Environmental Affordance Index: Measurement Scales to Evaluate the Spatial Needs of Family Members within Adult ICUs

ABSTRACT Background: As more adult intensive care units embrace open visitation policies and family-centered care, it becomes increasingly important to understand how the physical environment can best support family members while they navigate the critical illness or injury of a loved one. However, recommendations for the design of family-supportive spaces are typically anecdotal, and there is a paucity of empirical research regarding which design features best support their spatial needs. Purpose: The aim of this study was to develop instruments by which to evaluate the ability of affordances within the physical environment to support the spatial needs of family members of critically-ill patients (i.e., environmental congruence). Methods: An exploratory sequential design approach was used to explore the phenomenon and developed instruments by which to measure congruency. A thorough understanding was sought of the needs and experiences of family members within adult intensive care units, and a scoping review was conducted to reveal recommended environmental affordances for these settings. Results: From an a priori list of affordances, three instruments were developed. The Environmental Affordance Index was developed to evaluate the physical attributes within a given setting, and it formed the basis for two surveys to evaluate the spatial needs of family members. The Spatial Needs Inventory asks family members to rank the importance of recommended affordances for spaces within adult intensive care unit. The Spatial Needs Met survey provides an opportunity for family members to indicate if a given setting met their spatial needs. Conclusion: Future findings from the Environmental Affordance Index and survey instruments can potentially foster family-centered care, improve the design of adult intensive care units, influence visitation policies, and enhance family member well-being.