GARDEN AS RESTORATIVE ENVIRONMENT FOR CHILDREN IN MALAYSIAN HOSPITAL SETTING

Transcription

1 GARDEN AS RESTORATIVE ENVIRONMENT FOR CHILDREN IN MALAYSIAN HOSPITAL SETTING Ismail Said (PhD) Head of Department Department of Landscape Architecture Faculty of Built Environment Universiti Teknologi Malaysia 2006

2 Problem Statement I am bored, not free to move around, I feel restless, and I hate this place (ward) Zainul, aged 10, nephritic syndrome I hate taking medicine and injection Adibah, aged 12, blood complexion Paediatric patients experienced stress in ward.

3 WARD CONDITIONS Limited space Crowdedness Confinement Unpleasant sound Unfamiliar setting More negative affordances than positive ones STRESS REGRESSIVE BEHAVIOURS Boredom Fear Clinging to parents Anxiety Recluse Being passive Crying Restlessness Depressed mood OUTCOMES Low cognitive functioning Low physical functioning Low social functioning What are the properties and attributes of the ward affording stress to the hospitalised children?

4 Garden as Restorative Environment Restoration is reduction from stress and health recovery. Restoration is the positive shift of three areas of functioning: cognitive, physical and social. Cognitive: from boredom to fascination; from anxiety to relax and feeling calm and comfort; from fearful to cheerful and forgetting worries. Physical: from passive to active in play; from sedentary to lots of movement Social: from being alone and recluse to playing with peers and caregivers. Cognitive Functioning Restoration in Garden Social Functioning Physical Functioning

5 Garden as Restorative Environment Psycho-physiological stress reduction framework: Attention Restorative Theory (ART) and Stress Coping Restoration Theory (SCRT) ART: Involuntary attention such as viewing natural environment is an effortless functioning that allows a depleted attention capacity to recover and thus reduced mental fatigue. Four qualities of recovery from mental fatigue: a. Being away b. Extent c. Fascination d. Compatibility SCRT: Stress is reduced when the environment affords: a. Sense of security b. Sense of control c. Social support d. Physical movement and exercise e. Access to nature and other positive distractions

6 Children s Functioning: Play Play is sensual and motoric activities that is gathering and processing information through direct perception while moving in the landscape space. It involves physical and perceptual contacts with the elements of the environment affording the children to sense of control and to explore and manipulate the environment. Play involves interaction of a child with peers that leads to establishment of friendship and acquaintanceship. Play generates children to develop emotional values to a place such as like versus dislike, attraction against aversion, wonder versus indifference, joy in place o sorrow, curiosity instead of boredom, courage versus fear and fascination versus anxiety. SOCIAL SPACE PHYSIOGRAPHIC SPACE Use Memory Image Schema Topophilia INNER SPACE

7 Theory of Affordance Children value a place is not determined by its appearance but by its potential for affording play activities. That is, the perception and movement of children are influenced by the functional properties (affordances) of the garden. Affordances of garden as play space: (1) unending diversity, (2) feeling of timelessness, and (3) home of animals. Affordances of the garden: positive versus negative. Affordances can be categorised into: perceived, utilised and shaped. Utilised affordances permit performatory and exploratory activities, and shaped affordances allow productive activities.

8 The Aim of the Research To determine the properties and attributes of garden which enhances the restorative process of middle childhood paediatric patients (aged 6-12) that improves the children s functioning: physical, cognitive and social.

9 Methodology Garden at paediatric ward of Batu Pahat Hospital

10 MAIN STREET MAIN ENTRANCE ISOLATION WARD BATH TOILET TOILET BATH STORE A D E G MARS ROPE PLAY PAVILION & SPRINGRIDER PAVILION & SWING FISHPOND & PERGOLA A LAB D G C BATH W ASH AREA TOILET TOILET W ASH AREA BATH B E SIX BED WARD SIX BED WARD PAEDIATRIC WARD 2 SIX BED WARD FOUR BED WARD H F C B H PLAY AREA F ALPHABETICAL WALKS TRIANGULAR ROPE PLAY PATIO OVERTURNED URN

11 Methodology: Measuring Patients Behaviours Observational study with paired data on 31 middle childhood patients Phenomenological model Multi-source and multi-method data eliciting movement and perceptual judgments of patients (A) Behavioural mapping (B) Patient open-ended interview (C) Mother structured interview (D) Ward staff survey questionnaire (E) Focus-group interview on nurses

12 MAIN ENTRANCE TOILET BATH STORE MAIN STREET BATH TOILET Findings Externalising Behaviours (Overt) in Ward and Garden A MARS ROPE PLAY - rope play structure - sandpit - birdfeeder - sculptures of frog & snake - mural - treasure chest - timber benches - lawn - trees - foliage & flowering shrubs PAVILION & SPRINGRIDER - timber pavilion B - chatterbox - shovel - slide - hopscoth - springriders - sandpit - timber bench - treasure chest - lawn - trees - foliage & flowering shrubs D LAB PAVILION & SWING - timber pavilion A - timber ladder & swing - planting boxes - balancing bar - birdfeeder E - treasure chest - timber benches - lawn - foliage & flowering shrubs FISHPOND & PERGOLA - pond - filter system - timber bench - treasure chest - stepping stone G - stand pipe - timber pergola - trees - flowering & foliage shrubs BATH WASH AREA TOILET TOILET WASH AREA BATH SIX BED WARD SIX BED WARD ISOLATION WARD PAEDIATRIC WARD 2 SIX BED WARD FOUR BED WARD PLAY AREA MURAL WALL ALPHABETICAL WALKS - pebble-washed walk - timber seat - mural & timber portal - entrance portal - flowering shrubs C TRIANGULAR ROPE PLAY - large tree - sandpit - triangular rope play equipment - timber seats - treasure chests - flowering & foliage shrubs B PATIO - covered patio with rubber mat floor - mural - bucket swing - standpipe H F OVERTURNED URN - urn - lawn - flowering climbers - palms PATIENTS PLAY PARTICIPATION IN GARDEN AND BED LOCATION IN WARD Master Plan of Paediatric Ward's Garden, Batu Pahat Hospital N W S E

13 GARDEN PROPERTIES AND ATTRIBUTES Open greenery Space for free movement Sense of control Security Social play and supports Play equipments and garden features Plants and animals Tropical microclimate REDUCED STRESS Renewing Functioning PROGRESSIVE BEHAVIOURS Being relaxed Calm and comfort Cheerful Forgetting worries Active in play Independent Cooperative Playing with peers Acquaintanceship Decreased social withdrawal What are the properties and attributes of the garden affording stress reduction to the hospitalised children?

14 Perception of Patient towards the Garden: Pattern of Regularity Garden features and climatic factors and people Communities for children s restoration Social interactions with peers and caregivers Cognitive interactions including perception Physical interactions involving movement 1. The garden is a playground; as physiographic and social place for play. 2. The garden composed of several play areas equipped with play equipments, garden structures, vegetation and animals.

15 Perception of Patient towards the Garden: Pattern of Regularity 3. Play areas with more features were preferred than those with few. 4. Play equipments were preferred more than garden features. 5. Manipulating equipments were preferred more than non-manipulating ones. 6. Play equipments were more important than vegetation. 7. Without vegetation the garden was not a complete for play. 8. Vegetations provided shade, fruits for eating and habitat for small animals. 9. Animals were pleasant to watch, hear, and can be used as play tool. 10. Tropical climate was favourable for outdoor play.

16 The Assessment Model of Restorative Experience in a Hospital Garden Low to Mode rate Returning to ward END END Viewing the garden START I II Funct Access to garden ioning Observing garden from walkway Resting and Observing in garden V VI WARD III GARDEN Stage IV Play: Direct experience with garden features, climatic factors and people High Func tioning

17 It simply best playing here. I would like to call this garden Taman Seri Indah I can play with my brother. Look at the maggot.