Space for Interaction.: Qualifying group treatment for patient with chronic pain through optimization of space. A randomized pilot study.

Publikation: Konferencebidrag uden forlag/tidsskriftPoster

Abstract

SPACE FOR INTERACTION

QUALIFYING GROUP TREATMENT FOR PATIENTS WITH CHRONIC PAIN THROUGH OPTIMIZATION(?) OF SPACE. A RANDOMIZED PILOT STUDY.
In a Ph-D.

Mariane Ellen Jørgensen / Nurse + psykoterapist / maej@rn.dk / Pain Center / Aalborg University Hospital / Denmark / Mette Blicher Folmer / Architect + Nurse + PhD fellow / folmer@gaze.dk / Dept. of Architecture, Design and Media Technology/ Aalborg University / Denmark / Michael Mullins / Architect + PhD / Dept. of Architecture, Design and Media Technology/ Aalborg University / Denmark / Anne Kathrine Frandsen / Architect + PhD / Danish Building Research Institute / Aalborg University / Denmark

AIM
Research shows the hospital space has significance for human healing processes and the physical environment can have both positive and negative impact on the interaction between patients and staff.

In order to qualify treatment for patients with chronic pain, the effect and experience of two different rooms for group therapy were compared.

Three hypotheses were tested:
1) Room decor affects the interaction and thus the psychotherapeutic group therapy
2) The meaning of space for the interaction could be measured on the effect of treatment
3) The experimental room (Room B), was perceived as more comfortable and secure than the control room (Room A)


MIXED RESEARCH METHODS
93 patient’s accepted invitation to participate in the project. Of these 66 test persons completed treatment and research questions (22 male, 44 female, mean age 48.6 (CI95 %: 45,6 to 51,7)).

Group A (three treatment groups, n=18) received treatment in a general hospital room (room A), group B (three treatment groups, n=19) received treatment in a specially adapted space (room B) and group W (n =29) was patients on the waiting list for treatment.

Group treatments lasted five months and consisted of 10 sessions duration of 3 hours each. Test participants were blinded. The therapists were not.

Indoor and outdoor climate were measured during the treatment period.

Treatment effect was measured before and after in relation to quality of life (SF36 -v2, WHOQOL – Bref, BDI -II) and in relation to pain (RMQ, PCS, MPQ). Results indexed and analyzed with ANOVA.
Interaction level in the group was measured with Group Clima Questionnaire (GCQ) in week 2, 6 and 10, and compared. Satisfaction with treatment was measured. Data was analyzed with RM-ANOVA mixed model.

Space was assessed with Semantic Environmental Assessment (SMB) after treatment periods. Notes on spontaneous comments from the patients during the session were made. Results analyzed with ANOVA.

The six therapists were interviewed individually and afterwards in a group. There was used a semistructrued interview guide and data was categorizes in themes.

RESULTS
Room B was perceived as significantly more comfortable and secure than room A. Room B was rated 2.49 (CI95 %: 2.16 to 2.82) higher than Room A, on a scale from 1 to 7.

The therapists preferred room B for working in and described the room as a tool in the therapies.

There was no significant difference in effect of treatment, nor for quality of life or for pain in the three groups.

Patients in group A had significantly lower quality of life than group B and W, before and after treatment. The randomizing of patients did not work at this variable. This was considered in the analyzing and interpretation of the results.

There was no significant difference in control group and in experimental group in the evaluation of treatment. All the patients were satisfied or very satisfied with treatment.


CONCLUSION
Room B is perceived more secure and comfortable than room A, and the therapist experiences room B as their preferred working tool in the therapies

The treatment itself does not affect outcome measured as pain and life quality. Group A and B did not differ from group W (patients on waiting list), though all patient who received treatment was satisfied or very satisfied with treatment.


DISCUSSION
- Differences of the rooms even bigger for measure bigger differences?
- Effect of treatment - other outcome measurements?
- Therapist not blinded!
- Space as a working tool: Room A and room B are two different working tools affording different therapy, maybe differences in space is adopted by the way the therapist are working.
- Differences at baseline for quality of life
- The use of mixed methods research


OPTIMZING SPACE
VISION OF ROOM B
- Space is a team-mate
- It is a space where people want to stay
- The space exudes caring for people in all walks of life.
- Everything that is in the room is there for a reason. Everything is functional and contributes positively to the experience of the space.

Design solutions based on research, therapeutic experience and architectural experience

OBJECTIVES
That space can support group therapy through:
- Different needs of rest
- Psychic resting place
- Ease and order
- Stimulates zest for life
- Supporting communication


ROOM A and B
AIR
A: air-condition / 35 m2
B: air-condition / 48 m2 / smell of natural citrus in fresh drinking water

Artificial LIGHT
A: light in ceiling
B: pendant light over table / pendant light in center of the therapeutic circle / spots for arts on the walls / candles

SOUND and ACUSTICS
A: ghettoblaster
B: surround sound / soft surfaces / bookshelf / carpet

BODY COMFORT
A: chairs / one sofa
B: chairs / futons / beanbag / pillows /carpet / rocking chair

ART
A: patient’s pain drawings / one poster
B: photographic Art at the walls / stone sculpture /different kind of objects in wool, stone, glass, wood

Natural LIGHT
A: light from south but the room lays in shadow from building across the street
B: Light from north, but get reflected light from a building across

MENTAL COMFORT
A: Institutional layout and furniture / plastic cups / ghettoblaster / messy / Institutional colors / view to building across the street.
B: Art / body comfort / porcelain cups / furniture and colors in the space was selected with care /
high quality hi-fi / order but not perfection / view to the inlet Limfjorden
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Detaljer

SPACE FOR INTERACTION

QUALIFYING GROUP TREATMENT FOR PATIENTS WITH CHRONIC PAIN THROUGH OPTIMIZATION(?) OF SPACE. A RANDOMIZED PILOT STUDY.
In a Ph-D.

Mariane Ellen Jørgensen / Nurse + psykoterapist / maej@rn.dk / Pain Center / Aalborg University Hospital / Denmark / Mette Blicher Folmer / Architect + Nurse + PhD fellow / folmer@gaze.dk / Dept. of Architecture, Design and Media Technology/ Aalborg University / Denmark / Michael Mullins / Architect + PhD / Dept. of Architecture, Design and Media Technology/ Aalborg University / Denmark / Anne Kathrine Frandsen / Architect + PhD / Danish Building Research Institute / Aalborg University / Denmark

AIM
Research shows the hospital space has significance for human healing processes and the physical environment can have both positive and negative impact on the interaction between patients and staff.

In order to qualify treatment for patients with chronic pain, the effect and experience of two different rooms for group therapy were compared.

Three hypotheses were tested:
1) Room decor affects the interaction and thus the psychotherapeutic group therapy
2) The meaning of space for the interaction could be measured on the effect of treatment
3) The experimental room (Room B), was perceived as more comfortable and secure than the control room (Room A)


MIXED RESEARCH METHODS
93 patient’s accepted invitation to participate in the project. Of these 66 test persons completed treatment and research questions (22 male, 44 female, mean age 48.6 (CI95 %: 45,6 to 51,7)).

Group A (three treatment groups, n=18) received treatment in a general hospital room (room A), group B (three treatment groups, n=19) received treatment in a specially adapted space (room B) and group W (n =29) was patients on the waiting list for treatment.

Group treatments lasted five months and consisted of 10 sessions duration of 3 hours each. Test participants were blinded. The therapists were not.

Indoor and outdoor climate were measured during the treatment period.

Treatment effect was measured before and after in relation to quality of life (SF36 -v2, WHOQOL – Bref, BDI -II) and in relation to pain (RMQ, PCS, MPQ). Results indexed and analyzed with ANOVA.
Interaction level in the group was measured with Group Clima Questionnaire (GCQ) in week 2, 6 and 10, and compared. Satisfaction with treatment was measured. Data was analyzed with RM-ANOVA mixed model.

Space was assessed with Semantic Environmental Assessment (SMB) after treatment periods. Notes on spontaneous comments from the patients during the session were made. Results analyzed with ANOVA.

The six therapists were interviewed individually and afterwards in a group. There was used a semistructrued interview guide and data was categorizes in themes.

RESULTS
Room B was perceived as significantly more comfortable and secure than room A. Room B was rated 2.49 (CI95 %: 2.16 to 2.82) higher than Room A, on a scale from 1 to 7.

The therapists preferred room B for working in and described the room as a tool in the therapies.

There was no significant difference in effect of treatment, nor for quality of life or for pain in the three groups.

Patients in group A had significantly lower quality of life than group B and W, before and after treatment. The randomizing of patients did not work at this variable. This was considered in the analyzing and interpretation of the results.

There was no significant difference in control group and in experimental group in the evaluation of treatment. All the patients were satisfied or very satisfied with treatment.


CONCLUSION
Room B is perceived more secure and comfortable than room A, and the therapist experiences room B as their preferred working tool in the therapies

The treatment itself does not affect outcome measured as pain and life quality. Group A and B did not differ from group W (patients on waiting list), though all patient who received treatment was satisfied or very satisfied with treatment.


DISCUSSION
- Differences of the rooms even bigger for measure bigger differences?
- Effect of treatment - other outcome measurements?
- Therapist not blinded!
- Space as a working tool: Room A and room B are two different working tools affording different therapy, maybe differences in space is adopted by the way the therapist are working.
- Differences at baseline for quality of life
- The use of mixed methods research


OPTIMZING SPACE
VISION OF ROOM B
- Space is a team-mate
- It is a space where people want to stay
- The space exudes caring for people in all walks of life.
- Everything that is in the room is there for a reason. Everything is functional and contributes positively to the experience of the space.

Design solutions based on research, therapeutic experience and architectural experience

OBJECTIVES
That space can support group therapy through:
- Different needs of rest
- Psychic resting place
- Ease and order
- Stimulates zest for life
- Supporting communication


ROOM A and B
AIR
A: air-condition / 35 m2
B: air-condition / 48 m2 / smell of natural citrus in fresh drinking water

Artificial LIGHT
A: light in ceiling
B: pendant light over table / pendant light in center of the therapeutic circle / spots for arts on the walls / candles

SOUND and ACUSTICS
A: ghettoblaster
B: surround sound / soft surfaces / bookshelf / carpet

BODY COMFORT
A: chairs / one sofa
B: chairs / futons / beanbag / pillows /carpet / rocking chair

ART
A: patient’s pain drawings / one poster
B: photographic Art at the walls / stone sculpture /different kind of objects in wool, stone, glass, wood

Natural LIGHT
A: light from south but the room lays in shadow from building across the street
B: Light from north, but get reflected light from a building across

MENTAL COMFORT
A: Institutional layout and furniture / plastic cups / ghettoblaster / messy / Institutional colors / view to building across the street.
B: Art / body comfort / porcelain cups / furniture and colors in the space was selected with care /
high quality hi-fi / order but not perfection / view to the inlet Limfjorden
OriginalsprogEngelsk
Publikationsdato7 maj 2014
Antal sider1
StatusUdgivet - 7 maj 2014
PublikationsartForskning
Peer reviewJa
BegivenhedThe 7th World Congress of the World Institute of Pain (WIP 2014) - Maastricht, Holland
Varighed: 7 maj 201414 maj 2014
Konferencens nummer: 7

Konference

KonferenceThe 7th World Congress of the World Institute of Pain (WIP 2014)
Nummer7
LandHolland
ByMaastricht
Periode07/05/201414/05/2014

    Forskningsområder

  • healing architecture, pain

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