Towards a design theory for reducing aggression in psychiatric facilities

Roger S Ulrich, Lennart Bogren, Stefan Lundin

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Abstrakt

The paper proposes a tentative theory for designing psychiatric environments to foster reduced aggression and violence. A basic premise underlying the design theory is that environmental and psycho-social stressors mediate and trigger aggression. The theory posits that aggression will be reduced if the facility has been designed with an evidence-based bundle of stress-reducing environmental characteristics that are identified and discussed. To make possible a tentative empirical evaluation of the theory, findings are described from a study that compared aggressive incidents in three Swedish psychiatric hospitals of different design. A newer hospital was evaluated as superior to both an old hospital it replaced and another comparison hospital (control) with respect to having nearly all the environmental features identified in the stress-reducing bundle of the design theory. Findings from restraint use data were consistent with the design theory prediction that aggression would be lower in the newer hospital having several stress-reducing environmental features than in either the old or control hospitals. The use of chemical and physical restraints decreased substantially in the new hospital compared to the old hospital it replaced. By contrast, restraint use increased in the control hospital that cared for comparable psychiatric patients according to similar treatment protocols during the same period. The design theory and preliminary findings suggest the possibility that providing better psychiatric buildings with design guided by the best available evidence and theory can play an important role in reducing the serious patient and staff safety problem of aggressive behavior.
OriginalsprogEngelsk
TitelARCH 12: ARCHITECTURE / RESEARCH / CARE / HEALTH
Antal sider12
ForlagChalmers Institute of Technology
Publikationsdato2012
StatusUdgivet - 2012
BegivenhedARCH12 Conference: International Conference ARCH12 and Forum Vårdbyggnad Nordic Conference 2012 - Chalmers University of Technology, Gothenburg, Sverige
Varighed: 12 nov. 201214 nov. 2012

Konference

KonferenceARCH12 Conference
LokationChalmers University of Technology
LandSverige
ByGothenburg
Periode12/11/201214/11/2012

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