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NORDIC LIGHT & COLOUR
69
There are many factors influencing how we perceive and are
able to function in the environment. Aspects such as type of
walking surface, illumination and ambient conditions must
interact with aspects which involve visual and auditory percep-
tion, balance, orientation and cognition in order to support
safety. In summary there is a need for profound knowledge and
understanding of the complex balance between environmental
pressure and personal abilities.
The ecological model of ageing as a framework for adapting
the environment
Characteristic features of the ecological model of ageing,
developed by Lawton and Nahemow (1973), are that it predicts
behavioural outcomes by looking at an individual’s competence
in relation to environmental pressure. The model is built on the
following equation: B =
f (P, E)
, where B stands for behaviour,
f
for function,
P
for person or competence and
E
for environ-
ment, i.e. behaviour is a function of the person and the environ-
ment.
Competence is only a part of the person
(P)
and includes a
person’s biological health, sensory perceptual capacity, mo-
tor skills, cognitive capacity and ego strength. Adaptation is
predicted by examining the match between competence and
the demands of the environment. Environmental
(E)
pressure
encompasses the multiple demands of the environment upon
the individual. It includes aspects of the physical environment
(lighting, orientation cues, geographic distance), the personal
environment (family members, friends etc), supra-personal
environment (characteristics of the residents in a person’s
neighbourhood), and the social environment (norms, values in
the individuals’ society). According to the model the environ-
ments are classified on the basis of the ”demand character”
of the context in which the person acts. The demand character
could be positive, neutral or negative. When the capacity of the
individual is in balance with the pressure of the environment
the demand character is neutral. If the individual competence
deteriorates, the pressure from the environment must de-
crease as well in order to remain in balance. Outcomes for
individuals are dependent upon the strength of environmental
pressure in relation to an individual’s adaptation level and his
or her competence. The less competent the individual is, the
greater the impact of environmental factors is on that individ-
ual (Lawton & Nahemow 1973). The outcome, when a person
of a given level of competence is acting in an environment
with a given pressure level, could be placed on a continuum
from positive to negative and is manifested on two levels, as
behaviour and affect. Thereby it would be possible to predict
behavioural outcomes by looking at an individual’s competence
in relation to environmental pressure. There have been several
studies using the ecological model as a framework for nursing
actions in adapting the environment to patients needs.
Reduction of environmental pressure by modification of the
environment
Reducing the environmental pressure to meet the normal sen-
sory physiological changes that occur during the life-span has
been the focus of multidisciplinary interest by both research-
ers and practitioners over the years (Cannava 1994, Pastalan
1997, Wijk 2001, Ulrich 2012). The impact of the environment
on health and wellbeing is also one of the hallmarks of many
nursing theories (Nightingale 1969, Watson 1985).
The disease process itself affects the level of individual compe-
tence and most likely also the ability to handle the environmen-
tal press. Common changes in, for example, sensory acuity,
psychomotor speed, mobility, social roles during illness and
cognitive deterioration, make us more reliant on the physical
environment when we are ill. This could be expressed as dif-
ficulties to acquire and retain spatial-bound information and to
recognize features.
It has been assumed that a supportive environmental layout
could have a positive impact on behaviour despite loss of
functions (Lawton 1994). Also studies within the architectural
field are concerned about what demands a health promoting,
patient focused perspective puts on the planning and design of
hospitals (Dunlop 1993). It is therefore time to take a trans-dis-
ciplinary approach when working with the health care environ-
ment and being aware of the impact of the environment upon
the quality of care. By doing so the team-work may be instru-
mental in reducing some of the harmful effects of a negative
environmental design. The focus is on how to maximise the use
of the residents’ capacities in the environment with the aim of
finding a means to compensate for normal and pathological
specific loss of function in the individual. For example, collabo-
ration between architecture and nursing could be expanded
when planning for new institutions so as to promote a better
understanding of the special needs of the residents. Evaluation
of the individual’s personal competence should lead to different
approaches in order to adapt the environmental pressure and
promote independent functioning.
Colour in the environment
Colours are of great importance for most people in most
environments for the detection and identification of objects,
for information, and for the aesthetic point of view. Normally
the perceptual information of the environment is sufficient, but
visual and cognitive deterioration can have a negative impact
on how we perceive and act in the environment.
Wijk (2001) offers guidelines on how to use colours in the envi-
ronment based on research and experiments with patients and
controls. The importance of using colour contrasts to increase
visibility, colour coding and cueing to support object identifica-