Oxford dictionary, healing means to “make or become sound or healthy again [or] put right (an undesirable situation)” (Oxford Dictionaries, 2009a). The word cure is sometimes used as a synonym, though it is not the same. According to the same dictionary, curing means to “relieve (someone) of the symptoms of a disease or condition [or] end (a disease, condition, or problem) by treatment or appropriate action” (Oxford Dictionaries, 2009b). In general, whereas curing aims at removing factors that cause a specific disease or condition (pathogenesis), healing takes a more holistic approach, aimed at strengthening factors that promote health and well-being (salutogenesis). Zborowsky and Kreitzer (2008) describe healing as “harmony of mind, body and spirit”. A healing environment is therefore more than just a place to be cured. In fact, a healing environment can be effective even when cure is not possible. For example, a person who is suffering from an incurable disease may still experience benefits of a stay in a healing environments. Although the term healing environment is being used more and more, consensus on a clear definition still seems to be lacking (Van den Berg, 2005). However, several attempts have been made to formulate a precise meaning of the term. Very generally speaking, and somewhat simplistically, “a healing environment is one which makes us feel better, and feeling better is the key to getting better” (Department of Health, 2009). Although this definition provides a sense of what healing environments are about, it is too broad to be of practical use. Weterings (2003) goes into a little more detail when describing a healing environment as an environment that makes a stay in the hospital more comforable and contributes to the well-being of all users, in particular the recovery of patients. According to Ulrich (1999), the reduction of stress and mental fatigue play a crucial role in the positive effects of healing environments. But what exactly are the factors that make a stay in a healing environment more comfortable? Van den Berg (2005) emphasizes the importance of physical elements, such as nature and natural 1
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