تبیین مدل سه بعدی ارتقا کیفیت مراکز درمانی مبتنی بر شواهد (EBD)با تاکید بر رضایتمندی بیمار (موردپژوهی: بیمارستان بهمن)

نوع مقاله : مقاله پژوهشی

نویسندگان

1 پژوهشگر دوره دکتری تخصصی، دانشکده‌ی عمران، معماری و هنر، دانشگاه علوم و تحقیقات، تهران، ایران.

2 دانشیار گروه معماری، دانشکده عمران، معماری و هنر، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران.

3 دانشیار و عضو رسمی هیئت علمی دانشکده‌ی هنر، دانشگاه تربیت مدرس، تهران، ایران.

4 استاد و عضو رسمی هیئت علمی دانشکده‌ی معماری و شهرسازی، دانشگاه هنر تهران، تهران، ایران.

10.22034/rau.2024.2008955.1056

چکیده

اغلب بیمارستان‌ها، برای بیماران محیطى نامناسب برای سپری کردن روزهای بیماری و برای کارکنان، محیطى نامناسب برای انجام وظایف شغلى خود ایجاد کرده است. در طراحی مبتنی بر شواهد به عنوان یک رویکرد جدید در طراحی بیمارستان‌ها، بر اهمیت استفاده از داده‌های معتبر به موجب اثرگذاری بر فرایند طراحی تمرکز دارد. این رویکرد در طراحی بیمارستان‌ها به عنوان «تلاشی برای ارتقای بهبود زندگی بیماران و خانواده‌هایشان، کاهش استرس، بهبود فرایند درمان بیماری، ایمنی و امنیت بیماران» شناخته می‌شود

ارتقا اصول طراحی مراکز درمانی ﺑﺎ روش مبتنی بر شواهد و ﻣﺤﻮرﻳﺖ قرار دادن ﺑﻴﻤﺎر در جهت جلب رضایتمندی بیمار و ارائه چگونگی طراحی مراکز درمانی ﻛﺎرآﻣﺪ و ﻫﺪﻓﻤﻨﺪ با روش مبتنی بر شواهد از اهداف این پژوهش است.

این پروژه در راستای پژوهش توصیفی- تحلیلی بر اساس مطالعات کتابخانه‌ای، مشاهده میدانی و جمع‌آوری اطلاعات از طریق مصاحبه و دو مرحله پرسشنامه از 5 متخصص در زمینه طراحی معماری مراکز درمانی می‌باشد. نرم افزارهای مورد استفاده ASPECT و SPSS می‌باشد.

با توجه به اینکه که میانگین میزان رضایتمندی کارشناسان از کیفیت فضاهای بیمارستان بهمن در بخش خلوت و مشارکت (8/3)، دید (00/4)، دسترسی به طبیعت (7/3)، آسایش و کنترل (20/3)، خوانایی (2/4)، طراحی داخلی (3/5)، تسهیلات (00/3) و کارکنان (2/4) در مقیاس لیکرت به دست آمده است، حاکی از آن است که وضعیت متغیرهای تسهیلات، آسایش و کنترل، دسترسی به طبیعت و خلوت و مشارکت به ترتیب پایین‌تر از حد مورد انتظار است و متغیر‌های طراحی داخلی، خوانایی فضا، کارکنان و دید به ترتیب در وضعیت مناسب‌تری قرار دارند

کلیدواژه‌ها


عنوان مقاله [English]

A conceptual model for improving the architectural quality of evidence-based general hospital (EBD) with an emphasis on patient satisfaction(Case study: Bahman Hospital)

نویسندگان [English]

  • Aida Sadeghi 1
  • Azadeh Shahcheraghi 2
  • Khosro Daneshjoo 3
  • Seyed Behshid Hosseini 4
1 PhD researcher, Faculty of Civil Engineering, Architecture and Art, University of Science and Research, Tehran, Iran.
2 Associate Professor, Department of Architecture, Faculty of Civil Engineering, Architecture and Art, Science and Research Branch, Islamic Azad University, Tehran, Iran.
3 associate professor and official member of the Faculty of Arts, Tarbiat Modares University, Tehran,
4 full professor and official member of Faculty of Architecture and Urbanization, Art University of Tehran,Tehran, Iran.
چکیده [English]

The desirability of a space depends on the level of users' satisfaction with that environment. A person's satisfaction with the environment also depends on providing different levels of his personal and social needs. Various reasons are effective in intensifying the negative experience of being in the hospital. The first reason is prioritizing the treatment process and clinical relationships between spaces in the process of designing and building hospitals. In this attitude, the hospital is on one side and its users are on the other side, and there is no positive two-way interaction between them. The common designs of hospitals in Iran are typographical and they pay a lot of attention to the spatial function and compatibility of the space with the treatment procedure, and they unintentionally push the completely human conditions of the hospital towards buildings with a non-human appearance.

The second problem is the passive position of the patient in the treatment spaces. Defining a specific range for the presence of patients and depending on the staff due to the nature of the disease and especially the spatial design, puts them in a position of passivity. So that they are forced to spend the time of hospitalization only in the confined area of the hospital room and with the help of others. Such a situation has a negative effect on the individual's identity in the first place and in the second place on the patient's social life.

The third reason is the existence of a fixed thinking and idea about hospital spaces in the mentality of policy makers and designers. For example, in the public's view, the idea of a bed room is a general and fixed mentality, which usually manifests as a white room with standard sizes and no decorative elements.

This is while all the environmental elements together create a general atmosphere that the patient mentally compares with home during the days of his presence. The lack of meaning in the space of the inpatient ward affects the relationship between the patient and the environment and causes the patient to feel in an unfamiliar space and feel strange in that space and stress is created due to the mismatch with the environment.

The fourth reason is the lack of attention to the role of the quality of life related to the health of employees on the well-being of patients. Patients are greatly influenced by the conditions of the ward staff in the treatment process and their adaptation to the environment. Therefore, improving the supporting potential of the environment requires a two-sided vision, one side of which is the preferences of the patients and the other side is the preferences of the employees.

In recent years, when the safety of patients and improving their outcome have been taken into consideration, designers, due to the need to replace dilapidated buildings, due to the need of patients to provide patient-centered services, and due to the reduction of preventable accidents, to a topic called "based design" They turned to the evidence.



In evidence-based design, it focuses on the importance of using valid data to influence the design process. This approach in the design of hospitals is known as "an effort to improve the lives of patients and their families, reduce stress, improve the process of disease treatment, safety and security of patients".

Evidence-based design is used to create environments that support the presence of families, are effective in the treatment of illness, are effective for the performance of employees, and restore the power of employees under anxiety and work pressure. An evidence-based designer, together with an informed employer, make decisions based on the best available data obtained from their research and evaluation, and finally, a valid evidence-based treatment should result in work efficiency, improvements in treatment outcomes, economic performance, to satisfy the patients.

Today, the healthcare sector, like other social and economic sectors active in countries, seeks to adapt to these rapid changes in the world today. Medical centers, which are an important part of healthcare services, have been given special attention to align with the changes in most countries. What is common among different countries in the direction of possible future changes is to pay attention to the fact that medical centers need to be reviewed and redesigned. Among the changes that have recently suggested the need to redesign medical centers, we can refer to the advancement of health technology and In recent years, the expectations of patients from medical centers have changed towards changing the role of hospitals from providing medical services to increasing social welfare services.

The use of evidence and scientific data in order to make decisions about the patient care environment is rapidly developing and expanding in recent years; And if we do not base the quality of the therapeutic environment on the data and evidence of the research findings, it seems a risk.

کلیدواژه‌ها [English]

  • Medical centers
  • evidence-based design
  • satisfaction
  • patient-centered
  • patient rights