Beyond Satisfaction: Person-Centred Care and the Physical Environment Revisited-An Integrative Review.

BACKGROUND AND AIMS: To explore literature in relation to the physical healthcare environment and person-centred care to understand how it can be better supported at the system level. METHODS: An integrative review using the work of Whittmore and Knafl. The review was designed around problem identification, literature search, data evaluation, data analysis and presentation of stages. DATA SOURCES: CINAHL, Embase, PubMed and Scopus databases were searched, and 29 articles were included. FINDINGS: Articles were considered in relation to their context, and themes for each were generated. These were: Aged care (The 'Safety Gaze', Reconciling safety to support an environment of personhood and Nature and stimulation); Paediatrics and Neonatal (Supporting parenthood, Person-centred care (un)supported through control and Satisfaction and expertise); Maternity (Sterility versus person-centred care and Controlling the birth experience); Acute care (Participation in the environment, First and foremost a healing environment, Decentralised nurses station and single rooms); Mental Health (Safety versus person-centred care and Calming the environment); and Outpatient (Genuine access to information). The review found perceptions of safety and risk, and the idea of 'hotel culture', a negative connotation for healthcare staff. While person-centred design in hospitals makes for a more aesthetically pleasing environment and positive experience, it is argued these elements are superficial in nature, rather than authentic. CONCLUSION: While described as person-centred, many design elements were more about satisfaction than engagement and shared decision-making. Healthcare policymakers, accreditors and leaders must move beyond satisfaction and consider environmental changes that genuinely engage people in their care and promote shared decision-making. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: What is already known? Person-centred care is a requirement of health services. Person-centred environmental changes have recently occurred to the healthcare environment. What this article adds? Many healthcare designs are more about satisfaction rather than genuine partnership. While aesthetics are important for experience, we must move beyond satisfaction to ensure that systems and environments supports person-centred care. REPORTING METHOD: PRISMA. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.