What is Salutogenic Architecture? | ArchDaily


What is Salutogenic Architecture?

In a hospital, patients are always one conversation away from good or bad news. When not rushed into treatment rooms, patients often feel stressed about their health. Healthcare workers have one of the the most stressful jobs, with sudden changes in the patient’s condition. The general atmosphere in traditional hospitals seems tense and worrying, which affects the well-being of patients.

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At the end of the 1970s, Aaron Antonovskya professor, researcher and medical sociologist has identified the consequences of stress on health. survivor of the concentration camps, he wondered how most people who constantly battle disease manage to survive and stay healthy. Antonovsky shifted his research approach from disease to the origins of health, discovering how stress and lifestyle has an impact on health. The resulting model is called Salutogenesisderived from ‘hello’ i.e. health and ‘Genesis’ meaning origin.

Salutogenesis views health on a spectrum of “ease and disease” and identifies the aspects that move an individual from one state to the other. These aspects, called stressors, can be internal or external demands that disrupt the homeostasis of the body. Rather than trying to cure a sick patient, salutogenesis seeks to help people cope with or alleviate stressors.


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The theory began with an investigation into the origins of health. Antonovsky found his answer in what he calls Sense of consistency, the key concept of the salutogenic model. Sense of consistency is a scale that assesses how people view life and maintain their health through a sense of optimism and control. The concept explains why some stressed people get sick while others stay healthy. Three main components define a sense of coherence – understandability, manageability and meaning.

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© Cavan Images / Alamy Stock Photo

Salutogenic design

In the 1990s, architect Alan Dilani have suggested that the salutogenic method be applied not only to medical treatment but also to the architectural design of healthcare facilities to promote good health. Through his own research based on Antonovsky’s work, Dilani proposed Psychosocial support design as a framework for eradicating anxiety through the physical design of spaces. The framework illustrates the causes of stress and presents factors of well-being that support the healing process.

Starting from the concept of Sense of consistency, Dilani identified design qualities that enhance an individual’s sense of intelligibility, manageability and meaning. Although salutogenic design can be applied to any structure, it is most beneficial for healthcare facilities where the built environment influences patient recovery and promotes natural healing process.

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Courtesy of Adjaye Associates

sense of intelligibility

In the context of salutogenic design, comprehensibility refers to the extent to which one can notice that their environment is orderly, clear, and structured. People should be able to grasp the context in which they find themselves. Hospitals have a reputation for being places where understanding is delegated – Patients rarely understand their disease or how treatments work. They are usually introduced between rooms, having no sense of space on their own.

Architects can design spaces to accentuate more intuitive paths through master planning and the design of wayfinding systems. Healthcare design can also enhance a sense of comprehensibility through colors, landmarks, and views of nature. These tactics not only help patients understand their surroundings, but also build their confidence in carrying out their own initiatives.

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New Lady Cilento Children’s Hospital / Lyon + Conrad Gargett. Image © Dianna Snape

Sense of manageability

Manageability deals with an individual’s sense of control over their situation and environment. Traditional healthcare designs have made spaces manageable for staff with centralized services, infection control, patient monitoring and efficient organization of space. For patients, intravenous drips, incubation, heating/cooling, dialysis and other forms of “life support” help them feel they can get better on their own.

Salutogenic design can enable additional functionality of healthcare facilities to enhance patients’ sense of independence. By providing operable windows or access to facilities, a patient feels empowered to make health decisions and act accordingly. Accessibility to resources, staff, family and friends also empowers the patient to exercise control over their environment.

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Sayanomoto Clinic / Yamazaki Kentaro Design Workshop. Image © Naomi Kurozumi

sense of sense

The motivational aspect addressing the feeling of life having a emotional significance this is what Antonovsky calls sense of sense. The source of people’s meaning is usually found outside the walls of hospitals, such as family, friends, art, music, sports or religion. This makes it difficult to construct meaning in healthcare settings where patients are cut off from social interactions and the outside world. Healthcare architecture is also stereotyped as looking sterile and gloomy.

Through the salutogenic approach, health centers can incorporate art facilities, spaces for music and social support, and recreational spaces like libraries or gymnasiums. Hospitals can incorporate nature and animals into their facilities to inspire patients. Landscape views serve as positive distractions and have a proven effect in boosting patient recovery.

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Caboolture GP Super Clinic / Wilson Architects. Image © Alex Chomicz

Architecture as treatment

Several other models of salutogenic architecture have been developed such as Jan Golembiewski’s “neurology of salutogenic design”, Tye Farrow’s “salutogenic design method” and Roger Ulrich’s “supporting design theory”. What these models have in common is that they prioritize the mental state of the patient as a way to facilitate recovery. The salutogenic model and its allied design philosophy supports the idea that individuals have an innate ability to To heal.

It is also recognized that salutogenic architecture requires more than a design team. The entire care organization must understand the meaning and impact of salutogenic design in their existing systems. This form of design thinking encourages architects, healthcare workers and patients to think about how building elements can enhance the sense of coherence and equip architecture as a form of medical treatment.


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