Historically, the fields of architecture (design) and nursing (health) have been separate disciplines without much intersection. In recent years, the healthcare building boom has created a specialty practice for architects, focusing on healthcare design. With this new focus and specialty within architecture, the science of evidence-based design and the collaboration with clinical care staff have created a new partnership paradigm that is improving the built environment.
Ten dimensions of caring have been espoused by Watson’s Caritas Theory to comprise the construct of caring, which in turn facilitates healing for both the care giver and care recipient (Nelson & Watson, 2012). This article describes a study that examined the relationship between selected elements of architectural design and other factors (recent architectural change, unit size and shape, intersecting hallways, number and proximity of bathrooms and supply rooms, availability of nourishment, number and availability of computers, and rooms for staff gathering, for solitude, and for practice of Watson Caring Factors) and outcomes of caring that are important to nursing, including clinical staff caring for self, caring for others, and job satisfaction. The study took place in a hospital that was implementing Watson’s concepts of caring within their framework of care delivery. Statistically significant relationships were:
Caring for self was negatively related to number of supply rooms and number of Watson rooms or boxes. Caring for patients as reported by staff was negatively related to number of Watson rooms or boxes. Job satisfaction was positively related to number of bathrooms and negatively related to number of supply rooms. A small sample size required adjustment of the alpha to .15 and an effect size of .25, suggesting that replication studies with larger sample sizes may assist with development of a model of architecture that promotes behaviors as proposed by Watson and better outcomes for both patient and staff.
Watson’s theory of caring, caring, self-care, job satisfaction, architecture, evidence-based design
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Hozak, Mary Ann; Nelson, John; and Gregory, Debbie
"Relationship of Hospital Architecture to Nursing Staff Caring for Self, Caring for Patients, and Job Satisfaction,"
Interdisciplinary Journal of Partnership Studies:
1, Article 5. Available at: