Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND

December 2015 CULTURAL STUDIES ISSN 2356-5926

The role of interior architecture in the spaces of rehabilitation, especial for

children with a focus on evidences-based design approach1
Shima Taheri
Master student of Architecture, Department of architecture and urbanism faculty,
Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.
E-mail: ([email protected])

Maryam Ghasemi Sichani

Architecture PhD, assistant professor and faculty member of the Department of
Architecture, Department of architecture and urbanism faculty, Isfahan (Khorasgan)
Branch, Islamic Azad University, Isfahan, Iran.
E-mail: ([email protected])

Abstract

Since children's physical and psychological characteristics are different, it is obvious that
treatment spaces of children demand their specific interior design. In this article has been
tried to affect in the process of improving the sick children and increase the efficiency of
treatment spaces with the use of evidence-based approach, by relying on reducing stress and
anxiety caused by the presence in healthcare environments and enhance the peace and a
sense of belonging.The research method of the present article is kind of descriptive-analytic
and data gathering method is based on documentary study. The result of research is
presenting strategies in designing rehabilitation -treatment spaces for children that have
healing environmental quality.Features of light, color, the visual affecting forms , painting
and proportionate environmental graphic or children in waiting rooms, detection spaces and
rest and different treatment areas andalso establishing the game and entertainment spaces to
instill a sense of peace, security and stimulate the visual impressions and space relation and
perspective to the various interior spaces and or nature and landscapes of external area of
therapeutic spaces can have a significant impact by creating a positive distraction to
accelerate treatment process and increasing healing quality of therapeutic spaces of children.

Keywords: therapeutic spaces especially for children, positive distraction, rehabilitation,

color therapy, art therapy, play therapy, evidence-based design.

Introduction

1
This article is derived from the thesis of Shima Taheri as "Designing Rehabilitation Center of the Spinal Cord
Injury " architecture studentIsfahan (Khorasgan) BranchIslamic Azad University, Isfahan, Iran.

http://www.ijhcs.com/index.php/ijhcs/index Page 1758

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

Treatment spaces had been as one of the main principles and requirements in the healthcare of
community from the beginning of human life. Architectural desirable plans for an
Purpose that they are only can be quite useful in a form that different spaces are designed in
them based on the needs of users in order to improve and accelerate a variety of activities.
Children usually easily frustrated and tired of sitting and waiting as a result therapeutic spaces
should be happy and various to stimulate children's interest to stay in such an environment .So
the landscapes and entertaining sights and the role and plans and proper drawings for such
spaces are essential. In this research first we introduce the evidence-based design approach,
then we explore the way of effectiveness of the factors affecting in improving of children in
the rehabilitation -therapy spaces on the architecture. These drawings and paintings must be
attractive and very easy to understand for children in the therapeutic environments, and have
power of quick transfer of issue (Taheri, 2015).

2. Evidence-based design

2-Evidence-based design is an expression that is using more in the field of architecture and
design. This term can be seen more day after day in articles and lectures and on the Internet
.Evidence-based design has been widely studied in two recent conventions of the National
Institute of America architects and the definition of this term is presentable in this expression:

Evidence-based design with the consciously, explicit and wisely use is the best evidence and
measurement in making decisions about the design of each project (Hamilton and Watkins,
2009, p. 9). Experts know evidence-based design the result of the fusion of two scientific
approaches of building design based on performance and evidence-based medicine.
Performance-based design is an approach in the design process, which attempts to use
statistical and explicit relationships between design decisions and the degree of desirability of
meeting the needs. This approach aims to assess the efficiency of taken decisions in the
building design stage through analysis, evaluation and research. Today building the treatment
environments with the aim of improving clinical outcomes, reducing stress of patients and
personnel, reducing medical errors, increasing satisfaction of patients, families and staff and
try to reduce the high medical expenses, is considered as essential objectives in the
construction of medical centers in the future. The presence of a multi-disciplinary design team
and the use of evidence-based design process guarantee achieving to all these goals (Mardomi
and others, 2013, p. 3).

Natural environments often are considered as factors that reduce the feeling pressure, but
sometimes are in the number of stressful cases. Create green scenery while fatigue and
irritability, Green sceneries while fatigue and irritability, improve the mental state of patient
are highly effective in the treatment process. So this issue can be accelerated by creating
places for walking patients in green space (Ebrahimi, Ameneh, 2013).

http://www.ijhcs.com/index.php/ijhcs/index Page 1759

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

Image (2): Children waiting space design in order to evidence-

based design through the creation of a positive distraction, Source:
(site Pinterest, 2014)
1. Color, light of environmental Graphic

Color and light can have vast and complex effects on people's emotions and create reactions
of people to environment. As well as they are effective in increasing the rate of the recovery
of patients and enhancing understandable spatial quality in general way for patients, staff and
visitors (Abkar and Zamani, 2013).

Color and lighting can be powerful tools for marking, orienteering and finding the path.
Studies have shown that enhancing and increasing the visual quality of the environment, has
been caused to increase the speed of productivity rate of health centers to more than 15%.In
fact, these improvements have been attributed to certain elements of the visual environment
include :the use of appropriate color in interior decoration, show some art works , using
sunlight and create appealing visual views of the outside treatment spaces (ulrich, 1984).In
different spaces of hospital should be used of appropriate colors and compatible with that
space to create the warmth and relaxation feeling in patient. Entrance is of the most influential
parts of treatment spaces. If is imposed the severe stress to the patient at arrival time, this
stress will be effective in the entire duration of her/his treatment and has negative effect on
recovery process of patient. The use of factors that remove the entrance of treatment spaces of
the stressful condition, greatly help to the patient (Ahmadi, 2005).The insurance of optimal
color and brightness is vital for healthcare environments and creating pleasant in treatment
spaces can increase welfare standards and promote the sense of wellbeing. (Loe D, Perry M,
2000). The use of cool colors like blue and green promotes relaxation, enhance the sleeping
and rest and so on and in contrast, warm colors such as red, orange and yellow increase
physical and social activities and neutral colors like gray or beige are reduced attention and

http://www.ijhcs.com/index.php/ijhcs/index Page 1760

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

accuracy.In fact, the color can be as a tool that may be, is used as a functional and effective
tool in designing the treatment spaces , Relaxing light and colors that have been considered in
order to invite to relax and to reduce stress . (Gulak, 2000),

For example, in Treatment spaces of nursing stations serves as the heart of treatment spaces
and this space can be easily detected from the lighting model and used color in it regardless of
the design type. As well as color is as a functional and effective tool and in the patient's room
and this same color can be effective in controlling the intensity of effect of daylight or
reducing the sensitivity towards artificial light of course, this point is also clear that the cause
of being seen and color recognition is because of the existence light and brightness in
different spaces. The issue of the light is noteworthy in two titles of artificial light and natural
light (Abkar and Zamani 2013).

2. Art Therapy

Images (4-27) and (4-28) and (4-29):

Matching color and form in accordance
with the characteristics of young
children in spaces specific to the disabled
(Source: Pinterest, 2015)

http://www.ijhcs.com/index.php/ijhcs/index Page 1761

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

Art therapy explores the relationships, connections and new meanings in the safe space that
obtains alternative perspectives towards life and their relations for space users with others
hence, Art therapy can engage the person in multiple ways and includes perceptual, cognitive,
emotional, physical, social and psychological aspects. Development of Individual through art
therapy means development in all these areas (Karko and Sanderson, 2006).

Art Therapy is fluid, consistent and growing field. Although art had always been part of
human civilization in fact it was recognized only of World War II transformative and
recycling qualities (Hogan, 2001). Art therapists that work in rehabilitation centers are
engaged with a collection of issues, including problems related to physical health and verbal
and communication skills, stress, and social skills of disable.Each of these areas has its own
requirements in rehabilitation for art therapists (Jones, 2005).
A collection of art therapy strategies is needed in dealing with different patients that this is
due to the diversity of individuals and limitations and their disease. In fact, we have found
that consider many theories in the field of art therapy to offer patients (Rubin, 2001);
what is obvious is the field of art therapy that increasingly has been considered in the
rehabilitation and medical fields.In general it can be said, art therapy can be considered in
terms of production and display of art works by users of therapeutic spaces (Alyami, 2009, p.
283).
Art therapy interweaves techniques of mental therapy with creative processes to improve the
mental and social welfare health.Art Therapy Association of America, art therapy is defined
as follows: A profession related to mental health that uses the art creative processes to
improve the health and physical, mental and emotional social welfare in all age groups .Art
therapy is based on this belief that the creative process includes artistic expression, helps to
the public in solving conflicts and problems, strengthen communication skills, adjusting the
behavior, reducing the stress, increasing the self-esteem and self-awareness and gain better
and more insight ( Chery, 2008).

Since the today consideration of the health term is definable in 3 dimensions of mental, social
and physical. Using the capacities of art is fully justified in the rehabilitation process,
especially because of engaging the psychological aspects of person in physical disability, art
will have influential role. About art therapy is important to note that art therapist , by knowing
and surrounding than aspects of art and psychology, in order to create peace, motivation and
skills in persons with disabilities, takes into consideration the activities and artistic
productions not only for aesthetic approach but also because of the psychoanalytic role. Art
therapy on the basis of what was said in individual and group way in terms of doing artistic
activities in the fields of dramatic, music and visual and according to age of disabled persons?
Art therapy performance in terms of the Psychological is more concerned with two main
issues:

http://www.ijhcs.com/index.php/ijhcs/index Page 1762

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

1. Take advantage of capacity of creating art works in individual and group form to
transferor non-verbal latent of disabled person

2. Create a positive distraction for disabled persons and reduce stresses caused by their
disability, in this field using art works, visual arts and music in particular, have significant
contribution in designing spaces as well as in giving quality to space.

Images (3)
and (4) the use
of
environmental
graphics to
create visual
variety and
tension in the
areas of
rehabilitation
of children,
Reference:
(Arch Daily,
2015)

http://www.ijhcs.com/index.php/ijhcs/index Page 1763

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

5. Play therapy

sick child on the one hand because of physical limitations and on the other hand the necessity
of age and psychological characteristics of this era requires specialized spaces and are
proportional to these conditions therefore, in the rehabilitation center, part of the spaces is
organized jointly between different ages and the section of special spaces also is designed to
use for these people. In the design of these spaces in addition to the specific considerations of
designing for children with disabilities, necessary measures consider in order to give quality
to the spaces.It is obvious that the use of color, light, form, materials and equipment will have
a special place for children with disabilities in giving quality to the space of rehabilitation
center. Disabled children also with other disabled persons also need spaces for completing the
rehabilitation process in individual form with their families (such as physiotherapy,
occupational therapy, hydrotherapy, etc.) and can also in the form of group activities (e.g. in
the fields of art therapy, exercise therapy, nature therapy, etc.) use the facilities of the center
(Taheri, 2015).

6. Conclusion

One of the effective factors in improving child in treatment spaces is creating interaction
between the child and his/her treatment program, provides architectural space of this process
by using evidence-based design and creation positive distraction. In fact, the creation of form,
color, environmental graphics, natural elements and entertainment cause that children can feel
relaxed and have more security and this is very important in the process of healing children
.In this regard following architectural solutions are recommended:

Collective movements and games are part of children's daily activities;therefore in treatment
centers such spaces are also essential with furniture and appropriate means also inside the
rehabilitation center and also in outside spaces.

- Creating the creative in the design of space because of the need to dynamism and diversify
in treatment spaces.
- Creating the attractive environments and visual stimulation the sick children to create fun
and incidence the creativity.
- Creating flexible spaces to increase the sense of security and comfort of children
Ease in spatial separation for visitors and presences of parents
- Use Of color as a guide to the considered areas.
- Designing spaces, particularly play and waiting spaces shall be in a way to provide space for
children and their parents appropriately and simultaneously in order to reduce stress and
increase relaxation the security of children
- Create the garden and emphasizing on existence the green space in environment, the use of
internal design elements, such as the proper furniture,
- Create a sense of control, create the equipment to control lighting, heat and cold of room, the
control of TV, music and...

http://www.ijhcs.com/index.php/ijhcs/index Page 1764

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

- Pay attention to the scale of standards and lines of sight of children in designing all spaces
and furniture.

http://www.ijhcs.com/index.php/ijhcs/index Page 1765

Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

List of References

• Abkari, Ali and Sajjad Zamani, in 2013, the effect of colored light therapy in interior design
in terms of quality healing environment, the third national conference of interior architecture
and decoration, Isfahan.
• Ebrahimi, A., 2013, explores the role of interior design in offices with a view to healing
architecture, interior design and decoration of the third National Conference, Isfahan.
• Ahmadi. 2005. Birth Center, the missing link in the offices of Iran, Master's thesis, Faculty
of Medicine, University of Medical Sciences.
• Taheri Shima. 2015. Development of spinal cord injury rehabilitation center for the disabled.
Maryam Ghasemi Sichani. Islamic Azad University, Isfahan, Isfahan.
• Mardomi, Karim, Hashemnezhad Hashem., Bagheri Maliheh., Hassanpour Rahim Abad
Kasra.,2012.mlahzat architectural design to reduce noise pollution of the environment
Drmany.mhyt, 4: 141-154.

• Alyami Awad .2009.The Integration of art therapy into physical rehabilitation in Saudi
hospital.the art in psychotherapy 36, p: 282-288.
• Cherry LA.2008.Introduction to Alternative and Complementary Therapies, New York: the
Haworth press, Taylor and Francis Group, 247p.
• Gulak MB, 2000. "Architectural guidelines for state psychiatric hospitals", Hosp Common
Psychiatry; 42 (7): 705-7.
• Hamilton krik & Watkins david H.2009.Evidence Based Design for Multiple Building
Types, john wiely & sons Inc.
• Hogan S. 2001. Healing arts: The History of Art Therapy. London: Jessica Kingsley.

• Jones P. 2005. The Arts Therapies: A Revolution in Healthcare. Hove, E. Sussex & New
York: Brunner-Routledge.

• Karkou V, Sanderson P. 2006. Arts Therapies: A Research-Based Map of the Field.

Edinburgh: Elsevier Churchill Livingstone.

• Loe D, Perry M, 2000. "BRE information paper IP14 / 00: hospitals in the best light". CRC.
• Rubin, J. 2001. Approaches to the art therapy: theory and technique, Brunner Routledge.

• Tyson, M., "The Healing Landscape", Therapeutic Outdoor Environments, 2009.

• Ulrich RS. "View from a window may influence recovery from surgery", Science 1984; 224
(4647): 420-1.
http://www.ijhcs.com/index.php/ijhcs/index Page 1766
Special Issue INTERNATIONAL JOURNAL OF HUMANITIES AND
December 2015 CULTURAL STUDIES ISSN 2356-5926

• ArchDaily .2014 .Vandhalla Egmont Rehabilitation Centre / CUBO Arkitekter + Force4

Architects .Available from: http://www.archdaily.com/474130/vandhalla-egmont-
rehabilitation- centre-cubo-arkitekter-force4-architects/. [Accessed 24 Nov 2014].

• World health organization.2015.global reports. Available from: http: //

www.who.int/topics/disabilities/global reports. [Accessed 6 June 5, 2015].

http://www.ijhcs.com/index.php/ijhcs/index Page 1767