title: Psychosocially supportive design--Scandinavian health care design.
abstract: The major purpose of this paper is to discuss the basic ideas and criteria underlying contemporary health care design. Special attention is given to the growing shift in biomedical attitude from a largely pathogenic concept of disease to a more salutogenic perspective. This shift should not only lead to a stronger integration of building design and care philosophy but also result in an enhanced quality of medical care and strengthened health processes. Traditionally, the pathogenic perspective has tended to consider patients as objects and concentrated on individual "sick parts" of the human body, which were further and further divided into smaller parts and separately treated. Consistent with this perspective, health care facilities have been interpreted as medical-technical environments oriented toward the physical needs of the treated body part. From this perspective the main requirement placed on health care facilities has often been interpreted narrowly as the reduction of the risk of exposure to disease. Comparatively little priority has been given to calming the patients and making them feel relaxed in spite of traumatic hospital experiences and starkly institutional care environments. Other consequences of the pathogenic perspective have been that psychological, social and spiritual needs of patients have been largely disregarded in the design of Health care facilities, and often marginalized in the philosophy of delivering care. The emphasis on functional efficiency, together with the pathogenic conception of disease and health, has often produced health care facilities that are not psychosocially supportive. In recent years, however, a different perspective has emerged leading to a new paradigm. The modern disease concept is no longer narrowly pathogenic; rather, disease is seen as multifaceted and having a variety of causes or elements. The salutogenic perspective, which focuses on health promoting processes, has become much more central to the consideration of care philosophies and in the creation of new health care facilities. In this new paradigm, the focus is on the patients: along with their physical health needs the patients' psychological and social health needs are given major emphasis in the delivery of care activities and in the design of health care environments. Future research needs to develop care philosophies that focus on a broader concept of health, thus creating an awareness of the importance of psychosocially supportive design.
authors.affiliation: Karolinska Institute, Swedish National Institute for Psychosocial Factors and Health.
authors.forename: A
authors.initials: A
authors.lastname: Dilani
mesh_terms: D003159:Community-Institutional Relations; D004779:Environment Design; D006272:Health Facility Environment; D006293:Health Promotion; D006694:Holistic Health; D006749:Hospital Design and Construction; D006801:Humans; D007297:Inpatients / Q000523:psychology; D012064:Relaxation Therapy; D012537:Scandinavian and Nordic Countries; D013315:Stress, Psychological / Q000517:prevention & control