Optimizing patient control in cancer care

Cancer treatment and care models are evolving rapidly, and the improvements in cancer care facility design — and the design research knowledge base — are progressing in tandem. There were several studies on cancer facility design added to The Center for Health Design’s Knowledge Repository in recent months, and three new studies are highlighted here.

If you need the “big picture” on recent cancer care research and corresponding salient trends in modern facility design, a paper by Leonard Berry and colleagues provides just that. The aim is to provide evidence-based design considerations that address multiple stakeholder needs related to several considerations such as infection control, urgent care for cancer patients and palliative care. The authors discuss the value added when research is embedded in the design process.

Two other recent papers delve into more of the specific empirical evidence that support the processes Berry and his co-authors reference. 

Building on a well-known theory of supportive design for health care, Haddox and Jiang evaluated the effect of a positive-
distraction-based protocol for cancer patients in a bone marrow transplant unit. People with cancer often feel a loss of control over many aspects of life. For people whose treatment requires an inpatient stay, their sense of control may be even further limited by an unfamiliar medical setting. 

In this study, patients were asked to provide their own personally significant photographs and could ask staff to play a slideshow of the pictures on the monitor in their room. The feedback was positive and consistent with previous research on the stress-reducing impact of positive distractions. While there were several limitations, the study serves as a helpful pilot study for future research, as similar low-cost, person-centered design interventions could make a meaningful difference for patients battling cancer.

Another component of the theory of supportive design is access to social support. Social support is a core need throughout the lifespan, but there is something especially unique about the social needs of a teen. For adolescents and young adults (AYAs) with cancer, social needs are constantly shifting, but there is little research available to help us understand how the environment can both support AYA care and adapt to varied individual desires. 

Peditto and colleagues bring a light to this area that has been largely overlooked. The study recognizes that AYAs with cancer (surprisingly defined as those between the ages of 15 and 39) often find themselves in pediatric cancer centers designed for much younger patients. The findings include inadequacies in the way cancer facilities are planned for AYAs, particularly in the considerations of outdoor space, patient rooms, lounges and visitor accommodations, to name a few. The authors provide several nuanced recommendations for facilitating desired social support in the AYA oncology environment. 

For all of the recent evidence on design that can support excellence in cancer care — including and beyond diagnoses and treatment — you can find the citations mentioned here and many others on the topic in The Center for Health Design’s Knowledge Repository. 

The following citations from The Center for Health Design’s Knowledge Repository of health care design resources were used by the author when writing this column:

• L. L. Berry et al., “Using Evidence to Design Cancer Care Facilities,” American Journal of Medical Quality, 2020.
• J. C. Haddox and S. Jiang, “The Virtual Shelf: A Feasibility Study on Self-Selected Imagery and in-Patient Experience in a Cancer Treatment Setting,” in Proceedings of the Environmental Design Research Association 50th Conference, EDRA, Brooklyn, NY: Manifold Scholarship at The City University of New York, 2019.
• K. Peditto et al., “Inadequacy and Impact of Facility Design for Adolescents and Young Adults with Cancer,” Journal of Environmental Psychology 69, 2020, in press.

Melissa Piatkowski, Research Associate, The Center for Health Design