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Designing the physical environment for inpatient palliative care: a narrative review
  1. Kevin Wong1,
  2. Rebecca McLaughlan2,
  3. Anna Collins3 and
  4. Jennifer Philip3
  1. 1Austin Health, Heidelberg, Victoria, Australia
  2. 2School of Architecture & the Built Environment, The University of Newcastle, Callaghan, New South Wales, Australia
  3. 3Palliative Care Service, The University of Melbourne Medicine at St Vincent's Hospital, Fitzroy, Victoria, Australia
  1. Correspondence to Dr Kevin Wong, Austin Health, Heidelberg, Victoria, Australia; wongk4{at}austin.org.au

Abstract

Background It is essential that the physical environments in which inpatient palliative care is provided support the needs of patients and the facilitate the multidimensional delivery of palliative care. This review aims to identify the features and characteristics of inpatient palliative care environments that enhance or detract from the patient experience; and identify opportunities for progress within this field.

Method Three databases were searched: MEDLINE (1946–2020), PsycINFO (1806–2020) and CINAHL (1937–2020). Articles were screened by title and abstract with included studies read in full for data extraction. Data synthesis involved thematic analysis informed by the findings of the included literature. Inclusion criteria were studies with empirical methodology examining adult palliative care in the hospital, hospice or nursing home environment. Studies that examined palliative care delivered within the emergency department, ICU or within the home were excluded, as were those related to paediatric palliative care.

Results Four main themes were identified: the provision of privacy, facilitating interactions with family, facilitating comfort through homeliness and connections to nature.

Conclusions The board acceptance of single rooms as the preeminent design solution for supporting privacy, dignity and family interaction, alongside current conceptions of homeliness that typically focus on matters of interior design, are limiting possibilities for further design innovation within palliative care settings. Research that investigates a broader set of design strategies through which the built environment can support care, alongside enhanced interdisciplinary collaboration, could positively contribute to patient and family experiences of inpatient palliative care.

  • hospital care
  • hospice care
  • nursing home care
  • family management

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Footnotes

  • Twitter @AnnaLCollins

  • Contributors KW undertook data collection and analysis and led the writing of this paper. RM assisted with data analysis and led the discussion section of the paper. AC and JP were responsible for study conception, and provided guidance regarding methods, the identification of key themes and through subsequent drafts of the paper.

  • Funding RM is the recipient of an Australian Research Council Australian Discovery Early Career Award (project number DE190100730) funded by the Australian Government. AC is funded by an Emerging Leadership Investigator Grant awarded by the National Health and Medical Research Council (NHMRC GNT1173054).

  • Competing interests RM is the recipient of an Australian Research Council Australian Discovery Early Career Award (project number DE190100730) funded by the Australian Government. AC is funded by an Emerging Leadership Investigator Grant awarded by the National Health and Medical Research Council (NHMRC GNT1173054).

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