Purpose: This study differs in its methodological approach from previously published research by interpreting qualitative results against existing literature to understand how nurses conceptualize medical–surgical patient rooms as productive settings in relation to lighting, as well as the ways in which nurses believe these spaces could be enhanced for patient satisfaction. Methods: Content analysis was used to interpret themes emerging from nurses’ subjective responses to open-ended items. Three of the facilities had older, traditional lighting systems; one had a contemporary framework. Results: A theme of environmental control over both overhead and task lighting emerged from data from all items. Although controllability was among the “best” lighting attributes, more refinement is necessary for optimal staff productivity and patient satisfaction. Daylighting was also considered to be among the best attributes. Control over light level via additional dimming capability for patients, as well as additional light sources, was prominent across the four hospitals. Unique to the more modern facility, trespassing of light was problematic for nurses considering the experiences of patients—even where modern models exist, more attention can be paid to the ways in which window shades, and light sources outside of rooms, penetrate spaces and affect users. Conclusion: The finding that nurses and patients desire greater control over the lighting in patient rooms is consistent with Ulrich’s theory of supportive design for healthcare and coincides with advances in lighting technology. Despite differences in the level of sophistication in lighting among the four facilities, control continues to be a primary concern for nurses.

Purpose: The present study aims to contribute to current knowledge about nurses’ perceived importance of lighting in patient rooms and to compare these perceptions across different ages, work shifts, (day and night), and environments of care (traditional and contemporary). Background: Creating an environment of care in patient rooms that successfully balances energy efficiency concerns with the holistic needs of patients, families, and caregivers poses a major challenge for future lighting systems. This study adds to a growing evidence base on the effects of lighting on nurses’ job performance, job satisfaction, and overall perceptions of the environment. Method: Survey responses from 138 participants working in medical–surgical units in four hospitals were analyzed using a mixed-methods approach, with three of the hospitals having lighting systems characterized as providing a traditional environment of care (TEC) and the other hospital having lighting systems characterized as providing a contemporary environment of care (CEC). Results: No significant differences were found based on age or work shift, but several significant differences were found between participants working in the hospital with a CEC and those working in hospitals with a TEC. Participants from the hospital with a CEC lighting system consistently reported higher lighting quality, fewer patient complaints, and less need for supplemental lighting than the participants from the three hospitals with TEC lighting systems. Conclusion: The results of this study provide evidence that innovative lighting approaches and technologies are worth considering as an investment by hospital administrators looking to improve perceptions of the patient room environment.

Mild traumatic brain injury (TBI) is associated with persistent sleep-wake dysfunction, including insomnia and circadian rhythm disruption, which can exacerbate functional outcomes including mood, pain, and quality of life. Present therapies to treat sleep-wake disturbances in those with TBI (e.g., cognitive behavioral therapy for insomnia) are limited by marginal efficacy, poor patient acceptability, and/or high patient/provider burden. Thus, this study aimed to assess the feasibility and preliminary efficacy of morning bright light therapy, to improve sleep in Veterans with TBI (NCT03578003). Thirty-three Veterans with history of TBI were prospectively enrolled in a single-arm, open-label intervention using a lightbox (~10,000 lux at the eye) for 60-minutes every morning for 4-weeks. Pre- and post-intervention outcomes included questionnaires related to sleep, mood, TBI, post-traumatic stress disorder (PTSD), and pain; wrist actigraphy as a proxy for objective sleep; and blood-based biomarkers related to TBI/sleep. The protocol was rated favorably by ~75% of participants, with adherence to the lightbox and actigraphy being ~87% and 97%, respectively. Post-intervention improvements were observed in self-reported symptoms related to insomnia, mood, and pain; actigraphy-derived measures of sleep; and blood-based biomarkers related to peripheral inflammatory balance. The severity of comorbid PTSD was a significant positive predictor of response to treatment. Morning bright light therapy is a feasible and acceptable intervention that shows preliminary efficacy to treat disrupted sleep in Veterans with TBI. A full-scale randomized, placebo-controlled study with longitudinal follow-up is warranted to assess the efficacy of morning bright light therapy to improve sleep, biomarkers, and other TBI related symptoms.

Purpose: This study explores how aspects of lighting in patient rooms are experienced and evaluated by nurses while performing simulated work under various lighting conditions. The lighting conditions studied represent design standards consistent with different environments of care—traditional, contemporary, and future. Background: Recent advances in lighting research and technology create opportunities to use lighting in hospital rooms to improve everyday experience and provide researchers with opportunities to explore a new set of research questions about the effects of lighting on patients, guests, and staff. This study focuses on the experience of nurses delivering simulated patient care. Method: Perceptions of each of the 13 lighting conditions were evaluated by nurses using rating scales for difficulty of task completion, comfort, intensity, appropriateness of the lighting color, and naturalness of the lighting during the task. The nurses’ ratings were analyzed alongside qualitative reflections to provide insight into their responses. Results: Significant differences were found for several a priori hypotheses. Interesting findings provide insight into lighting to support circadian synchronization, lighting at night, the distribution of light in the patient room and the use of multiple lighting zones, and the use of colored lighting. Conclusion: The results of this study provide insight into potential benefits and concerns of these new features for patient room lighting systems and reveal gaps in the existing evidence base that can inform future investigations.

Researchers have been exploring the influence of light on health in office settings for over two decades; however, a greater understanding of physiological responses and technology advancements are shifting the way researchers study the influence of light in realistic environments. New technologies paired with Ecological Momentary Assessments (EMAs) administered via smartphones provide ways to collect information about individual light exposure and occupant response throughout the day. The study aims to document occupant response to tunable lighting in a real office environment, including potential beneficial or adverse health and well-being effects. Twenty-three office employees agreed to participate in a twelve-week study examining occupant response to two lighting conditions (static vs. dynamic). No significant differences were observed for any of the measures, highlighting the importance and complexity of in-situ studies conducted in realistic environments. While prior office studies have shown a significant influence on daytime sleepiness and sleep quality, research has not shown mood or stress to be significantly impacted by lighting conditions. Correlation analyses regarding lighting satisfaction, environmental satisfaction, and visual comfort demonstrate a significant relationship between certain items that may inform future studies. Further, the high correlation means it is reasonable to assume that many environmental factors in offices can influence occupant behavior and well-being.

Objective: This study explores whether “future” lighting systems that provide greater control and opportunity for circadian synchronization are acceptable to participants in the role of patients. Background: Tunable, dimmable light emitting diode systems provide multiple potential benefits for healthcare. They can provide significant energy savings, support circadian synchronization by varying the spectrum and intensity of light over the course of the day, address nighttime navigation needs, and provide user-friendly control. There is an emerging understanding of the important visual and nonvisual effects of light; however, important questions remain about the experience and acceptability of this “future” lighting if we are to adopt it broadly. Methods: Volunteer participants (34) performed a series of tasks typical of patients, such as reading or watching a video, in a full-scale simulated inpatient room. Each participant conducted these tasks under 12 lighting conditions in a counterbalanced order that included varying illuminance levels, correlated color temperatures (CCTs), and in a few conditions, saturated colors. The participants rated each lighting condition on comfort, intensity, appropriateness, and naturalness. Results and Conclusions: The participants found that conditions with CCTs of 5,000 K and higher were significantly less comfortable and less natural than conditions with lower CCTs. Conditions with lighting distributed in multiple zones in the patient room were viewed more favorably than a traditional overbed configuration. The participants in this simulated patient study reacted negatively to colored lighting on the footwall of the room but found a mixture of warmer and cooler luminaire CCTs acceptable.