Phenomenology of the Lived Experience of Multiple Sclerosis Patients in the Architectural Space of Razi Hospital in Tabriz City, Iran

Adineh Ghahremani , Hadi; Akbari Namdar , Shabnam; Sattari Sarbangholi , Hassan

Volume 15 - Articles-1404 MEJDS (2025) 15: 30 | Back to browse issues page

Mendeley

Zotero

RefWorks

Adineh Ghahremani H, Akbari Namdar S, Sattari Sarbangholi H. Phenomenology of the Lived Experience of Multiple Sclerosis Patients in the Architectural Space of Razi Hospital in Tabriz City, Iran. MEJDS 2025; 15 (0) :30-30
URL: http://jdisabilstud.org/article-1-3569-en.html

Phenomenology of the Lived Experience of Multiple Sclerosis Patients in the Architectural Space of Razi Hospital in Tabriz City, Iran

Hadi Adineh Ghahremani¹

, Shabnam Akbari Namdar ^*²

, Hassan Sattari Sarbangholi³

1- PhD Student, Department of Architecture, Tabriz Branch, Islamic Azad University, Tabriz, Iran
2- Assistant Professor, Department of Architecture, Tabriz Branch, Islamic Azad University, Tabriz, Iran
3- Associate Professor, Department of Architecture and Urban Planning, Tabriz Branch, Islamic Azad University, Tabriz, Iran

Abstract: (366 Views)

Abstract
Background & Objectives: Multiple sclerosis (MS), a chronic neurological disorder, imposes significant physical, psychological, and social challenges on patients. Architecture can profoundly influence patients' emotional responses, sense of control, and overall experience during treatment and hospitalization. Ambient lighting and natural landscapes positively affect patient morale and recovery. In particular, the layout and design of healthcare facilities may reduce or exacerbate the feelings of confinement and helplessness that patients experience, affecting their mental and physical well–being. The lived experience of patients with MS in healthcare settings is not only limited to physical dimensions but also includes psychological and social dimensions. The need to design spaces to support people with mobility impairments cannot be ignored. As patients with MS often face challenges such as mobility limitations and fatigue, accessible architecture is essential not only for comfort but also as a factor affecting quality of life. This study explores the lived experiences of patients with MS in the architectural environment of Razi Hospital, a specialized healthcare setting in Tabriz City, Iran.
Methods: A qualitative interpretive phenomenological approach was adopted. The study population consisted of all patients with MS living in Tabriz who had been hospitalized or treated at Razi Hospital. Purposive sampling was performed using the snowball technique. The inclusion criteria for participants in the study were as follows: a definitive diagnosis of multiple sclerosis by a neurologist, having at least one hospitalization or referral to Razi Hospital in Tabriz in the last three years, the ability to express one's experiences, willingness to participate in the study, aged over 18 years. Interviews continued until theoretical saturation was reached. According to Table 1, 20 patients (12 women and 8 men) with an average age of 30.7 years (age range 20–53 years) were interviewed. The disease duration in the participants ranged from 1 to 13 years. Regarding marital status, 13 were single, and 7 were married. The participants had diverse occupations and education, including students, teachers, homemakers, artists, taxi drivers, and employees. Data were collected through in–depth semi–structured interviews. Interviews were conducted between May and October 2021. Due to the COVID–19 pandemic and in–person restrictions, most interviews were conducted by telephone or video call. When possible, in-person interviews were conducted in a quiet, private location agreed upon by the participant (usually the participant's home or the researcher's workplace). Data analysis was conducted using the 6-step thematic analysis method (Braun & Clarke, 2006). To facilitate the data analysis process, MAXQDA software version 2020 was used.
Results: Five main themes and 15 subthemes were extracted from the data: 1) stressful environment with components of environmental pollution, lack of peace, fear, and insecurity; 2) alien space with lack of privacy, feeling of alienation, and experience of discrimination; 3) non-therapeutic environment with lack of natural elements, inaccessibility, and depressive space; 4) unmet needs including the need for peace, the need for social space, and the need for independence; 5) architectural aspirations with a focus on nature-centeredness, human-centeredness, and community-centeredness.
Conclusion: Based on the research findings, the architectural space of Razi Hospital is experienced as a stressful and unsupportive environment that does not meet the needs of MS patients. Reconsidering the design of treatment environments with an emphasis on user-centered and nature-centered approaches is necessary to improve the quality of life of these patients.

Keywords: Multiple sclerosis, Lived experience, Therapeutic architecture, User-centered design, Hospital environment

Full-Text [PDF 339 kb] (89 Downloads)

Type of Study: Original Research Article | Subject: Architecture

References

1. Khademian Z, Kazemi Ara F, Gholamzadeh S. the effect of self care education based on Orem's nursing theory on quality of life and self–efficacy in patients with hypertension: a quasi-experimental study. Int J Community Based Nurs Midwifery. 2020;8(2):140–9. [DOI]

2. Bogaert B. Moving toward person–centered care: valuing emotions in hospital design and architecture. HERD. 2022;15(2):355–64. [DOI]

3. Simonsen TP, Duff C. Healing architecture and psychiatric practice: (re)ordering work and space in an in–patient ward in Denmark. Sociol Health Illn. 2020;42(2):379–92. [DOI]

4. Clinton–McHarg T, Paul C, Sanson–Fisher R, Turon H, Butler M, Lindeman R. Are the physical environments of treatment centres meeting recommendations for patient–centred care? Perceptions of Haematological Cancer Patients. Int J Environ Res Public Health. 2021;18(9):4892. [DOI]

5. MacAllister L, Bellanti D, Sakallaris BR. Exploring inpatients' experiences of healing and healing spaces: a mixed methods study. J Patient Exp. 2016;3(4):119–30. [DOI]

6. Kütmeç Yilmaz C, Kara FŞ. The effect of spiritual well–being on adaptation to chronic illness among people with chronic illnesses. Perspect Psychiatr Care. 2021;57(1):318–25. [DOI]

7. Hassen M, Mekonnen H, Derseh L, Lindgren H, Erlandsson K. Living with stigmatized identity: an interpretative phenomenological analysis of the lived experiences of patients with chronic illness in Ethiopia. Research Square; 2023. [DOI]

8. Wilson RL, Hutton A, Foureur M. Promoting mental health recovery by design: physical, procedural, and relational security in the context of the mental health built environment. Int J Ment Health Nurs. 2023;32(1):147–61. [DOI]

9. Alvarenga W de A, Machado JR, Leite ACAB, Caldeira S, Vieira M, da Rocha SS, et al. Spiritual needs of Brazilian children and adolescents with chronic illnesses: a thematic analysis. J Pediatr Nurs. 2021;60:e39–45. [DOI]

10. Meiers SJ, Eggenberger SK, Krumwiede NK, Deppa B. Measuring family members' experiences of integrating chronic illness into family life: preliminary validity and reliability of the family integration experience scale: chronic illness (FIES:CI). J Fam Nurs. 2020;26(2):111–25. [DOI]

11. Leite ACAB, Garcia-Vivar C, Neris RR, Alvarenga W de A, Nascimento LC. The experience of hope in families of children and adolescents living with chronic illness: a thematic synthesis of qualitative studies. J Adv Nurs. 2019;75(12):3246–62. [DOI]

12. Untaru EN, Han H, Bălăşescu S, Kim B, Ariza–Montes A. Green atmospherics as nature–based solutions and patient responses and behaviors in healthcare establishments from Romania. SAGE Open. 2023;13(1):21582440231162531. [DOI]

13. Warbung T, Soedarso N, Carina R. Lighting and coloring in creating atmosphere of worship in church. In: 2nd International Conference of Science and Technology for the Internet of Things [Internet]. Yogyakarta, Indonesia: ICSTI; 2019 [cited 2025 May 10]. [DOI]

14. Karaman GD, Avci AN. Analyzing natural lighting conditions from the perspective of biophilic design in indoor office environments. Earth Environ Sci. 2022;1099(1):012034. [DOI]

15. Ibrahim EAAE, Gassoum A, IshagAgib IEI. Quality of life among Sudanese patients with multiple sclerosis in Khartoum state using (MSQoL–54) questionnaire. BMC Res Notes. 2019;12(1):533. [DOI]

16. Ichikawa CR de F, Szylit R. Validation of the family integration experience scale: chronic illness for the portuguese language spoken in Brazil. Rev Lat Am Enfermagem. 2024;32:e4248. [DOI]

17. Van Denend T, Gecht-Silver M, Kish J, Plow M, Preissner K. Appreciating the experience of multiple sclerosis fatigue. Br J Occup Ther. 2023;86(6):441–50. [DOI]

18. Rodríguez–Agudelo Y, Nava–Adán J, Paz–Rodríguez F, Abundes–Corona A, Flores–Rivera J, Corona T. Quality of life and mental health in multiple sclerosis patients during the COVID–19 Pandemic. Mult Scler Relat Disord. 2023;70:104487. [DOI]

19. Aranđelović B, Simić S, Simin D, Mikić M, Dolinaj V, Bogdanović Vasić S, et al. Determining the need for palliative care patients with multiple sclerosis–a cross–sectional study. Healthcare (Basel). 2024;12(20):2024. [DOI]

20. Braithwaite V, Ti L, Fairbairn N, Ahamad K, McLean M, Harrison S, et al. Building a hospital–based addiction medicine consultation service in Vancouver, Canada: the path taken and lessons learned. Addiction. 2021;116(7):1892–900. [DOI]

21. Marshall AP, Takefala T, Williams LT, Spencer A, Grealish L, Roberts S. Health practitioner practices and their influence on nutritional intake of hospitalised patients. Int J Nurs Sci. 2019;6(2):162–8. [DOI]

22. Zhang P, Liu C, Qi W, Xie X, Su Y. Analysis of the influencing factors of postoperative constipation in patients undergoing cardiovascular surgery: a cross–sectional and prospective study. Heart Surg Forum. 2024;27(1):E038–47. [DOI]

23. Byrne KA, Roth PJ, Cumby S, Goodwin E, Herbert K, Schmidt WM, et al. Recovery barrier characterizations by hospitalized patients with substance use disorders: results from a randomized clinical study on inpatient peer recovery coaching. Int J Environ Res Public Health. 2024;21(1):93. [DOI]

24. Babbu AH, Haque M. Design characteristics for sustainable pediatric healthcare environments: stakeholder's perception. European Journal of Sustainable Development. 2023;12(1):113. [DOI]

25. Hooper P, Boulange C, Arciniegas G, Foster S, Bolleter J, Pettit C. Exploring the potential for planning support systems to bridge the research-translation gap between public health and urban planning. Int J Health Geogr. 2021;20(1):36. [DOI]

26. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77–101.

27. Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills, CA: Sage; 1985.

28. Tindall RM, Ferris M, Townsend M, Boschert G, Moylan S. A first–hand experience of co–design in mental health service design: opportunities, challenges, and lessons. Int J Ment Health Nurs. 2021;30(6):1693–702. [DOI]

29. Workman A, Campbell SL, Williamson GJ, Lucani C, Bowman DMJS, Cooling N, et al. Understanding the perspectives and needs of multiple stakeholders: Identifying key elements of a digital health intervention to protect against environmental hazards. PLOS Digit Health. 2024;3(1):e0000444. [DOI]

30. Gesler WM, Kearns RA. Culture/Place/Health. London: Routledge; 2005. [DOI]

31. Lee K. The interior experience of architecture: an emotional connection between space and the body. Buildings. 2022;12(3):326. [DOI]

32. Malepe TC, Havenga Y, Mabusela PD. Barriers to family–centred care of hospitalised children at a hospital in Gauteng. Health SA. 2022;27:1786. [DOI]

33. Martins AB, Barrie H, Visvanathan R, Daniel L, Martins LA, Ranasinghe D, et al. A multidisciplinary exploratory approach for investigating the experience of older adults attending hospital services. HERD. 2021;14(1):141–63. [DOI]

34. Foster S, Maitland C, Hooper P, Bolleter J, Duckworth–Smith A, Giles–Corti B, et al. High Life study protocol: a cross–sectional investigation of the influence of apartment building design policy on resident health and well–being. BMJ Open. 2019;9(8):e029220. [DOI]

35. David–Mukoro K, Atulegwu A, Audu SE. Perception of medical doctors on the effectiveness of therapeutic architecture. African Journal of Environmental Sciences and Renewable Energy. 2024;17(1):11–24. [DOI]

36. Gaekwad JS, Sal Moslehian A, Roös PB, Walker A. A meta–analysis of emotional evidence for the biophilia hypothesis and implications for biophilic design. Front Psychol. 2022;13:750245. [DOI]

37. Iriani WL, Subiyantoro H. Ecological architectural of museum buildings in the humid tropics (case study: museum Gunungapi Merapi). Arsitektura: Jurnal concepts Ilmiah Arsitektur dan Lingkungan Binaan. 2023;21(1):151–60. [DOI]

38. Putrino D, Ripp J, Herrera JE, Cortes M, Kellner C, Rizk D, et al. Multisensory, nature–inspired recharge rooms yield short–term reductions in perceived stress among frontline healthcare workers. Front Psychol. 2020;11:560833. [DOI]

39. Nair M. Translation of therapeutic architecture as a guideline for residential design. In: The Evolving Scholar [Internet]. Delft, Rotterdam: ARCH22; 2022 [cited 2025 May 2]. [Article]

40. Shaikh H, Sava–Segal C. Biophilic architecture: using cognitive science principles to understand impact on well-being. J Stud Res. 2024;13(1). [DOI]