Health Through Imagery — Assumptions

    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 them strongly

    People consistently report feeling anxious, scared, exposed, and isolated when they are in health care settings.


    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 families experiences.

     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 Imagery project 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).