Mission Ready: Changing the Dialogue between Veterans and Their Care Teams in the Clinical Setting

Laut, Pamela J.

Purpose: To gain insight into current level of evidence on human reaction to lighting on an inpatient psychiatric unit. As the environmental design of the psychiatric unit evolves to maintain safety of the patients and staff, opportunities exist to offer evidence based physical changes to create healing environments using ambient lighting to influence mood and circadian rhythms. Creating a least rigidly sterile environment on the psychiatric unit has been a norm to encourage treatment participation. The objective of this literature review is to determine if a positive relationship exists between controlled lighting on the psychiatric unit, circadian rhythm, and patient’s mood.

Method: This presentation describes the use of the VHA wellness model to guide the methodology used to identify evidence based ambient lighting strategies to promote a healing environment. Databases were searched utilizing key words: ambient lighting, circadian rhythm, psychiatry, psychiatric disorders, mental illness, and environmental design. The search identified 29 articles for review with 3 additional articles obtained from the reference lists from reviewed articles. Eighteen of the reviewed articles were relevant to this review. Ten research articles and eight non-research articles are summarized in an evidence-based table. One systematic review with meta-analysis was noted, 4 quasi-experimental designs, and five descriptive/exploratory designs were included in the evidence table. Eight non-research designs were included and consisted of literature reviews, systematic reviews of non-experimental designs, and expert opinions. The evidence table was used to identify evidence based changes and develop evaluation plans using VHA existing data to provide objective outcomes measures to evaluate success as changes are made to meet the unique need for Veterans requiring inpatient psychiatric care.

Conclusion: Research on ambient lighting’s impact on psychiatric units is limited. Overall, current data does suggest benefit from ambient lighting however the significance over control groups was minimal.