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NORDIC LIGHT & COLOUR
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consumer surveys, direct behaviour observation, expert judge-
ments or experimental design and environmental trials. The
logic of using consumer surveys for evaluation is clearly to ask
the experts, the residents and staff, with all their experience
of staying in different types of health care settings, to assess
the quality of care and the context of care. The limitation of this
method is primarily due to that most existing questionnaires
are quite complex in nature with a lack of focusing on environ-
mental items. For most of the instruments presented in the
literature the most necessary prerequisite needed before rating
is a thorough training period of the persons in charge to use
them. It needs to be pointed out that also when using a more
qualitative design a systematic approach is necessary. This
includes a specific definition of outcomes and how they fit user
needs, the use of evidence based and best-practise knowledge
from the literature together with the opinions of a reference
group, and a step-by-step guidance for the observer task of
documenting desired and non-desired behaviours and design
evaluations.
Nevertheless the outmost impact factor belong to studies
that adapt the randomized controlled experimental study
design including two or more environmental alternatives, with
participants randomized into two groups, specific outcome
variables documented in advance , and where data gathering
is done through reliable and validated tests, observations and
ratings herefore the on-going attempts of constructing specific
evidence-based questionnaires facing the needs of various us-
ers of the environment including the patient, significant others
and the staff, are most welcome and promising (Elf et al 2012).
Future directions
Caring sciences including both medical and nursing sciences
are often considered as clinical sciences, with the primary aim
of fighting against disease and promoting health. It is neverthe-
less evident that these two goals are closely related to each
other since evidence-based facts derived from basic research
ought to be essential for the more practical clinical science.
However, the way basic results are implemented in clinical
practise is determined by the values and ethical considerations
currently prevalent in the society. This essay high-light some
issues to consider during the design process of health-care
institutions, which, if implemented in the environment, are of
importance for residents’ function and well being. A prerequi-
site for a design that meets users’ needs is a tight collabora-
tion between representatives of all the groups involved from
the start. That is the residents themselves together with their
family members, the staff, the managing directors, architects,
designers, researchers in the field and experts on specific
aspects of the environment such as colour design, illumina-
tion, ventilation and gardening. During the analysis the different
perspectives are weighted against each other to conclude upon
the summarized effect of the intervention.
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