Brick Walls vs Trees

These days, gallbladder surgery is most often done through a laparoscope, without a large incision. Additionally, it is usually performed as an outpatient, without the need for hospital admission. When admission is required, hospital stays are typically quite short. But back in the 1970s and early 1980s, even uncomplicated gallbladder surgery patients were typically hospitalized for a week or more because the surgical incisions used at the time were large and could be quite painful. Recovery from this type of surgery was far more prolonged than it is now.

Researchers wondered why some people seemed to recover from the surgery faster than others. They began to question if environmental issues might be playing a role.

Paoli Hospital, where the study I am about to discuss was conducted, is a small community hospital in the town of Paoli, Pennsylvania. On the hospital floor where postoperative gallbladder patients recovered, some of the rooms had windows that offered a view of a brick wall, while others looked out onto a large stand of trees. The rooms were otherwise exactly the same. It was decided to evaluate whether this one environmental difference could be playing a role in patient recovery.

Patients in the rooms with differing views were matched by age, gender, weight, and whether or not they were smokers. In this way, the researchers could ensure that the patients in the rooms with differing views had no characteristics that might make one group more likely to report a different experience than the other. They also attempted to eliminate any potential differences in medical care during the recovery phase by also matching the patients in both room types to care by the same doctors and nurses.

What would you rather look at from your hospital bed? This, or……

This? © Howard Grill

Forty-six patient records were examined, half of which were from patients assigned to rooms with the brick wall view and the other half from those assigned to rooms with a view of the trees. From a subjective standpoint, patients in the 'brick wall rooms' reported being more depressed and also experienced more postoperative pain. Objectively, they required an average of one additional day of hospitalization (increasing the cost of care) and required significantly more pain medication than the patients in the 'tree rooms.'

The differences between the two groups were surprisingly large. Patients in rooms overlooking the trees fared four times better than the ‘brick wall rooms’ for some of the measured parameters. Over time, this led to further environmental studies of various types, all of which have shown that views of nature enhance the healing and recovery processes. Over the years, the conclusions of studies like this have led to significant changes in patient care and hospital design.


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