"It's Lonely": Patients' Experiences of the Physical Environment at a Newly Built Stroke Unit.

Objective: The aim of this study was to explore patients' experiences of the physical environment at a newly built stroke unit.

Background: For a person who survives a stroke, life can change dramatically. The physical environment is essential for patients' health and well-being. To reduce infections, a majority of new healthcare facilities mainly have a single-room design. However, in the context of stroke care, knowledge of how patients experience the physical environment, particularly their experience of a single-room design, is scarce.

Method: This study used a qualitative design. Patients ( = 16) participated in semistructured individual interviews. Data were collected in December 2015 and February 2017 in Sweden; interviews were transcribed verbatim and analyzed using content analysis.

Results: Two main themes were identified: (i) incongruence exists between community and privacy and (ii) connectedness with the outside world provides distraction and a sense of normality. In single rooms, social support was absent and a sense of loneliness was expressed. Patients were positively distracted when they looked at nature or activities that went on outside their windows.

Conclusions: The physical environment is significant for patients with stroke. This study highlights potential areas for architectural improvements in stroke units, primarily around designing communal areas with meeting places and providing opportunities to participate in the world outside the unit. A future challenge is to design stroke units that support both community and privacy. Exploring patients' experiences could be a starting point when designing new healthcare environments and inform evidence-based design.