Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Planning, Development, and Preservation

Committee Member

Dr. Dina Battisto, Committee Chair

Committee Member

Dr. Vincent Blouin

Committee Member

Dr. Patrick Gerard

Committee Member

Dr. James McCubbin


Surgeons endure a significant amount of mental stress while operating in complex and intense surgical environments. In the United States, most operating rooms are windowless spaces that rely on artificial lighting and mechanical ventilation. Surgeons spend much of their day in these surgical environments with little access to exterior views or daylight. There is a growing body of occupational health research that supports the therapeutic benefits of views and daylight in various non-surgical work environments. It is reasonable to consider that windows in operating rooms may mitigate surgeon mental stress and consequently improve surgeon occupational health.

This study used a quasi-experimental strategy with an equivalent time samples study design to understand how window access may influence surgeon mental stress in a real operating room setting. Measures of surgeon mental stress from pairs of observed surgical procedures were compared with and without the window treatment. Surgeon mental stress was assessed with a combination of physiological and subjective measures to include momentary stress questionnaires, high-frequency component of heart rate intervals, salivary cortisol, and general stress surveys. Observational measures of surgeon task lighting levels and surgeon gaze direction were considered in the analysis. The study outcomes provide a better understanding of how window access may influence surgeon mental stress in the operating room. Furthermore, this study showed how clinical research methods might be adapted to investigate features of the built environment.



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