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.
Keywords: environmental perception; hospitals; lighting; nurse satisfaction; patient rooms.