Do Patients Do Better if Their Hospital Room Has a Nice View?

JANUARY 17, 2017
Caitlyn Fitzpatrick
psychiatry, hospital medicine, emergency medicine, surgery, major depressive disorder, depression, window view, sunlight, vitamin D, Cleveland Clinic

Before the first Cleveland Clinical regional hospital in Ohio opened its doors on November 15, it was not without taking design considerations into mind first. Architect Randy Geise, EDAC, designed the five-story, $161-million Cleveland Clinical Avon Hospital, but he had some patient-focused questions.

“He speculated whether a view of the sky, buildings, or nature (grass, trees, etc.) made a difference [in patient outcomes]. We had no idea,” Nancy M. Albert, PhD, associate chief nursing officer at the Cleveland Clinic Health System, explained in a news release.

The unanswered question prompted Albert to conduct a study, with the end goal of finding if window views (specifically light exposure) had an impact on patients’ psychological profile, perceptions of general health, and clinical outcomes. The patients had heart disease and were being treated both medically and surgically.

The light exposure-mental health link certainly isn’t a new concept. Seasonal affective disorder (SAD) has been well-documented. When the season changes result in less sunlight, people prone to SAD get depressed.

It’s even been reported that the prevalence of SAD is seven times higher in people living in Washington State.

Albert and colleagues randomly assigned 463 patients to one of three views—building wall, sky, and full view of nature—to evaluate outcomes over the course of five months during the summer and fall. The participants had all been awake and alert for at least two days leading up to the study and were placed in private rooms. Comorbidities were taken into consideration when analyzing the data.

The participants were exposed to different lighting conditions, ranging from full sun to full clouds, between 11 a.m. and 1 p.m. so that questionnaire answers were taken at the period when the sun was at its highest point.

“In our study, we tried to include factors, such as anxiety and depression, associated with long-standing notions that people have about light, nature, and health,” said Albert, who also holds her CCNS, CHFN, CCRN, NE-BC, FAHA, FFCM, FAAN.

Results showed that only one of seven hospital-care factors—four patient characteristics and three psychological factors—were influenced by the type of view patients were exposed to.

Patients who had a sky or nature window view had higher perceptions of general health. However, in multivariable analyses, patient characteristics related to having the window view were controlled. So when compared to a building wall view, sky and nature views were associated with fewer comorbidities, but then perceptions of general health were the same among the three groups.

“When patients are medically ill or recovering from a surgical procedure, window view may not be an important factor of physical or emotional health and clinical outcomes,” Albert concluded.

It looks like old-fashioned grade A medical care is what really matters in a hospital.

The news release was provided by the Cleveland Clinic.

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