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.

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.

The look and feel of one’s environment, be it built or organic, has great influence on mood, behavior, and general comfort. Through exploratory qualitative research, this study intends to explore the presence of wellness features in Scandinavian Design throughout the growth of the Scandinavian modern movement, and how these practices may be integrated and adapted in both commercial and residential design in the United States (U.S.). What do Scandinavian designers perceive as the essential traits of the Scandinavian design style, and what relationship, if any, exists between these traits and the concept of wellness? To answer this question, the researcher made use of a purposive sampling method based on exploratory qualitative research methodology, conducting three in-person, semi-structured interviews and extracting themes based on thematic coding. During data analysis three primary themes were identified: sustainability, materiality, and community. The data reported in this study provides some insight into Scandinavian designers’ perceptions of their own practices, and begins to connect these factors to a more global approach to architecture and design.

The main aim of this thesis is to study the Saudi Arabia designers level of awareness about sustainable interior materials and to what extent are Saudi Arabia designers specifying sustainable interior materials in their interior designs? The problem statement relies on understanding how does this may impact the Saudi Arabia environment. In order to comply with these objectives, a telephone interviews were built, to test the designer’s knowledge about sustainable interior materials. The results showed that the Saudi Arabia interior designers are not fully aware of sustainable interior materials and there is a lack of interest in applying sustainable interior materials in their projects.

This research aims to investigate the social environment in a brand-new type of café, pet café, and to maximum the benefit of this type of cafe. While pet cafés, especially cat cafés, are becoming increasingly common in the United States (U.S.), Asian countries have been in this kind of business since 1998. The most common and popular is the cat café. Even though the owners of cat cafés in the U.S. have learned and imitated the cat café in Asia, the cultural differences and the restrictions resulted in differences in format and design.

Interior and furniture design was investigated to afford motivation to people who are pet lovers and can be potential customers. Most of the research about pets illustrates a positive influence on psychological health and social support. On the other hand, a café with pets can be attractive and interactive more than a general café, to offer a recreational activity and a comfortable social environment and therapy from pets.

Juxtaposing the cat café in the U.S. against the pet café in China, is explored to investigate the difference between these countries and how they can learn from each other and make improvements to design. Research on what is the difference between the cat café in the U.S. and China are reflected on two parts of outcomes—design and business.

The author explores the influences on the interiors of Hollywood films of the late 1920s and 30s. The Exposition des Arts Décoratifs et Industriels Modernes, Paris 1925 is examined in historical context and its influence on design trends internationally.

The Hollywood film industry is examined, in general, and Metro-Goldwyn-Mayer and its longtime art director, Cedric Gibbons, in particular. Eight MGM films are discussed and their interiors analyzed for related influence from the 1925 Paris Exposition.

The thesis makes a case for the influence of the 1925 Paris Exposition on Cedric Gibbons and the interiors of the MGM films of the late 1920s and 30s.

The United States elderly population is becoming increasingly larger, there is a need for a more adequate housing type to accommodate this population. It is estimated that by 2020, there will be a need for approximately 1.6 to 2.9 million units of affordable Assisted Living (Blake, 2005). With limited income and higher health bills, adequate housing becomes a low priority. It is estimated that 7.1 million elderly households have serious housing problems. (Blake, 2005) The scope of this research will look at literature, case studies, and interviews to begin to create and understand the necessary design aspects of Assisted Living and Affordable Housing to better create a housing typology that includes both low income residents and Assisted Living needs. This research hopes to have an outcome of Design Recommendations that can be utilized by designers when designing for an Affordable Assisted Living typology.

"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.

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.

Individuals' experiences, environment, and education greatly impact their entire being. Similarly, a designer is affected by these elements, which impacts how, what and why they design. In order for design education to generate designers who are more socially aware problem solvers, that education must introduce complex social matters and not just design skills. Traditionally designers learned through apprenticing a master. Most design education has moved away from this traditional model and has begun incorporating a well-rounded program of study, yet there are still more improvements to be made. This research proposes a new Integrated Transformational Experience Model, ITEM, for design education which will be rooted in sustainability, cultural integration, social embeddedness, and discipline collaboration. The designer will be introduced to new ideas and experiences from the immersion of current social issues where they will gain experience creating solutions to global problems enabling them to become catalysts of change. This research is based on interviews with industrial design students to gain insights, benefits and drawbacks of the current model of design education. This research will expand on the current model for design education, combining new ideas that will shed light on the future of design disciplines through the education and motivation of designers. The desired outcome of this study is to incorporate hands on learning through social issues in design classrooms, identify ways to educate future problem solvers, and inspire more research on this issue.