1- Islamic Azad University
2- Islamic Azad UniversityIslamic Azad University
2- Islamic Azad UniversityIslamic Azad University
Abstract: (4 Views)
Background & Objectives: Multiple Sclerosis (MS) is a chronic neurological condition that presents profound physical, psychological, and social challenges for affected individuals, necessitating healthcare environments that support recovery and well-being. Research increasingly recognizes the interplay between physical surroundings and patient outcomes, particularly for chronic illnesses like MS, where architecture can influence emotional responses, stress levels, and social interactions. Elements such as natural light, accessible layouts, and green spaces have been shown to enhance patient experiences, yet the specific impact of hospital design on MS patients in Iran remains insufficiently explored. This study sought to investigate the lived experiences of MS patients with the architectural environment of Razi Hospital in Tabriz, aiming to elucidate how spatial design affects their health and quality of life, and to identify opportunities for improvement in therapeutic settings.
Methods: This qualitative research adopted an interpretive phenomenological approach to delve into the subjective experiences of MS patients. Data were gathered through in-depth, semi-structured interviews with 20 participants (12 women, 8 men; mean age 30.7 years, range 20–53 years), all diagnosed with MS and having received treatment or been admitted to Razi Hospital within the prior three years. Participants were recruited via purposive sampling with a snowball technique, continuing until theoretical saturation was reached. Interviews, conducted from May to October 2021, lasted 45 to 90 minutes and were primarily virtual (telephone or video calls) due to COVID-19 constraints, though some occurred in-person in quiet, agreed-upon locations. Questions like “What has been your experience of Razi Hospital’s architectural environment?” prompted detailed responses, which were recorded with consent. Data analysis followed Braun and Clarke’s six-step thematic analysis, using MAXQDA 2020 for organization. Trustworthiness was ensured through prolonged engagement, participant checks (5 participants reviewed findings), peer debriefing, and triangulation with field and reflective notes, adhering to Guba and Lincoln’s criteria.
Results: Analysis identified five overarching themes from participants’ narratives: Stressful Environment: Patients described the hospital as anxiety-inducing, citing environmental pollution (e.g., noise, unpleasant odors), lack of peace (e.g., crowded wards), and fear or insecurity (e.g., proximity to psychiatric patients). These factors were universally noted (100% of participants) as detrimental, given stress’s role in MS exacerbation. Alienating Space: A sense of detachment emerged, with sub-themes of absent privacy (e.g., shared facilities), alienation (e.g., feeling the space wasn’t designed for them), and discrimination (e.g., perceived neglect of MS-specific needs), reported by 90% of participants. Non-Therapeutic Environment: The setting was seen as counterproductive to healing, marked by missing natural elements (e.g., limited greenery or sunlight), inaccessibility (e.g., narrow, mobility-unfriendly corridors), and a gloomy ambiance (e.g., cold colors, poor lighting), noted by 95% of participants. Unmet Needs: Participants articulated needs for tranquility (100% endorsement), social spaces (e.g., areas for peer interaction), and independence (e.g., autonomy in navigation), which the current design failed to address. Architectural Aspirations: Patients envisioned ideal spaces featuring nature-centric design (e.g., gardens, natural light), human-centric adjustments (e.g., ergonomic layouts), and community-centric areas (e.g., MS-specific social hubs), reflecting a holistic vision for supportive environments.
Conclusion: The architectural environment of Razi Hospital is perceived by MS patients as stressful, alienating, and non-therapeutic, neglecting critical needs like calm, privacy, and accessibility. This misalignment exacerbates the challenges of living with MS, undermining patients’ physical, psychological, and social well-being. Participants’ aspirations for nature-infused, user-focused, and community-oriented designs highlight the potential of architecture to transform healthcare experiences. Given MS’s chronicity and environmental sensitivity, redesigning therapeutic spaces with patient input is imperative to foster healing, reduce stress, and enhance quality of life. This study advocates for a shift toward user-centered, biophilic, and inclusive architectural approaches in healthcare facilities, urging collaboration between designers, clinicians, and patients to create empowering environments. Future efforts should extend these insights to broader contexts and refine design standards for MS care.
Methods: This qualitative research adopted an interpretive phenomenological approach to delve into the subjective experiences of MS patients. Data were gathered through in-depth, semi-structured interviews with 20 participants (12 women, 8 men; mean age 30.7 years, range 20–53 years), all diagnosed with MS and having received treatment or been admitted to Razi Hospital within the prior three years. Participants were recruited via purposive sampling with a snowball technique, continuing until theoretical saturation was reached. Interviews, conducted from May to October 2021, lasted 45 to 90 minutes and were primarily virtual (telephone or video calls) due to COVID-19 constraints, though some occurred in-person in quiet, agreed-upon locations. Questions like “What has been your experience of Razi Hospital’s architectural environment?” prompted detailed responses, which were recorded with consent. Data analysis followed Braun and Clarke’s six-step thematic analysis, using MAXQDA 2020 for organization. Trustworthiness was ensured through prolonged engagement, participant checks (5 participants reviewed findings), peer debriefing, and triangulation with field and reflective notes, adhering to Guba and Lincoln’s criteria.
Results: Analysis identified five overarching themes from participants’ narratives: Stressful Environment: Patients described the hospital as anxiety-inducing, citing environmental pollution (e.g., noise, unpleasant odors), lack of peace (e.g., crowded wards), and fear or insecurity (e.g., proximity to psychiatric patients). These factors were universally noted (100% of participants) as detrimental, given stress’s role in MS exacerbation. Alienating Space: A sense of detachment emerged, with sub-themes of absent privacy (e.g., shared facilities), alienation (e.g., feeling the space wasn’t designed for them), and discrimination (e.g., perceived neglect of MS-specific needs), reported by 90% of participants. Non-Therapeutic Environment: The setting was seen as counterproductive to healing, marked by missing natural elements (e.g., limited greenery or sunlight), inaccessibility (e.g., narrow, mobility-unfriendly corridors), and a gloomy ambiance (e.g., cold colors, poor lighting), noted by 95% of participants. Unmet Needs: Participants articulated needs for tranquility (100% endorsement), social spaces (e.g., areas for peer interaction), and independence (e.g., autonomy in navigation), which the current design failed to address. Architectural Aspirations: Patients envisioned ideal spaces featuring nature-centric design (e.g., gardens, natural light), human-centric adjustments (e.g., ergonomic layouts), and community-centric areas (e.g., MS-specific social hubs), reflecting a holistic vision for supportive environments.
Conclusion: The architectural environment of Razi Hospital is perceived by MS patients as stressful, alienating, and non-therapeutic, neglecting critical needs like calm, privacy, and accessibility. This misalignment exacerbates the challenges of living with MS, undermining patients’ physical, psychological, and social well-being. Participants’ aspirations for nature-infused, user-focused, and community-oriented designs highlight the potential of architecture to transform healthcare experiences. Given MS’s chronicity and environmental sensitivity, redesigning therapeutic spaces with patient input is imperative to foster healing, reduce stress, and enhance quality of life. This study advocates for a shift toward user-centered, biophilic, and inclusive architectural approaches in healthcare facilities, urging collaboration between designers, clinicians, and patients to create empowering environments. Future efforts should extend these insights to broader contexts and refine design standards for MS care.
Keywords: Multiple Sclerosis, Lived Experience, Therapeutic Architecture, Razi Hospital, User-Centered Design
Type of Study: Original Research Article |
Subject:
Architecture
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