An Analysis of Physiotherapy Facilities' Spatial Design Requirements for Spinal Injured Patients.

Abstract

Based on the recent rampant increase among the traumatic Spinal Injured patients at Mulago Hospital as reported by Nbs Television on 5th September 2019 through a news broadcast, the President of Uganda Association of Physiotherapy -Dr. Susan Akori said that Spinal Injuries have escalated to at least 30-50 cases on a daily basis at Mulago Hospital of which most of the patients are people working in offices. Akori also said that most of the patients received at Mulago Physiotherapy Department are affected by low back pain coupled with muscle spasms which last between 4-12 weeks. It is upon this background that this research seeks to analyze physiotherapy facilities‘ spatial design requirements for Spinal Injured Patients diagnosed at Mulago Hospital located within Kampala, Uganda. The research aimed at reviewing the planning and design principles considered for physiotherapy facilities. It also investigated how spatial layout and design of physiotherapy facilities influences the treatment of Spinal Injured patients. The research found out the extent to which the local existing physiotherapy facilities have considered planning and design principles for the treatment of Spinal Injured patients and lastly, the research also recommended standards of spaces that are dedicated to the treatment of Spinal Injured patients. Different research methodologies like qualitative and quantitative methods were used during this research process and they were achieved through the use of participatory observations, questionnaires, hand sketches, photography and tape measure. The use of questionnaires was both open and closed ended, carried out to understand the perceptions of physiotherapists, Spinal Injured patients and the patients‘ relatives regarding the spatial design requirements of physiotherapy facilities at Mulago Hospital. The photography method was used to have proper field work records / events during the research studies. The use of a tape measure was to determine overall dimensions of both Existing and As Built physiotherapy facilities within Mulago Hospital. Observations were also used to locate issues encountered and other nonverbal cues which the research participants could not openly disclose. Key findings showed that, despite the fact that the physiotherapy facilities were strategically located and providing average services to the patients, they still lacked standard user facilities needed especially in areas where the number of Spinal Injured patients kept on increasing dramatically. Adequate facilities for Patients‘ relatives were missing and there was less or no accommodation space, storage spaces as well as interactive environments. Mulago physiotherapy facilities were also not designed from scratch to favor specific spatial design requirements for Spinal Injured patients. The As Built physiotherapy facility seemed like a modification of spaces designed for other functions which in the long run affected the spatial layout and experience for the Spinal Injured patients. Nature inclusion into the design of the facilities was also limited. Finally, the recent design of Physiotherapy facilities within Mulago Hospital was not really up to standards in terms of functional, psychological and specific spatial design requirements for Spinal Injured patients and other users at large. From a design perspective, Mulago physiotherapy facilities tried to respond to the Spinal Injured patients‘ needs through various design aspects. For example; the use of ramps that make circulation or movement of wheelchair SI patients comfortable, the use of some specific spaces that are required for a functional, healthier and comfortable healing environment for Spinal Injured patients i.e. (occupational therapy, physical therapy, SI patients‘ rooms) among others. However, the facilities also lacked Spinal Injured patients‘ car parking spaces and better functional waiting areas. During peak hours of the day, a number of patients reporting to the Existing facility had no space for parking and therefore ended up using the nearby access road which hindered vehicular traffic flow. Despite the fact that the As Built facility had some specific spaces designed for the SI patient, it also lacked a number of primary spaces according to the design standards. For example; Multipurpose room, kinesiotherapy space, patients‘ clinics, Urodynamics Laboratory, Dayroom, among others. It is recommended that these specific spaces can be added to the Existing Physiotherapy Facility through engaging professional organizations in the building and construction industry like USA and UNABCEC in conjunction with the Ministry of Health. These organizations should come up with strict design and construction supervision policies or regulations governing proper planning and design of physiotherapy Facilities. These policies must be proposed as well as followed accordingly and failure to abide with them, legal action should be put in place.