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Seeing through patients' eyes

HD, Jun 2004 by Mahoney, Claire

Claire Mahoney reports on how a US photographer was inspired by first-hand experience to develop visual methods of alleviating the tedium of hospital stays.

In 1977 photographer Joey Fischer was visiting his father in the ICU. On one visit his father confided that in order to relieve the boredom of lying for hours in a hospital bed, he used to count the holes in the ceiling several times a day. Fischer realised that this lack of visual stimulation was a major problem for many hospital patients who were, more often than not, faced with a sterile environment that didn't help them feel very positive about their reasons for being there.

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He decided that patients' experience might be improved if they at least had something pleasing to look at. It was then that he decided to use his skills as a nature photographer to introduce images to the hospital environment that could be placed anywhere where patients might benefit from looking at them.

Nearly 30 years on, his Visual therapy panels' have been installed in over 3,000 hospitals and clinics worldwide, (80 of them in the UK), from recovery rooms through to oncology centres, delivery suites, paediatric departments, hospital lobbies and corridors. Fischer's company the Art Research Institute (ARI), which he runs with his hospital interior designer wife, was honoured with a Smithsonian award for his contribution for his work in healthcare.

He says his ideas are supported by Roger Ulrich's research*, which confirms that patients who have certain types of visual distraction before or during treatment - at what Fischer calls 'focal points' - will experience lower blood pressure, have less incidence of nervous twitching or movement requiring repeat treatment, and will walk away with a more positive experience of the facility.

The images are typically calming scenes of nature - beautiful beaches, parks and gardens; scenes of sky and water. They are turned into giant backlit murals, which are printed onto a Cibachrome plastic base.

"Research shows that patients experience lower blood pressure, heart and pulse rates and use less pain medication when the hospital environment is enhanced by photographic interpretations of nature," explains Fischer. "Our goal is to reduce patient stress, the length of hospital stays and ultimately costs."

One area where the images have proved to be particularly beneficial is in radiation treatment centres where centre administrators and radiologists say that the images help patients to relax during CT and MR scans or therapy treatment.

"Backlit transparencies cast a warming glow and provide an instantly calming ambience into any environment, but in particular, for cancer patients who are usually trapped in the basement of a facility in a concrete bunker. It is here that our imagery provides the most patient and staff benefit - it is usually the only visual relief," says Fischer.

Nancy Sears Grouse of the Radiation Oncology Clinic at the National Cancer Institute in Bethesda, Maryland in the US, says the majority of patients that she deals with are about to undergo "intracranial steriotaxic radiosurgery". She says: "Instead of staring at a blank ceiling for minutes to hours at a time, our patients can now almost imagine themselves reclining beneath a canopy of autumn foliage on a sunny afternoon."

There are two types of transparencies. Firstly 'Indows', which are designed for windowless rooms or corridors and generally can be designed in any size to suit the hospital or clinics reguirements. Ceiling mural transparencies (CMTs) are generally installed within standard 2 ft x 4 ft and 2 ft x 2 ft fluorescent fixtures by replacing the diffuser lens in these fixtures with custom-fitted panels. Panels designed for MR environments are illuminated with specially shielded lightboxes. Transmitted light passes through the colours in the image creating an instant 'ambient' effect.

Images can either be selected from ARI's extensive library or can be taken of the surrounding landscape. Major equipment manufacturers such as Philips, Siemens and Hitachi have also thrown their weight behind the product and now offer the panels with their imaging equipment to prospective customers. Philips even has ARI imagery on display alongside its products in its main showroom in Holland. Fischer says that currently over 50% of their projects around the world are funded by equipment manufacturers. "Visual therapy is a competitive edge for a facility, especially in this age of hospitals scrambling for ways to attract and satisfy patients."

For more information visit www.visualtherapy.com

REFERENCE

Roger S Ulrich: 'View through a window may influence recovery from surgery', Science (The American Association for the Advancement of Science) 27 April 1984, Volume 224, pp 420-421.

Seeing through patients' eyes

HD, Jun 2004 by Mahoney, Claire

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