Preprint Article Version 2 Preserved in Portico This version is not peer-reviewed

Exploring the Use of the AEDET Hospital Evaluation Toolkit to Create a Better Healing Environment for Cancer Patients Beyond the Global North

Version 1 : Received: 4 September 2023 / Approved: 5 September 2023 / Online: 6 September 2023 (02:32:27 CEST)
Version 2 : Received: 24 September 2023 / Approved: 25 September 2023 / Online: 25 September 2023 (07:05:33 CEST)

A peer-reviewed article of this Preprint also exists.

Tekbiyik Tekin, B.; Dincyurek, O. Exploring the Use of the AEDET Hospital Evaluation Toolkit to Create a Better Healing Environment for Cancer Patients beyond the Global North. Buildings 2023, 13, 2588. Tekbiyik Tekin, B.; Dincyurek, O. Exploring the Use of the AEDET Hospital Evaluation Toolkit to Create a Better Healing Environment for Cancer Patients beyond the Global North. Buildings 2023, 13, 2588.

Abstract

Today, numerous studies have shown that the physical environment in hospitals can significantly influence patients' well-being, comfort, and recovery. However, this is currently neglected in hospitals in the Global South. Therefore, there is an urgent need to increase the awareness to make it more applicable worldwide. Thus, this study focuses on improving the healing environment standards, by exploring the impact of evidence-based design and patient-centred care in hospitals for cancer patients; particularly the architectural space quality, on patient health outcomes as well as hospital staff health and wellbeing. In Global North countries, such as the UK, the Achieving Excellence Design Evaluation Toolkit (AEDET), is used by its National Health Services, to assess the effectiveness of various environmental attributes. However, these toolkits have not been designed for and do not work well within Global South countries, such as Northern Cyprus. To examine and compare the effectiveness of different physical environmental attributes and to evaluate user responses, the Post-Occupancy Evaluation Method and the AEDET toolkit have been used in the study. These were applied to both public and private hospitals in Northern Cyprus, involving cancer patients, staff, and professionals (n=220). The findings reveal the strength and weaknesses in terms of environmental comfort based on the aspects of evidence-based design of the hospitals such as natural light, air quality, noise, view, infection control, etc., to create a more optimal physical environment for better psychological outcomes. This is the first study to propose an adaptation of the AEDET toolkit to assist architects in designing healthcare facilities that are responsive to the requirements of hospital patients and staff; and to promote the quality of healing environment for improved health and well-being outcomes.

Keywords

hospitals; Environmental design; environmental comfort; healing environment; patient-centred care; evidence-based design; architectural space quality; health and wellbeing outcomes

Subject

Arts and Humanities, Architecture

Comments (1)

Comment 1
Received: 25 September 2023
Commenter: Bedia tekin
Commenter's Conflict of Interests: Author
Comment:  The research objectives have been updated and revised in line with the actual content making them more focused, as per the recommendation. The toolkit has been tested. We changed the language of the objectives to be more explicit about what the study focuses. We have revised the objectives accordingly.We agree that the study is not a redesign and it is about exploring the hospital evaluation toolkit. This has been changed within the paper. Also, the title have been changed from ‘Redesigning’ to ‘Exploring’ to reflect this.  Part of the study was the evaluation of the two hospitals to create a better healing environment, the contribution we claim is more about the recommendations for these toolkits. With the interviews of the architects, during the interviews, claim come from the results of the questionnaires or comments, or the base of the interviews, as part of the data analysis and part of the discussion. AEDET is more related with professionals, aspect is more meets with the patient use. Currently this statement makes it claim that it’s not supported by these data and interviews have been included to the study. Interviews with the architects strengthens the argument.The gap has been highlighted and stated more explicitly.  The main gap and wider implication are that the evaluation toolkits, designed for Global South contexts, are not fit for purpose for Global South countries, such as N. Cyprus. To the best of our knowledge this is the first paper to provide recommendations on adapting the evaluation toolkits to suit Global South contexts. Separated literature and methodology as per the suggestion.    The Limitation section has been moved into conclusion and case study have been moved earlier.Bar Charts and Radar tables are added to describe the methods of the comparison. See; chart 1, chart 2, chart 3, chart 4. Moved the limitation of the study to the conclusion - see pages 21-22.Several references have been added for the EBD and evaluation methods for hospital design. Existing references have been added to support the argument in the conclusion part. All these and more recent references have been updated and added to the paper and the reference list. You may see from the lines of 155-160, 82-87, 117-120, 121-124 and 77-81.This is currently beyond the scope of the paper. However a statement has been a statement recognising this and pointing readers to related work on fractals within biophilia by Taylor -see lines 160-165.Long paragraphs have been removed and revised. Figure 2 and Figure 3 have been updated and shown as Table 2 and Table 3 which is adopted from the AEDET Evolution Criteria and modified as; in general have been divided under 3 sections. Namely  Impact, Build Quality and Functionality. The ASPECT table is made clearer and more legible.  Chart 1 and Chart 3 is added to support the findings. We have added some points in the pages 3-4 with adding some supported references from Donald Ruggles, and discussion based on the case studies which we explored added in the conclusion part.
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