Therapeutic goals of hospice care environment: A systematic literature review

Abstract

Identification of environmental Therapeutic Goals (TGs) has proven essential in providing useful guidance for planning and design (Cohen & Weisman 1991 ). Though age-specific environmental dimensions have been suggested by several researchers during 1980's to 1990's, none of them focused on dying patients and their experience in hospice care environment, so the need for categorizing dimensions for hospice environment is evident. The objective of this study is to identify the Therapeutic Goals of hospice environment focusing on patients' experience. This study employed a systematic literature review with an approach developed by Hawker and colleagues in 2002. This study had considered a wide-ranging literature search: 7 electronic databases search (PubMed, PsyciNFO, Social Science Citation Index, Science Citation Index, ProQuest Dissertations & Thesis, Avery, and Cochrane Library), reference list search, examination of literatures recommended by relevant experts, and Google search for books, reports, and guidelines. In total 48 literatures included; 39 full text articles, 2 books, 5 guidelines, and 2 reports. The data has extracted from these literatures onto a standard template (matrix) for comparison and analysis for coding and thematic development. The study identified eight themes as TGs which have direct influence on patients' experience of hospice care environment: provide continuity of self, provision of access to nature, provision of privacy, facilitate social interaction, maximize safety & security, provision of autonomy, regulate stimulation, and provision of spiritual care. These goals reflect two characteristics; each expresses a basic or derived major patient's need, and a potential environmental facilitator for the satisfaction of the need (Lawton et al. 2000). As the physical environment of hospice has significant impact on the patients' quality of life and the possibility of a good death (Cohen et al. 2001 ), these TGs have a positive effect on patients' lives.