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- All Subjects: 19765
- Genre: Masters Thesis
- Creators: Lamb, Gerri
- Member of: Theses and Dissertations
Description
A growing body of research shows that characteristics of the built environment in healthcare facilities impact patients' well-being. Research findings suggest that patients form judgments of perceived quality care based on environmental characteristics. Patient outcomes and ratings of quality of care are linked to the environments' ability to reduce patient stress as well as influence perceptions of quality of care. Historically, this research has been focused in the hospital environment. The United States healthcare system heavily relies on hospitals to treat (rather than prevent) illness, leading to a high per capita healthcare expenditure. Currently, this healthcare system is shifting to rely heavily on ambulatory care settings and primary care providers to detect, prevent, and manage expensive medical conditions. The highest rates of preventable disease and the lowest rates of primary care usage are found in the young adult population (ages 18 to 24). More than any other patient population, this segment rates their satisfaction with healthcare significantly low. For this population education, early detection, and monitoring will be key for a primary care focused model to have the greatest impact on care and long-term savings. Strong patient-physician connections ensure the success of a primary care focused model. The physical environment has the opportunity to provide a message consistent with a physician's practice values and goals. Environmental cues in the waiting area have the potential to relay these messages to the patient prior to physician contact. Through an understanding and optimization of these cues patient perception of quality of care may be increased, thus improving the patient-physician relationship. This study provides insight on how to optimize environmental impact on the healthcare experience. This descriptive exploratory study utilized a non-verbal self-report instrument to collect demographic information and measure participant's responses to two panoramic photos of primary care provider waiting areas. Respondents were asked to identify physical elements in the photos that contributed to their perceptions of the quality of care to be expected. The sample population consisted of 33, 18 to 24 year-olds leaving a total of 234 emotional markers and comments. Qualitative and quantitative revealed three key themes of appeal, comfort, and regard. Physical elements, in the photos, related to the themes include: General areas that were important to the respondents were the seating and reception areas, as well as the overall appearance of the waiting area. Key elements identified to be significant characteristics influencing perceptions of quality of care are presented in this study.
ContributorsBadura, Kerri (Author) / Lamb, Gerri (Thesis advisor) / Heywood, William (Committee member) / Wolf, Peter (Committee member) / Arizona State University (Publisher)
Created2012
Description
The goal of this research was to contribute to the understanding of how the physical design of Intensive Care Unit (ICU) environments may be improved to enhance nursing communication, and in turn, the quality and safety of patient outcomes. This study was guided by two research questions: (1) What are the major characteristics of nurse communication in a hybrid ICU nurse station design? (2) What are the factors in the built environment that enhance or hinder nurse communication in a hybrid ICU nurse station design? The research design was exploratory and qualitative. Observations were conducted in two ICUs with hybrid nurse station layouts. Participant observation was used to systematically observe and document nurse communication and the physical attributes of the ICU nurse work environment that affect communication. Literature, observations, and information regarding staffing and design about the selected ICUs were analyzed for the generation of concepts and the exploration of significant themes. Results show that nurse interactions with other staff members varied within the different zones of the ICU pod. A biaxial map illustrates four key types of core nurse communication interactions: At ease, On guard, In motion, and On the edge. The quadrants representing barriers to nurse communication are On guard and On the edge, and included interactions with other staff members in the pod. The quadrants representing facilitators to nurse communication are At ease and In motion. The hybrid nurse station layout supported nurse-nurse communication, but not communication interactions with other staff members present on the pod. The results provide a broad understanding of how nurse communication is affected by the environment in which nurses work, and allows for the emergence of design opportunities to enhance nurse communication.
ContributorsNewcomb, Emily Michelle Darling (Author) / Lamb, Gerri (Thesis advisor) / Stein, Morris (Thesis advisor) / Wolf, Peter (Committee member) / Arizona State University (Publisher)
Created2011
Description
"Too often, people in pain are stuck in limbo. With no diagnosis there is no prognosis. They feel that without knowing what is wrong, there is no way to make it right" (Lewandowski, 2006, p. ix). Research has shown that environmental factors, such as views of nature, positive distractions and natural light can reduce anxiety and pain (Ulrich, 1984). Patients with chronic, painful diseases are often worried, anxious and tired. Doctor's appointments for those with a chronic pain diagnosis can be devastating (Gilron, Peter, Watson, Cahill, & Moulin, 2006). The research question explored in this study is: Does the layout, seating and elements of positive distraction in the pain center waiting room relate to the patients experience of pain and distress? This study utilized a mixed-method approach. A purposive sample of 39 individuals participated in the study. The study employed the Positive and Negative Affect Schedule (PANAS), the Lewandowski Pain Scale (LPS) and a researcher developed Spatial Perception Instrument (SPI) rating the appearance and comfort of a pain center waiting room in a large metropolitan area. Results indicated that there were no significant correlations between pain, distress and the waiting room environment. It is intended that this study will provide a framework for future research in the area of chronic pain and distress in order to advance the understanding of research in the waiting area environment and the effect it may have on the patient.
ContributorsDraper, Heather (Author) / Bender, Diane (Thesis advisor) / Shraiky, James (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2012
Description
ABSTRACT Nursing physical fatigue is a critical issue that may lead to degradation of care delivery and ultimately result in medical errors. This issue is equally relevant due to the looming shortage of nurses, which has been linked to the physical demands and potential occupational hazards intrinsic to the profession; as well as to the graying of the nursing workforce who experiences gradual loss of strength and agility that accompanies aging as time in the career advances. In a hospital Emergency Department, the level of nursing physical fatigue can potentially reach its threshold in light of challenging workloads, scope of job assignments and demanding schedules. While in other safety-sensitive industries such as aviation and nuclear plants, similar concerns have been the object of systematic research and addressed with consequent regulations, just recently, the healthcare sector has been engaged in further investigations. This study proposed to explore the linkage between Emergency Department design-layout and nursing physical fatigue. It was expected that further understanding on this relationship would support evidence-based design propositions linking nursing wellness, job satisfaction, and performance to a higher quality of care and improved patient safety levels. To this end, data collection was performed during four weeks in a community-based hospital. A convenience sample of twenty-four eligible nurses was invited to participate in this two-part study. The first section consisted of the completion of a self-administered questionnaire, which assessed nurses' perception of the impact of working conditions on nursing physical fatigue. The second section included the monitoring, through the use of accelerometers, of nurses' actual activity intensity levels during three consecutive shifts. Among other findings, data demonstrated that nurses perceive several attributes or components of the built environment as potential contributors to physical fatigue. In addition, various operational practices and organizational protocols were linked to physical fatigue. Contrary to nurses' perception of physical fatigue, their actual physical activity levels fell mostly between sedentary or light intensity ranges. This paradox offers the opportunity for design interventions that, in alignment with operational practices and organizational protocols will enhance nurses' performance and improve nurses' retention.
ContributorsShakman, Karen (Author) / Bender, Diane (Thesis advisor) / Stein, Morris (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2011
Description
In the United States, seasonal influenza is responsible for enormous medical costs and lost earnings as well as thousands of deaths. Medical masks are effective non-pharmaceutical preventions for minimizing the spread of illness in the event of an influenza outbreak. However, people in the United States rarely wear face masks the way many people in Asian countries do.
In a previous study of public response to the 2009 influenza A H1N1 pandemic, 71% of United States respondents supported the recommendation to wear a mask during the flu outbreak, while only 8% of respondents reported they wore a mask in public to protect themselves from getting sick. What are the factors that cause this gap? The purpose of this exploratory study is to identify barriers to the wearing of masks among adults in the United States.
The research was conducted through an online survey of 84 American residents via the Survey Monkey Audience service to collect their opinions on influenza, mask-wearing, and the perceived barriers to wearing face masks for flu prevention. The results are presented in the descriptive analysis and the non-parametric analysis.
The results showed a barrier against social interaction is a significant factor (p=0.003) regarding the impact between flu experience and the perceived barriers. The participants believed mask-wearing may lead other people difficult to perceiving their feelings. Regarding the relationship between mask-wearing experience and the perceived barriers, there were significant differences in perceived benefits (p=0.028), perceived risks (p= 0.003), and social value (p=0.021). Participants who have had worn masks had perceived higher benefits of mask-wearing, higher risks of catching the flu, and a higher agreement of importance to protect other people from getting the flu from them. The most common perceived barrier among the participants is product satisfaction. 85.71% of the participants agreed that wearing face masks is uncomfortable. 80.95% of the participants agreed with the importance to wear face masks as it protects other people from getting the flu from them, but only 37.5% of the participants with flu history had worn face masks.
By examining barriers to the wearing of masks for influenza prevention, this study can assess public willingness to adopt personal prevention behaviors and provide information for related policies in the future.
In a previous study of public response to the 2009 influenza A H1N1 pandemic, 71% of United States respondents supported the recommendation to wear a mask during the flu outbreak, while only 8% of respondents reported they wore a mask in public to protect themselves from getting sick. What are the factors that cause this gap? The purpose of this exploratory study is to identify barriers to the wearing of masks among adults in the United States.
The research was conducted through an online survey of 84 American residents via the Survey Monkey Audience service to collect their opinions on influenza, mask-wearing, and the perceived barriers to wearing face masks for flu prevention. The results are presented in the descriptive analysis and the non-parametric analysis.
The results showed a barrier against social interaction is a significant factor (p=0.003) regarding the impact between flu experience and the perceived barriers. The participants believed mask-wearing may lead other people difficult to perceiving their feelings. Regarding the relationship between mask-wearing experience and the perceived barriers, there were significant differences in perceived benefits (p=0.028), perceived risks (p= 0.003), and social value (p=0.021). Participants who have had worn masks had perceived higher benefits of mask-wearing, higher risks of catching the flu, and a higher agreement of importance to protect other people from getting the flu from them. The most common perceived barrier among the participants is product satisfaction. 85.71% of the participants agreed that wearing face masks is uncomfortable. 80.95% of the participants agreed with the importance to wear face masks as it protects other people from getting the flu from them, but only 37.5% of the participants with flu history had worn face masks.
By examining barriers to the wearing of masks for influenza prevention, this study can assess public willingness to adopt personal prevention behaviors and provide information for related policies in the future.
ContributorsHung, Yu-Wen (Author) / Herring, Donald (Thesis advisor) / Velasquez, Joseph (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2018
Description
ABSTRACT The catalyst for this research was rooted in a patient satisfaction survey reported the need for an ambient quiet setting. This study used a descriptive comparative design augmented with qualitative data. The sample consisted of 54 participants came from one of three primary care clinics listened to 22 minutes of existing natural clinical sounds while the others listened to therapeutic sound hertz in a treatment room. The survey data correlated identify if an association existed or not to add therapeutic soundscape hertz back into a clinical ambient setting could affect the patient experience and wellness. Rather than, continue with abatement program efforts to remove unwanted sounds or mask the noise. Quantitative data were collected on mood states and biometric measures consisted of respiratory, heart, pulse systolic, and diastolic blood pressure rates. Qualitative data 5-Point Likert scale and open-ended questions determined participants' awareness of ambient sounds within the clinical setting. Data from participants were analyzed and compared separately for each clinic. The metrics were found to be statistically correlated (p<0.05) for the POMS-A survey and biometric measures using a Chi-square test. After the intervention, two clinics reported a 60%, and the third clinic an 80% mood state changes. Clinic 2-M reported the greatest significant mood state change. The t-Test validation biometric measures showed no significant evidence among the test and control groups for Clinic 1-L (396, 417, 444 Hz). Clinics 2-M (528, 639 Hz) and Clinic 3-H (714, 852 Hz) did share significant evidence to respiratory, heart, and systolic blood pressure rates. The respondents revealed 27% had a positive opinion of the therapeutic sound hertz perceived as silent or quiet, 59% had a negative opinion of unwanted sounds included communication as disruptive, and 16% felt the clinic’s physical design was poor. As a whole, this study indicates exposing patients to therapeutic sound hertz had a positive impact on their biopsychosocial wellness states. The value and novelty of this study show by adding selective distinct therapeutic sound hertz levels back into the clinic setting have profound implications for future researchers to build upon how the quality soundscape performance effects on the patient.
Contributorstate, angela diane (Author) / Bender, Diane (Thesis advisor) / Takamura, John (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2022