Understanding the healthcare soundscape: The importance of sound on the subjective feelings of patient and nurses

The auditory landscape (or soundscape) of a healthcare environment has an important influence on patient and staff life. A soundscape encompasses the sources and perception of sound and acknowledges the context in which they are heard. However, this is often an overlooked aspect in healthcare design, with most emphasis being placed on simple assessment of sound levels thus failing to consider this broader approach. In order to improve healthcare soundscapes, it is important to understand patient and staff perceptions and its wider influence on the whole environment. This paper reports on a semi-structured interview study involving patients and nurses within a ward environment at a UK hospital. The study focused on understanding the perception of the cardio-thoracic ward soundscape, with the specific aim being to identify the subjective response to this, specifically understanding how it makes both patients and nurses feel. A total of 27 in-situ interviews were conducted (11 patients and 16 nurses) to extract patients and nurse perceptions within the ward environment. Using thematic coding to analyse the interviews, 37 categories relating to various aspects of the soundscape were obtained contained within nine key themes. This showed the soundscape is a diverse mix of sound sources with the perception dependent, not only on specific sounds, but also the physical and social context in which they are heard. The results of these interviews were then used in a laboratory study, in which members of the public and healthcare professionals rated various healthcare soundscapes recordings according to key semantics gained from the interviews. Factor analysis then led to principal dimensions which describe this subjective response to such soundscapes. Further discussion includes use of these dimensions as a benchmarking tool for improving the perception of the soundscape, through behavioural and physical interventions. The ultimate aim of this work is to enhance the wellbeing of individuals within hospital wards, through a more positive perception of the soundscape.