اهمیت خلوت بیمار در طراحی معماری محیط های درمانی به منظور ارتقاء کیفیت درمان و بهبودی آن ها

خلوت به‌عنوان یکی از نیازهای اساسی انسان اهمیت به‌سزایی در سیستم مراقبت‌های بهد‌اشتی د‌ارد و برآورد‌ه نشدن آن استرس بسیاری به بیمار وارد می‌کند که در روند بهبود‌ی‌اش تأثیر نامطلوبی خواهد گذاشت. بسیاری از صاحب‌نظران اخلاق پزشکی برآوردن خلوت را ستون اصلی ارائه مراقبت‌های درمانی می‌د‌انند. تحقیقات در ایران و سراسر دنیا نشان د‌اد‌ه است که علی‌رغم آنکه پرستاران و د‌یگر کارکنان بر این باورند که خلوت بیماران رعایت می‌شود ولی بیماران از میزان خلوت خود راضی نیستند. این تحقیق به‌دنبال پاسخگویی به این سؤال است که خلوت بیماران چگونه می‌تواند در ارتقای نظام درمان و بهبود‌ی‌اش مؤثر واقع شود و جایگاه معماری در تحقق خلوت لازم برای بیمار چیست؟ این مطالعه با رویکرد کیفی از تکنیک مطالعه کتابخانه‌ای و سپس مشاهد‌ه در دو بیمارستان انتخابی گودرز و مرتاض در شهر یزد برای یافتن نکاتی در رابطه با خلوت بیماران بهره می‌گیرد. در نهایت دو گروه از بیماران بستری انتخاب شدند و مصاحبه نیمه‌ساختار یافته انجام گرفت. نتایج نشان می‌د‌هد که خلوت در فضاهای درمانی تابع شرایط‌ فرهنگی، نوع و شدت بیماری، روحیات فرد‌ی، طول زمان بستری، روش ارائه خدمات، فعالیت‌های کادر پزشکی و موارد‌ی از این قبیل است که طراح فضاهای درمانی باید آنها را در نظر بگیرد و راهکارهای معمارانه‌ای در برآوردن خلوت لازم برای بیمار بستری خلق کند.

Privacy as one of the human essential needs in the health care system is very important, and lack of the satisfaction of it will cause lots of stresses on patients. These stresses include negative effects on the recovery procedure. The affliction of the mentioned stresses comes from environmental factors like unfamiliar surrounding, lack of the privacy and individual spaces, deficit of independency, and uncertainty about the result of treatments or illness. Most of the medical moral connoisseurs believe that preparation of privacy is the essential base for providing the health cares. In the Iran and all around the world, the researches have indicated that opposite to what nurses and other staffs believe that the patient’s privacy is observed, the patients are not satisfied of their privacy rate. In the medical environment the separation of the patients from their families and their usual life, hospitalization and staying in the sharing rooms, and repetition of information registration cause more interruption in their requires from the privacy. The methods of preparing privacy in health care spaces and hospitals are very important and should be chosen carefully because these methods should not interrupt medical services and cause problems in the health care systems.
This research is arguing for answers to this question that how the patients’ privacy can effect on the enhancement of health care system and recovery, and what the architectural role in the patient’s needful privacy is. In this research the importance of privacy for the patient who confined on the bed in the health care space, the different attempts they make to obtain enough privacy for themselves, and finally the role of architecture to bring about and improve the quality of satisfaction are discussed. This study deals with finding some points about patients’ privacy with qualitative approaches via literature review, observation and surveyin two focus groups in two hospitals in the Yazd. Despite of the small variation in comparable hospitals, the result shows some similarities in the same points that could be considerable. The results reveal that the importance of privacy is undeniable in the health care spaces especially in the required of visual and vocal privacies. It is not being ignored that in the hospitals, as a health care center, patients have to stay for days, so the preparing privacy methods are very important and require excessive attention. Privacy in the health care spaces depends on cultural various conditions, type and intensity of disease, personal habits, duration of confined on the bed, methods of giving services and medical activities. In addition to patient privacy necessity, this situation will change in the period of the treatment as the treatments policies may change.
Regarding to the purposes mentioned above, the architects should consider appropriate strategies based on the specific conditions in the health care centers. Some points like individual space, observing the distances and personalization are total qualifications that should be achieved in various forms and the architectures and designers should consider and innovate architectural methods to prepare them. Some practical suggestions have been presented as results of this research so that they could be helpful for architectures to use.

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