Soundscapes in acute and rehabilitation NHS hospital environments: a mixed methods study.

ABSTRACT Objectives: To assess hospital soundscapes, typically within those departments where patients with Acquired Brain Injury (ABI) are cared for. To investigate soundscapes effects among staff and patients. Design: A mixed methods observational study Setting: 5 units within an NHS hospital Trust Participants: Patients with and without ABI (n=31); staff members (n=23) Interventions: n/a Outcome measures: Sound level measurements were collected over 7-day periods; interviews and questionnaires were conducted with staff and patients. Qualitative and quantitative data were triangulated. Results: Sound pressure levels consistently exceeded World Health Organization recommendations. Higher levels and unpredictable/irregular sounds were perceived as most disruptive to staff and patients. Escalations of sound affected ease and effectiveness of communication, further exacerbated by use of personal protective equipment. Patients tended to be more tolerant of disruptive sounds during the day but less so at night. Intermittent equipment sounds, sounds of patient agitation, and instances of staff discussing inappropriate topics for a hospital setting negatively affected both patients and staff. Certain sounds were perceived positively and helped patients, particularly those with ABI, orient themselves in their surroundings. Conclusions: Soundscapes in hospital settings are important for patient and staff health and wellbeing. Recommendations towards improved sound environments are provided.