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    • Part II of this study addresses the

    2018-10-22

    Part II of this additional hints study addresses the design in a supposed operationalization phase that was guided by both data sets of Part I. Furthermore, the data were used to develop a checklist for architects. The design was based on the joint description of a fictional persona by two of the authors (JVH and AE). The persona was operationalized in a design scenario, which is described as a sequence of the rooms and spaces, and the way design features contribute to a sense of home. Moreover, the retrofitting project also incorporated design features that address the independence of residents and human factors of care professionals. The design of the apartment was applied in the actual retrofitting of an apartment inside an existing nursing home in Eindhoven, the Netherlands. The surface area of the apartment was 58m2, which is relatively large for Dutch standards. The apartment would be used as a test and training facility for a nursing home organization and its care professionals and residents.
    Results: feeling at home in nursing homes and the role of the built environment The themes and quotes of both data sets were merged, and five “architectural” themes were identified, which reflect the state of the art of the scientific literature and residents’ perspectives. The built environment includes the layout of a space, its interior design, and the surroundings. Results from the literature and qualitative study from the perspective of residents, their family members, and staff show that the following factors contribute to a sense of home: private and public spaces, personal belongings, technology, look and feel, and the outdoors and location (Rijnaard et al., 2016; van Hoof et al., 2016a). These factors constitute the theme “built environment.” This theoretical section outlines how these factors influence the sense of home.
    Results: operationalization and design guidelines in constructing a sense of home
    Discussion, conclusions, and implications for design practice This study found that the built environment—both from theoretical and user-centered perspectives—can contribute to a sense of home in nursing homes. The study introduced a novel and reliable overview that evaluates the impact of architectural programming and design in creating a sense of home in nursing homes. The sense of home is composed of different scale levels, from the connection with outdoors to the quality of furniture and architectural layout of the room. A particular apartment was refurbished to demonstrate how the architectural themes are operationalized and to connect both data sets in architectural practice. The construction of demonstration dwellings stimulates the discussion and education on the role of architectural features in supporting adequate healthcare and improving the quality of living at an old age (van Hoof and Kort, 2009; van Hoof et al., 2013). The retrofitting of the apartment is an example of how scientific research results are translated into an actual architectural design, and is therefore an example of integrated and evidence-based design (van Hoof et al., 2015b). Through the evidence-based design, architects can bridge the gap between the realms of evidence-based healthcare and architecture. The Center for Health Design (2017) defines evidence-based design as “the process of basing decisions about the built environment on credible research to achieve the best possible outcomes.” This design process includes eight steps: defining evidence-based goals and objectives; creating design concepts; collecting baseline performance measures; monitoring of design implementation; and constructing and executing a post-occupancy evaluation. This process is in accordance with the study of Brawley (2005), who stated that the goal of evidence-based design is to improve outcomes and continuously monitor the success of designs for subsequent decision making. The step of conducting a post-occupancy evaluation with tenants is scheduled; chorionic villi sampling (CVS) evaluation is according to the effects of the built environment on the sense of home. Through the use and occupancy of the apartment, the real-life experiences of residents and professionals are collected, for example, through workshops and qualitative research. For instance, a psychogeriatric training school is offered by a nursing home organization, wherein the participants take care of professionals as a part of their training. The caregivers experimented with features in the apartment and discussed issues, such as privacy and implications for their own practice. Their feedback and that of other visitors are collected in a special “guestbook.” Thus, the apartment service is a platform that can be improved step-by-step in an ongoing design effort. For example, during the renovation projects, good practices are shared and implemented throughout the organization and even with the wider community.