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Room Design—A Phenomenological-Hermeneutical Study

A Factor in Creating a Caring Environment

Sundberg, Fredrika, CCRN; Fridh, Isabell, PhD, CCRN; Olausson, Sepideh, PhD, CCRN; Lindahl, Berit, PhD, CCRN

doi: 10.1097/CNQ.0000000000000267
Original Articles

Medical technology has progressed tremendously over the last few decades, but the same development cannot be seen in the design of these intensive care unit environments. Authors report results of a study of evidence-based room design, emphasizing the impact on conveying a caring attitude to patients. Ten nonparticipant observations were conducted in patient rooms with 2 different designs, followed by interviews. The data were analyzed using a phenomenological-hermeneutical approach. The results did not reveal that it was obvious that redesigned spaces resulted in a more caring attitude. The meanings of caring displayed during nursing activities were interpreted by interpreting gazes. Some of the nursing staff had an instrumental gaze, interpreted as caring with a task-orientated approach, while others communicated their caring with an attentive and attuned gaze, where the needs of the patients regulated the working shift. The study findings indicated that caring may not be perceived when nurses use a task-oriented approach. However, when nurses practice a person-centered approach, using an attentive and attuned gaze, caring is conveyed. Caring in intensive care contexts needs to be assisted by a supportive environment design that cultivates the caring approach.

Department of Caring Science, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden (Ms Sundberg and Drs Fridh and Lindahl); Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden (Dr Fridh); and Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Dr Olausson).

Correspondence: Fredrika Sundberg, CCRN, Department of Caring Science, Faculty of Caring Science, Work Life and Social Welfare, University of Boras, Allégatan 1, 501 90 Boras, Sweden (

This work was supported by the Swedish Research Council, Stockholm, Sweden (grant number 521-2013-969). They had no involvement in any part of the research process.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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