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Building scale and well-being in a hospice: a qualitative exploration
  1. Margo Annemans1,
  2. Koen Coomans1,2 and
  3. Ann Heylighen1
  1. 1KU Leuven, Department of Architecture, Research[x]Design, Leuven, Belgium
  2. 2D E Architecten, Tervuren, Belgium
  1. Correspondence to Dr Margo Annemans, Department of Architecture, KU Leuven, Leuven 3001, Belgium; margo.annemans{at}


Objective This study explored how built space plays out in palliative care, focusing on spatial aspects that could support or hamper patients’, relatives’ and caregivers’ well-being.

Methods This study was conducted in a freestanding small-scale hospice combining a residential part for eight guests with a day-care part for groups of about five persons. Observations were combined with semistructured, individual interviews with eight guests (sometimes accompanied by relatives) and three focus-group interviews with staff, volunteers and relatives. All interviews were audio-recorded and transcribed verbatim. Data were analysed based on the Qualitative Analysis Guide of Leuven.

Results The most important spatial aspects that impact on physical and social well-being in palliative care turned out to be the building scale and physical proximity. The small-scale setting counters the (often negative) association of palliative care with hospital environments. When the medical condition of the guest allows, it makes communal or outdoor spaces reachable, which enhances emotional and social well-being. In worse conditions, it still makes that care and nature are always nearby. The compactness of communal spaces intensifies social contacts.

Conclusions The building scale and physical proximity play out in the relationship between the building and its surroundings, between the residential and the day-care parts and among people within the building. Future research could investigate to what extent these spatial aspects are relevant in more conventional palliative care units or even in general hospital wards.

  • hospice care
  • quality of life

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  • Correction notice This paper has been corrected since it was first published online. The title of the manuscript has been changed.

  • Contributors MA planned and conducted the research and took the lead in reporting the work described in the article. KC planned and conducted the research and commented on the reporting in the article. AH planned the research, commented on the reporting in the article, and he holds the final responsibility of the overall content as a guarantor.

  • Funding This study was supported by Agentschap Innoveren en Ondernemen (grand number FIS TETRA 140570), Kom op tegen Kanker (Suzanne Duchesne Fund), and a Postdoctoral Fellowship of the Research Foundation–Flanders (FWO).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Approval was obtained from the Social and Societal Ethics Committee of the KU Leuven and the Ethics Committee of the hospital of which the residential part is an administrative part.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.