Assumptions underlying the selection and
placement of images for health care settings and to be tested and refined
through monitoring and research.
Visual images are important to
how people experience an environment, they are memorable and people react to
People consistently report
feeling anxious, scared, exposed, and isolated when they are in health care
People who are sick experience visual images in the environment differently
than those who are well. Persons who are sick, weak, and afraid experience the
environment much more intensely. Research demonstrates that people when ill or distressed go “inside”
visual images more than they do when feeling healthy and vital. Moreover, they are more sensitive to
the implied and symbolic messages associated with the images and experience
them more personally.
Patients and family members are not familiar with the health care environment. This
includes the physical space, routines, words used (including signs), machines
and equipment, and the roles of the people with whom they interact. This
unfamiliarity contributes to anxiety and a sense of lack of control and threat.
Staff and patients (including
family members or significant others) differ not only in their familiarity with
the environment but also in level of education, literacy, health literacy, and
importantly emotional state. Staff
may not always be the best source of information about the patients and
The perceptions of patients and
families are important even if they are not “objective” or precise. We expect
there will be differences in the experiences reported by patients and families
and the beliefs of health care providers (and researchers) about those
experiences. To the extent that we encourage asking questions and sharing
experiences everyone learns and has more fun.
We use images as a method to
increase the sense of positive connection with the facility and staff and
reduce isolation and fear. We believe this can measurably influence health
outcomes and well being. Therefore, the placement of images will be based on
where patients and family members spend significant time (duration or
intensity). This differs from the
usual practice of using artwork as decoration in public places (hallways).
People do not learn complex
intellectual content well when they are anxious or sick. Thus, posters aimed at
health education may be more anxiety provoking particularly if they include
many words, pictures of dissociated body parts, complex instructions and
warnings may actually contribute to a negative experience. It may be more
appropriate to address the patients’ emotional state than our perception of
their lack of information.
A checklist based on
evidence-based guidelines will be developed to aid NVRH and Health Through
staff with the process of art selection and placement and to help monitor
responses and impact.
Monitoring the assumptions and conducting research about the impact of
visual images in health care settings is the mission of our “health through
imagery”. Research methods will include qualitative, quantitative, and
observational approaches to data collection. Staff, family members, and patients who choose to
participate will be able to do so confidentially with minimal effort. We also welcome input on our adapted
guidelines on “restorative” imagery (available HERE).