Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Planning, Design, and the Built Environment

Committee Chair/Advisor

Anjali Joseph, Committee Chair

Committee Member

William Bridges

Committee Member

David Allison

Committee Member

June Pilcher


Heart disease is the leading cause of death in the United States. Being diagnosed with heart disease can lead to depression, anxiety, sleep disruption, and delirium symptoms, which can cause prolonged hospital stays among patients. Evidence suggests that the presence of daylight and window views can influence these symptoms positively. However, no studies to date have differentiated the impact of daylight from window views on heart disease patients or addressed how window use can impact patient recovery in cardiac intensive care units (CICUs).

This IRB-approved study employed a retrospective and prospective quasiexperimental approach to investigate CICU rooms of the same size with daylight and views (patient bed parallel to the full-height, south-facing window), rooms with daylight and no views (patient bed perpendicular to the window), and windowless rooms. The first phase of the study entailed analyzing retrospective data between 2015 to 2019. In the second phase, 21 CICU patients were recruited through purposive sampling. Data regarding depression/anxiety, sleep quality, and lighting were collected prospectively through questionnaires, actigraphy, and data loggers. Linear regression models were developed for each outcome of interest to control for confounding variables.

Based on the results, rooms with windows supported patient recovery in general; however, rooms with daylight and views significantly reduced patients’ typical CICU LOS compared to the windowless rooms. While room type was not significantly associated with mortality and delirium, patients receiving palliative care and opioid medications in rooms with daylight and views had significantly lower odds of mortality and delirium than other iii patients. In phase two, the availability of daylight in windowed rooms significantly improved CICU patients’ perceived sleep quality. Patients in windowed rooms also reported a lower average anxiety/depression score; however, the difference was not statistically significant. Moreover, higher light levels in rooms significantly reduced analgesic intake and improved actigraphic sleep efficiency among patients.

This study helps architects with design decisions regarding CICU room layouts by indicating the bed orientation that best supports patient recovery. Identifying the type of patients who benefit most from direct access to daylight and views can also help CICU stakeholders with patient assignments and hospital training programs.



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