MASTER OF ARCHITECTURE I KULIYYAH OF ARCHITECTURE AND ENVIRONMENTAL DESIGN
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR
POSTPARTUM DEPRESSION 2019/2020
PREPARED BY
LIYANA YUSOFF
SUPERVISOR I ASSOC. PROF.DR. FADZIDAH ABDULLAH
Dedicated for ibu, along, angah, and all the mothers out there, Thank you.
ABSTRACT
The design thesis are to solve the issues of postpartum depression mother .The design thesis are more focusing on spiritual , physical and psychological need for the postpartum mothers. Different methodologies are been used as part of the design thesis to cater the objective of the design thesis. The primary methodology are the case study. The case studies are used to analyze the space or activities needed for for the postpartum mother. For the secondary methodology , interview are being used to understand user's depression to cater psychological treatment for postpartum's depression mother. Spaces are being finalized through the methadologies and the objective of the design thesis. The outcome of the design will help to cater the issues and gives solution to cater problem with the special client. Moreover, for the site selection, the thesis are correspond with healing components needed for the users in terms of greenary,view and others.The building element, components, materials are been analyze to make sure it helps in terms of treatment for postpartum mothers
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
LIST OF FIGURES FIGURE 1.0 - The figure shows mood disorders suffers from postnatal
02
depression (source : Getty / Istock) FIGURE 1.1 - The figure shows characteristic of different personalities
03
happens to postnatal patients (source : Marcel Dzama) FIGURE 1.2 - The figure shows an abstract version of a person that
05
experience mental illness (source : Tourbillon) FIGURE 1.3 - The figure shows an abstract version of a person that
07
experiences mental breakdown or mental illness (source : Daehyun Kim / Moonasi) FIGURE 1.4 - The figure shows an abstract version of a person that
08
experiences mental breakdown or mental illness (source : Daehyun Kim / Moonasi) FIGURE 1.5 - The figure shows an abstract version of a person that
09
experiences depression (source : Daehyun Kim / Moonasi) FIGURE 1.6 - The figure shows an illustration of men and woman
11
experience depression after giving birth (source : Decue Wu / MICA) FIGURE 1.7 - The figure shows an illustration of a woman with different
12
personalities (source : Wattpad) FIGURE 1.8 - The figure shows opinions from different perspective
regarding depression (source : Roshaidai ,2016) FIGURE 1.9 - The figure shows an abstract version of a person that
experiences mental breakdown or mental illness (source : Daehyun Kim
13
15
/ Moonasi) FIGURE 1.10 - Design Thesis Framework (source : Daehyun Kim / Moonasi) FIGURE 1.11 - The figure shows an abstract version of a person that
experiences depression (source : Daehyun Kim / Moonasi) FIGURE 2.1 - The figure shows woman experience related to the
emotional changes (source : Roshaidai , 2016)
16
17
19
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 2.2 - The figure shows woman experience related to the
20
behavioural changes (source :Roshaidai ,2016) FIGURE 2.3 - The figure shows woman experience related to the
physiological changes (source : Roshaidai ,2016) FIGURE 2.4 - Examples of Herbs that being used as part of confinement
20
25
treatment (source : Despositphotos -JanPitruszka) FIGURE 2.5 - The curing process through the medical intervention with
28
the healing environment FIGURE 2.6 - The different type of outdoor view which shows different
29
type of results (source : Ulrich & Roger S ,2000) FIGURE 3.1 - Design Thesis Framework
36
FIGURE 3.2 The elavation and section of Nuuk's Pschtrich Clinic ,
37
Greenland (source : Dezeen - Levy ,2018) FIGURE 3.3 The Ground Floor Plans of Nuuk's Pschtrich Clinic ,
37
Greenland (source : Dezeen - Levy ,2018) FIGURE 3.4 The elevation of Nuuk's Pschtrich Clinic , Greenland (source
38
: Dezeen - Levy ,2018) FIGURE 3.5 The patient quartes were designed with large windows and
38
generous height (source : Dezeen - Levy ,2018) FIGURE 3.6 Architectural diagram that captures natural lighting in the
38
building (source : Dezeen - Levy ,2018) FIGURE 3.7 Interior Perspective that shows wood is the primary material
38
used in the building (source :Dezeen - Levy ,2018) FIGURE 3.8 Fragmented units that being divided into three categories
39
administration,medical and shelter. (source : Future Architect : Kristo , 2019) FIGURE 3.9 The site plan of the building (source : Future Architect :
39
Kristo , 2019)
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 3.10 The interior perspective that shows different of lighting
40
based on the function of the spaces (source : Future Architect : Kristo , 2019) FIGURE 3.11 The interior perspective that shows the uses of natural
lighting in the space (source : Future Architect : Kristo , 2019) FIGURE 3.12 Diagram of exploration of space in the building (source :
40
41
Future Architect : Kristo , 2019) FIGURE 3.13 The interior perspective of the building.
42
FIGURE 3.14 The close up of the construction that used C-channel
42
aluminium to repplicate timber construction. FIGURE 4.1 The table used shows the incident rate of suicide per
46
100,000 population ( source : National Suicide Registry , 2009 ) FIGURE 4.2 The table shows the prevelance (%) of current depression
46
(source : National Health Morbidity Survey , 2011) FIGURE 4.3 The specialised psychiatric hospitals in Malaysia and states
46
populations (source : National Health Morbidity Survey , 2011) FIGURE 4.4 Key Plan and Location Plans of the proposed site
47
FIGURE 4.5 The population structure at Kulaijaya ( source : Department 4 7 of Statistic Malaysia) FIGURE 4.6 The present and the future zoning at the proposed site
selection ( source : Rancangan Tempatan Johor Bahru , 2020 ) FIGURE 4.7 The accessibility from the proposed site to the public
48
49
places. (source : google maps ) FIGURE 4.8 Traffic (weekday and weekend) from proposed site to the
49
public places (source : google maps ) FIGURE 4.9 Public facilities for religion purposes near the selected site.
50
FIGURE 4.10 Public facilities for healthcare purposes near the selected
50
site. INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 4.11 Neighbourhood context in terms of target user attraction in
51
macro scale FIGURE 4.12 Neighbourhood context in terms of target user attraction in
51
micro scale FIGURE 4.13 Neighbourhood context for nearby facilities at Felda Taib
52
Andak FIGURE 4.14 Natural features that surrounded the proposed site.
52
FIGURE 4.15 Utilities in the neighbourhood context for the proposed site
53
FIGURE 4.16 View from the proposed site ( source : google earth)
54
FIGURE 4.17 The sun path diagram and the sensory surrounding by the
54
side FIGURE 4.18 The climate of the proposed site in terms of
temperature,precipitation and wind pattern (source : World Weather
54
Online , 2020) FIGURE 6.1 Abstract representation of complementary of one unit to
61
another ( source : Karl Otto) FIGURE 6.2 Brief explanation the concept of the design thesis ' senada'
62
FIGURE 6.3 The zoning of the buiding based on the theory of the design
62
thesis. FIGURE 6.4 Diagram for design development from site synthesis
63
FIGURE 6.5 Diagram design development for the buiding project
63
FIGURE 6.6 Perspective view from the client's room
64
FIGURE 6.7 Floor Plan of the client's room
64
FIGURE 6.8 Sectional cut of the building to show the part of the client's
64
room
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 6.9 Perspective view from the babies room and the pre-function 6 5 space . FIGURE 6.10 Floor Plan part of the babies room and doctor's room.
65
FIGURE 6.11 Sectional cut of the buiding to show the part of the babies
65
room and doctor's room. FIGURE 6.12 The site plan and the exterior perspective of the design
66
thesis project FIGURE 6.13 The ground floor plan of the design thesis project
67
FIGURE 6.14 The first floor plan of the design thesis project
68
FIGURE 6.15 The second floor plan of the design thesis project
69
FIGURE 6.16 The third floor plan of the design thesis project
70
FIGURE 6.17 The elevations of the design thesis project
70
FIGURE 6.18 The sections of the design thesis project
71
FIGURE 6.19 The interior perspective view from the couselling room.
72
FIGURE 6.20 The interior perspective view from the upper room balcony. 7 2 FIGURE 6.21 The interior perspective view from the lower room balcony
72
FIGURE 6.22 The interior perspective view from the client's room
72
FIGURE 6.23 The exterior perspective view from outside of cafetaria.
73
FIGURE 6.24 The exterior perspective view from the pathway of the
73
residential area FIGURE 6.25 The exterior perspective view from the wetland
73
FIGURE 6.26 The exterior perspective view from the thereupatic garden
73
FIGURE 6.27 The exterior perspective view from the residential block
73
FIGURE 6.28 The exterior perspective view from the wetland
73
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 6.29 The exterior perspective from the thereupatic garden
74
FIGURE 7.1 The exterior perspective from client's blocks
76
FIGURE 7.2 Example of earthen colours
77
FIGURE 7.3 Example of white colours
77
FIGURE 7.4 Examples of lavendar colour
77
FIGURE 7.5 Examples of blue-green colours
77
FIGURE 7.6 Examples of soft-pink colours
77
FIGURE 7.7 Example of vegetation - healing through sight Swiss Chard 'Bright Light'
78
FIGURE 7.8 Example of vegetation - healing through sight Heuchera ' Chocolate Ruffles'
78
FIGURE 7.9 Example of vegetation - healing through sight Sunflowers 'Helianthus Anuus'
78
FIGURE 7.10 Example of vegetation - healing through sound Quaking Grass 'Briza Maxima'
78
FIGURE 7.11 Example of vegetation - healing through sound Nigella Damascena
78
FIGURE 7.12 Example of vegetation - healing through sound Miscanthus oligostachyus
78
FIGURE 7.13 Exterior perspective of the building with example of healing plants.
79
FIGURE 7.14 Example of vegetation - healing through touch Lamb's ears
79
FIGURE 7.15 Example of vegetation - healing through touch Silver Sage 'Salvia Argentea'
79
FIGURE 7.16 Example of vegetation - healing through touch Jurusalem Sage 'Phlomis Fruticosa'
79
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 7.17 Example of vegetation - healing through smell Curry plant 'Helichrysum italicum'
79
FIGURE 7.18 Example of vegetation - healing through smell Lavandula angustifolia ‘Hidcote’
79
FIGURE 7.19 Example of vegetation - healing through smell Sweet Pea 'Lathyrus Odoratus'
79
FIGURE 7.20 Interior Perspection from the swimming pool that shows the uses of Light pipes
80
FIGURE 7.21 Diagram on how the light diffused through the space
80
FIGURE 7.22 The dagram shows the process on how the light pipes are works.
80
FIGURE 7.23 The floor plan on where the location of the light pipes in the proposed building.
80
FIGURE 7.24 The diagram shows the process of the grey water tratment system in the building,
80
FIGURE 7.25 The section of the building that shows the process 81 of the grey water treatment system FIGURE 7.26 Examples of vegetation that use for filtering the grey water
81
FIGURE 7.27 Examples of vegetation that use for filtering the grey water
81
FIGURE 7.28 Acoustic panels that being used as part of the ceiling
81
FIGURE 7.29 Section of the building that shows the special feautures of the building.
82
FIGURE 8.1 The abstract painting of 'harmony' ( source : Elizabeth karlson)
84
FIGURE 8.2 The construction method of cast-in-situ construction with reinforced concrete materials
85
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 8.3 The construction method of cast-in-situ construction
85
FIGURE 8.4 Sectional part of the construction that shows the details of the foundation and the slab
85
FIGURE 8.5 Concrete Masonary Block (CMU)
86
FIGURE 8.6 Examples of Concrete Masony Unit (CMU)
86
FIGURE 8.7 Details of construction using concrete masony Block (CMU)
87
FIGURE 8.8 Details of column and beam construction
87
FIGURE 8.9 Details of construction using pecast concrete hollow core slab
88
FIGURE 8.10 Details of construction using prefabricated aluminium roof truss
89
FIGURE 8.11 Details sequence of construction using IBS
90
FIGURE 8.12Â Construction details structure of the building
91
FIGURE 8.13 Detail A - Construction details of the roof with the rain gutter
92
FIGURE 8.14 Detail B - Construction details of the beam,column 92 and the roof FIGURE 8.15 Detail C - Construction details of the foundation and the slab
92
FIGURE 8.16 Details D - Construction details of glulam column and aluminium sturucture.
93
FIGURE 9.1 Example of water tank module (1.2m x 1.2m x 1.2m)
98
FIGURE 9.2 Water plumbing schematic layout.
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FIGURE 9.3 The summary of provision for water supply
99
FIGURE 9.4 The Fifth schedule for designation of purpose groups (source : Uniform Buiding By Law)
100
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
FIGURE 9.5 Dimension of buildings and compartments based on the purpose groups. (source : Uniform Buiding by Law)
100
FIGURE 9.6 Law 225 Detecting and extinguishing fire (source : Uniform Buiding by Law)
100
FIGURE 9.7 From seventh Schedule ,the maximum travel distance allowed for the purpose building (source : Uniform Building by Law)
101
FIGURE 9.8 Diagram shows the escape staircase for the purpose building based on the distance allowed by law.
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FIGURE 9.9 The active provision on the Tenth Schedule (source : Uniform Building by Law)
101
FIGURE 9.10 The diagram shows the summary of compliance for the purpose building
102
FIGURE 9.11 The table shows the type of TNB substation and tranformer needed for the purpose building
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FIGURE 9.12 The diagram shows the process of the electrical from the main source to the building
103
FIGURE 9.13 The diagram shows the location of the use of aircond and the use of natural ventilation in the building
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FIGURE 9.14 The summary of compliance the use of electrical system in the building.
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FIGURE 9.15 The services pathway from the mainhole surrounded the building to the IWK
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FIGURE 9.16 The services pathway to collect disposal items from each block to the main collecting point.
106
FIGURE 9.17 Vertical transportation provided in the building with the service pathway that can be used to load the items
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INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
LIST OF TABLES TABLE 1.0 - Summary of postpartum affective disorder (World Health Organization ,2009)
11
TABLE 2.1 - Recommended weight lost for postpartum woman (Mayo clinic,n.d)
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TABLE 2.2 Treatments by Malay culture in the postpartum period. (Rachel (2017) , Zuraidah (2018) , Mahtas (2015) and Lynn (2019))
23 24
TABLE 2.3 Common categories of food to be consumed and avoided during postpartum period. (Rachel , 2017)
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TABLE 3.1 Analysis of spaces on confinement center
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TABLE 4.1 Criteria for site selection
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TABLE 4.2 Details of Mukim at Kulai,Johor
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TABLE 4.3 SWOT of the proposed site
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TABLE 5.1 Schedule of Accomodation (SOA) of Recovery Center for Postpartum Depression
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TABLE 8.1 Industrialized Building System (IBS) Score Calculation
94
TABLE 9.1 The number of sanitary fitting in the building
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TABLE 9.2 The amount of water capacity required for the sanitary fittings
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INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
TABLE OF CONTENT 01 CHAPTER 1 - INTRODUCTION Mental Health I Mental Illness I Depression I Postpartum Depression I Design thesis Issue I Design Thesis Questions I Design Thesis Objective I Design thesis Scope and Limitations I Design Thesis Significant I Design Thesis Structure
01 - 17
02 CHAPTER 2 - LITERATURE REVIEW Woman experience with postpartum depression I Healing after pregnancy or childbirth I Traditional confinement method in Malaysia (Malay,Chinese and Indian) I The Healing Process I The Healing Element
18 - 34
03 CHAPTER 3 - PRECEDENT AND CASE STUDIES Nuuk’s Psychiatric Clinic I ExperientialHealing Spaces I Bangunan Dato' Muhamad Ibrahim Munsyhi , Nusajaya,Johor I Confinement Center
35 - 44
04 CHAPTER 4 - SITE ANALYSIS AND SYNTHESIS Site Locations I Site Selection Criteria / Justifications I Land Use and Zoning Neighborhood context (Man-Made Features , Natural Features ) I Disaster Risk Locations I Accessibility I Utilities I Climate I Sensory I Site section I Site Synthesis I SWOT Analysis
45 - 55
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
05 CHAPTER 5 - DESIGN BRIEF The Client I Design concept I Site summary I Target users I Architectural Aspect I Functional requirement I Schedule of Accommodation I summary
56 - 59
06 CHAPTER 6 - DESIGN DEVELOPMENT Introduction I Masterplanning I Design Criteria I Design Strategies I Design Development I Building concept and Typology I Site Planning I Schematic Design I Finalize Design Scheme I Perspective Views I Summary
60 - 74
07 CHAPTER 7 - SPECIAL STUDIES Architectural Design for Healing Environment
75 - 82
08 CHAPTER 8 - CONSTRUCTION AND STRUCTURAL DESIGN Introduction I Structure System Overview Choice of material I Foundation System I Main structural System (Post and Beam) I Floor System I Wall System I Roof System I Construction System and Materials overvies I Curved glulam timber Truss Roof I Construction Details I Summary
83 - 95
09 CHAPTER 9 - BUILDING SERVICES Introduction I Water supply and drainage I Ventilation System I Fire protection system I Electrical Distribution System I Sanitary and Sewarage System I Telecommunication and Control System
96 - 107
CONCLUSION
108
REFERENCES
109 - 122
APPENDICES
123 - 135
INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA (IIUM)
RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
01
CHAPTER 1 introduction
CHAPTER 1
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RECOVERING CENTER FOR POSTPARTUM DEPRESSION
2019 / 2020
Introduction
FIGURE 1
This chapter explain the understanding of research studies from mental health to postpartum depression. From mental health to mental illness, depression are being recognized to be the main part of the research studies. The thesis are focusing on the main population that affected by depression which are the elderly, the critical and the postpartum depresion. As the research studies are more focussing on the youth ,the postpartum depression population are being chose to be part of the design thesis. Theoretical Framework are being created to identify issues, questions, and objectives for the particular research studies. Relevant case studies are being chose based on the theoretical framework of the studies. CHAPTER 1
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Mental Health FIGURE 1.1
" MENTAL HEALTH IS TO BE ABLE TO UNDERSTAND THEIR CAPABILITIES OF HANDLING THEIR LIFE WHICH ABLE TO WORK TOWARDS THEIR ACHIEVEMENT IN LIFE."
CHAPTER 1
The definitions for mental health in World Health Organization (2013) is mental health are an abilities for an individual to cope with the level of stresses of life which are the ability to contribute to the society. It also a capacity of an individual to promote subjective well-being and optimal functioning to achieve an individual and collective goals (Ministry of Health ,1997). The idea of mental health is to be able to understand their capabilities of handling their life which able to work towards their achievement in life. This gives a positive impacts or vibes for an individual and the surrounding society. Malaysia compromise in three main ethnic groups : the Malay (66.1%), Chinese (25.3%) and Indians (7.4%). Therefore, the concept of mental health and mental illness in Malaysia can be address to different perspectives which influence by different races and religious belief (Tsuey Chong, Mohamad, & Er, 2013).
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Mental Health definitions of mental health based on different belief, religions and races FIGURE 1.1
Malay
"Heredity, periodicity, congenital, brain strain, stress (including interpersonal) , susceptibility , infection , contagion, delayed onset, conditioning and resistance"
Chinese
Factors related to selfworthiness, which is measured by the material achievement (includes education, occupation and monetary gain) that brings the expected honour to the family (Haque, 2005)
Indian
Centralised on the concept of the mindbody dichotomy and summed up in the four aims of life - “Dharma, Kama, Artha and Moksha�
CHAPTER 1
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Mental illness
Mental illness is a condition that gives negative impact on individual itself. According to Canadian Mental Health Association (2015) , it affects on how people think, feel, behave or interact with other people . It is an uncontrollably conditions that can be reduced by psychological treatments. By 2020
,
mental
illness
is
expected to be the second biggest
health
problem
affecting Malaysia heart disease and the prevalence of mental heath problems among people aged 16 years and above was 29.2% as approximately 4.2 million (National Health Morbidity Survey,2015)
FIGURE 1.2
CHAPTER 1
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RECOVERING CENTER FOR POSTPARTUM DEPRESSION
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Mental illness
definitions of mental illness based on different belief, religions and races
Malay “...as a spirit possession or as a social punishment � (Deva,2004). Mental illness is an outcome of abandoning or neglecting traditional values" (Haque & Masuan , 2002)
Chinese The lack of spirit or the weakness of yin and yang (Tsuey Chong,Mohammad & Er, 2013). The Chinese believe that mental illness is caused by problem related to selfworthiness
Indian
Indians believe that evil doers could cast a spell on an individual to make them ill (Haque , 2005)
FIGURE 1.2
CHAPTER 1
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Mental illness Type of Mental illness
01 SCHIZOPHRENIA Schizophrenia is a mental disorder that affects people behavior , emotions and the way that they think. Major symptoms includes hallucination, delusions , loss of personality , confusion , agitation , social withdrawal , psychosis and or extremely odd behaviour 02 MANIC / BIPOLAR DISORDER Manic disorder is characterized by extreme and unpredictable mood changes in the sufferers. Mania often involves sleeplessness, sometimes for days, along with hallucinations , psychosis, grandiose delusions, or paranoid rage. 03 DEPRESSION Depression is a common mental illness. It may described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities. It also contributes feelings of worthlessness or excessive guilt
FIGURE 1.3
CHAPTER 1
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Depression
DEPRESSION IS A COMMON MENTAL DISORDER THAT PRESENTS WITH DEPRESSED MOOD, LOSS OF INTEREST OR PLEASURE, DECREASED ENERGY, FEELINGS OF GUILT OR LOW SELF-WORTH, DISTURBED SLEEP OR APPETITE AND POOR CONCENTRATION
FIGURE 1.4
CAUSES OF DEPRESSION 01 TRAUMA When people experience trauma on early age, it can cause a longterm changes in how their brains responds to fear and stress. 02 GENETICS Mood disorders and risk of suicide tend to run in families. 03 LIFE CIRCUMSTANCES Marital status and financial problem may effects a person to develop depression in their life.
CHAPTER 1
04 BRAIN STRUCTURE Depression also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation. 05 OTHER MEDICAL CONDITIONS People who have history of sleep disturbances ,medical illness, chronic pain, anxiety and attention deficit hyperactive disorder (ADHD) 06 DRUG AND ALCOHOL ABUSE 30% of people with substance abuse problems also have depression
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Form of Depression Depression can be categorized into different form of illness. Example of depression are persistent depressive disorder, psychotic depression , bipolar disorder, seasonal affective disorder and postpartum depression. The most uncommon form of depression in Malaysia are the seasonal affective disorder. 01 PERSISTANT DEPRESSIVE DISORDER (DYSTHYMIA) Major depression along with less severe symptoms of depression 02 PSYCHOTIC DEPRESSION Depression that comes with false fixed beliefs (delusions) and hallucination. 03 SEASONAL AFFECTIVE DISORDER 30% of people with substance abuse problems also have depression
04 PBIPOLAR DISORDER A person experiences extreme high euphoric or irritable -moods called 'mania' or a ales severe form called hypomania 05 POSTPARTUM DEPRESSION Depression that are more extreme than 'baby blues' that many woman experience after giving birth
The most common population affected by depression called major depressive disorder populations . There are three populations that classified under this category which are elderly, chronic medical illness and pregnant or postpartum woman FIGURE 1.5
CHAPTER 1
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Postpartum Depression Postnatal depression can lead to difficult temperament, attentional, emotional and behavioral problems in children and adolescence (Field ,2011). The most devastating consequences of postnatal depression and other mental health disorder are at a higher risk of suicidal ideation, suicidal attempt or suicide (Orsolini et al,2016). There are statistic in Asia that indicates a wide range of 3.5% to 63.3% mothers suffering from postnatal depression (Klainin and Arthur,2009). According to World Health Organization (2017), in Malaysia estimates that 13% of women in the postpartum period experience mental health disorders, with depression being particularly common. However,according to Valerie (2019) , Malaysia has the lowest rates of postpartum mood and anxiety disorders (PMAD) at just 3% compared to 15% in the United states (Valerie ,2019). Thus postpartum depression in Malaysia shows the lowest percentage if being compared with other countries. This is because the existing of traditional confinement method that being used until no in Malaysia
CHAPTER 1
Perinatal
Mood
and
Anxiety
Disorders (PMAD) which are statistically grouped together under postpartum depression or postnatal depression (PND). It is a depression that happen during the period after giving birth. This type of depression involving baby
the
and
mother
also
her
,
her
family
(National Institute of Mental Health,2013)
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Postpartum Depression Type of Postpartum Depression
There are three degrees of postpartum mood disorders i.e baby blues, postpartum depression and postpartum psychosis. According to Table 1.0 shows the summary of postpartum affective disorder on the prevalence, summary onset, duration and required treatment (WHO,2009) Table 1.0 Summary of postpartum affective disorder (WHO,2009)
01 POSTPARTUM BLUES Postpartum  blues is the most common mood disturbance after childbirth. After a few days of delivery , which involve 3 to 4 days ,a new mother may associate with a sudden mood swings, unexplained weeping, irritablity and impatience, lack of sleep, crying spells, generalize anxiety, sleep and appetite disturbance (WHO,2008 and Rajanna et al ,2011) . Postnatal blues are considered mild and happen in a short period of time do not required treatment other that reassurance. Often, joining a support group of new moms or talking with other moms helps. However up to 20% of woman with postpartum blues may develop major depression in the first year of postpartum (Campbell et al ,1992)
CHAPTER 1
FIGURE 1.6
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02 POSTPARTUM DEPRESSION (PPD) Postpartum depression happens a few days or months after giving birth. It usually begins within the first six weeks of postpartum and some of the cases required professional helps. The symptoms of postpartum depression are generally the same with postpartum blues which are sadness, despair, anxiety, irritability - but she feels them a little bit more stronger compared to those with postpartum blues. Postpartum depression is a serious conditions that can be treated with medication and counseling. When a woman’s ability to function is affected, a healthcare provider is needed.
03 PUERPERAL OR POSTPARTUM PSCHOSIS (PPD)
FIGURE 1.7
CHAPTER 1
Postpartum psychosis is uncommon mental illness that can effects a new mothers. This illness make a woman loss their reality, having auditory and visual hallucination (clearly believe something that are not real). Other symptoms also included such as insomnia (not be able to sleep),feeling angry or frustrated ,restlessness and strange feelings and behaviour. Woman who suffer with postpartum psychosis are needed treatment right away or being hospitalize because they are at risk for hurting themselves or someone else.
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Design Thesis Issues 01 STIGMA Stigma is a negative perceptions that created prejudice which leads to stereotypes and discrimination among a group of people. Stigma has been identified as a significant barrier to those who seek for help or care. Stigma creates feeling of shame, selfblame and hopelessness. It also creates loneliness, isolation and social exclusion from the community.
Family Perspective
Friends Perspective
Employers Perspective
As an individual who suffer with depression, stigma make the illness a lot more severe .It leads to an individual to belief that the conditions that they are having is not real and do not want others to know about their own conditions. The affects in a person may lead to a severe depression that involving hurting oneself.
Health Providers Perspective
FIGURE 1.8
02 SOCIAL ISSUES One of the social issue affected the postpartum depression are the lack of awareness from the community. According to Yeap & Low (2009), mental health knowledge associate with the increasing number of mental health. Many of the respondents believe that the issue of mental illness is something that is not being given enough exposure and attention in the mass media spaces (Hassan, Kassim & Hamzah,2018). The insufficient knowledge about psychiatric illness and treatment options for the illness creates conservative attitude from family members about mental health patients (Loo & Furnharn , 2012).Thus ,the patient hesitant to seek for proper medical solutions.
CHAPTER 1
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03 ENVIRONMENTAL ISSUES One of the issues that enhance by the postpartum woman are the environmental factors specific more in terms of the lifestyle. In this modern world, the idea of perfectionism are being intergrated well with the societies. Unhealthy social comparison happening without knowing the consequence on their mental health. Postpartum woman during those time shows psychological and physical changes in them.The comparison in tems of body weight, and physical attraction are one the examples.There are no strong sense of identity that lead to low self esteem disorder and depression especially for them who’s going through hormonal changes.
Responding to the issues discussed, the following question are raised : I. What are the spaces that able to cater the psychological and physical changes of postpartum woman ? ii.What are the traditional method or spaces needed to treat postpartum woman?
Design Thesis Question
iii.How to change the stigma of family members regarding postpartum depression?
Design Thesis Objective
The design thesis objective are : I. To enhance a healing environment for postpartum woman in term of physical and psychological needs ii.To evaluate proper space and method of confinement using traditional methods. iii.To educate and create awareness regarding postpartum depression.
CHAPTER 1
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Design Thesis Scope and Limitation
The design thesis study covers on the scope of postpartum depression and treatment for postpartum woman. The limitation for this research are : 1) The study for postpartum depression treatment limit to psychological method and traditional method. 2) The treatment for postpartum depression limit to woman and the family that affected. 3) The target users for the research framework focussing on the youth and does not involve on others medical condition.
The Significant
The findings of this research able create awareness among mothers and family that being affected regarding the postpartum depression. This awareness able to educate others and being more aware and sensitive regarding this matter. Moreover, the findings use able identify traditional culture to treat postpartum woman. The research able to identify the losing identities and create a new platform to enhance the culture to another new level. The design thesis also able to find characteristic of healing spaces or activities that can be use as part of the healing architectural study.. FIGURE 1.9
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Design Thesis Framework An outline of the design thesis framework compromise the relevant chapter in the design thesis as shown in the figure 1.10
FIGURE 1.10
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FIGURE 1.11
Summary This chapter contains general introduction and overview of the design thesis is all about. It underline the background of the study, the issues,the research questions,aim and objective. The outcomes of this research may benefit the healing element for postpartum woman by creating needed facilities and condusive environment. The following chapter discusses further on general idea of the architecture and its criteria for the implementation on the design thesis. It also elaborates on the feasibility and its application based on the minimum standards and guideline.
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02
CHAPTER 2 literature review
CHAPTER 2
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Introduction The literature review covers various aspects on postnatal depression. Chapter 2 covers the internal aspect of woman with depression.For example,the change of behavior , emotional and physiological. The understanding of internal aspect had been explained further in this chapter. Furthermore, this chapter also covers traditional confinement method for postpartum woman. This section has been focussing on what kind of treatment that has been using. it also covers method of modernity that has been enhancing the tratment for postpartum woman. Lastly, one of the findings in this research are the healing environment. This study is to complement the design thesis which are the recovering center for postpartum depression.
Woman experience with Postpartum Depression Emotional Changes
CHAPTER 2
Emotional changes are uncontrolled feeling that has been experiencing by postpartum woman. The emotional changes has been leading them to be a different character and have negative thought about everything. Based on Roshaidai (2016), womans has been discussing having a feelings of being different such as ‘loss of interest/excitement’, ‘easilly irritated’ and ‘not being a normal person’. Despite the lack of understanding with the emotional changes, the ‘sudden changes’ awared them that their emotions were different before fertility. Figure 2.1 shows an example of woman experiencing emotional changes.
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The negative thoughts have been leading them to have negative feelings and suicidal ideation. The idea of suicidal has been coming from the feeling of being depress and the feeling of not being an important person (Roshaidai,2016). Thus, emotional support from their love ones are very important to make sure the mothers are feeling wanted or needed. The list below shows examples of symptoms that have been happening with mothers after delivery (Northamptonshire Healthcare, 2019) 1. Anxiety : Obsessed with unhelpful, unrealistic and negative fears about her baby. 2. Panic attacks : Heartbeat and breathing becomes irregular and occur in a stressful situations. 3. Low mood : Feels sad and their thought will be negative and focus more on the failures. Will have mixed emotions towards their partner. 4. Guilt,shame and blame : Overwhelmed with the feeling that they should be grateful for the baby.
FIGURE 2.10
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Behavioral Changes
The emotional changes have been creating a sense of uncontrolled behaviour to the postpartum woman These changes experienced by the temperamental actions. According to Merriam (n.d), temperamental actions are impulsive mood changes that shows unpredictable behaviour or performance. According to her, they unawared with the pain cause it have been dissociating from the physical pain Moreover, according to Rushadai (2016), it includes shouting at others, breaking things and treating the baby harshly. Thus, it is an action that unable to control angerness and sadness which increase the aggresive behaviour of a person. Figure 2.2 shows an example of womans experienced related to the behavioural changes
FIGURE 2.30
Physiological Changes
Physiological changes is part of bahavioural changes. Examples of physiological changes are sleep deprivation, loss of appetite and physical discomfort. Physiological changes are unhealthy conditions that have been effecting body functions of postpartum woman that experiencing emotional stress. Figure 2.3 shows an example of womans experienced related to the physiological changes.
FIGURE 2.20
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Introduction
The first six weeks are important for postpartum woman.According to Valerie (2019), within those period, 80% of the hormonal had been unbalanced and 90% shrinkaged of the perineum organs.She also stated that those period are the ‘Healing Window of opportunity’ that the body has been naturally transitioning to non-pregnancy state .It means , only minimum efforts required by new moms for healing after childbirth. The following sections shows phases of healing for postpartum woman.
Healing after pregnancy or childbirth
Phase I - The first six weeks (Intense Healing Process)
Every women has their own way on losing weight with their own pace. However for postpartum woman, according to Valerie (2019), they have claimed that breastfeeding may burn as much as 500 calories per day, depends on how they eat and breastfeeding. According to her, during childbirth, 4 -5 kg may be lost due to the baby, placenta and fluids. Following the next 3-4 week, another 4-9 kg loss of fluid and fat. Table 2.1 shows recommended weight lost for postpartum woman (Mayo clinic,n.d)
Table 2.1 Recommended weight lost for postpartum woman (Mayo clinic,n.d)
Postpartum woman ables to burn fat 7x times higher than the usual period during the first 2-4 weeks after delivery. The average weight loss is naturally occur without any engaging in any form of exercise. Furthermore, the healing process is involving specific guidelines surrounding their lifestyle and personal care.It has been resulting to elevate the energy level and ables to balance the emotional changes and physical recovery.
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Phase II - 6 weeks and beyond
This period shows the transitioning of a new mother’s body back to nonpregnancy state. Thus, the reducement of unwanted fluid, fat, flatunce have been slowing down tremendously. Most of the new mother’s are fully recovered during those period of time and ables to go back to their usual activities.
Traditional confinement Method in Malaysia Introduction
Within the Malaysia communities , the postnatal period are commonly referred to as postnatal confinement. Postnatal practice or postnatal confinement is a traditional treatment to heal and to restore energy within a specific period of time (Zuraidah et al , 2018). Every culture has its own methods of confinement . However, they have been sharing several similarities in terms of the key elements used in the postnatal practice, dietary restriction and companions in the postnatal period (Roshaidai,2015). The following sections shows the confinement methods that have been using by Malay,Chinese and Indian.
The Malay Postnatal care or Confinement
According to Ministry of Health Malaysia (2014), the postnatal period is called masa dalam pantang which both mother and the baby needs to be remain inside the house around 44 days . Some culture in a longer period of 60 days to 100 days confinemnet. For those who had undergone Cesarean (surgery) birth, special precautions are taking into consideration compared to those with normal birth.According to Zuraidah (2018) ,the usual postnatal treatment nowdays are hot compress (bertungku), heat treatment (berdiang),herbal bath,body wrap(berbengkung / berbarut) and body massage.Based on Table 2.2 are the treatment by Malay culture in the postpartum period.
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Table 2.2 Treatment by Malay culture in the postpartum period. (Rachel (2017) , Zuraidah (2018) , Mahtas (2015) and Lynn (2019))
* Wind is believed to enter the body through the pores, unfused sections of the skull, and especially the big toe. Excess wind in the body is associated with a range of ill health effects, including aches, pains, bloating, and poor mental health.
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Based on Table 2.2 , there are few significant of traditional methods for confinement. It have been depending on the scenario, patients, belief and even for the midwives. For example, for certain midwives, starting day of confinement occured during the specific day of confinement period, while some are determined by their returns from the hospital.Thus, the variation may happen depending on the locations and belief . However, it will be depending on the new mother itself whether they are suitable or comfortable with the treatment provided.
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Foods are important to give nutrients and energy to the new mothers. The needs to understand what kind of foods that are beneficial for the mothers are important. According to Rachel (2017), hot foods have been considering in a postpartum period where it helps to balance the cold in the body. Moreover according to her also, foods that have been considering as 'itchy' or 'sharp foods' need to be avoided as in some belief it can bring harm to the new mothers.This is because of sensitivity after childbirth. Thus,precautions in terms of foods need to be taken place and considered.
Table 2.3 Common categories of foods to be consumed and avoided during postpartum period. (Rachel , 2017)
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The Chinese Postnatal care or Confinement
For chinese womans, confinement period has been depending on the individual itself. The most common are within one month (30 days) to 44 days. According to Zuraidah et al (2018) , by using the same concept, they can't go out of the house the entire confinement period. Chinese community have been believing that one of the postnatal care is to get away from the wind and bathing. According to Zuraidah et. al.(2018), wind have been considering as 'evil' because it effects womans body especially when they are washing their hair. As a result, the postnatal woman would not take a bath in days or weeks depends on the comfort of the mothers. However, according to Valerie (2019) , they will take a bathe with hot water , mixed with herbs. According to her, hot water (boiled) cannot be mixed with cold water as it need to let it cooled down naturally to get a warm temperature. Moreover, the chinese community also have been focussing on foods and nutritions during the confinement period. According to figure 2.4, they are not encouraged to drink plain water nonetheless they have been emphasizing on taking herbs such as ginseng soup, red date and ‘lihing’ during confinement. This method ables to remove the cold temperature or the ‘wind’ to warm up the mother’s body. CHAPTER 2
FIGURE 2.4
Cold things ables to cause diarrhoea in baby and mothers, body swelling , stomach discomfort, aches and pain , delay in lochia expulsion and cough(Raven et al ,2007), Thus, hot foods are recommended to restore postpartum woman’s health. There are several traditional methods that have been used in their community. However , according to Poh et. al.(2005), the most effective method are in terms of dietary. There are no significant studies regarding the effectiveness of other treatment on postpartum woman
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The Indian Postnatal care or Confinement
The confinement practice for Indian community have been foccusing also to avoid postnatal woman with cold or wind. According to Zuraidah (2018) the Indian have been believing to not wash the hair daily but only on the odd days. For example, postpartum womans have been washing their hair on day 3, 5, 7 until one month of confinement. They have been bathing after sunrise or mid-morning to prevent the cold on the morning and night.According to Zuraidah (2018),postpartum woman's hair need to be dry to avoid postpartum deperession. The postnatal care for Indian community have been foccusing also on food restriction.The concept are similar with Malay and Chinese culture where cold and 'wind' foods need to be avoided. Examples of food are cucumber, murungai (Moringa oleifera) fruits, eggplant, jack fruit and grapes (Young,2015).
Moreover,the confinement practice have been involving massage or maalish to the new mother and the baby. According to Sheela (2017) , the massage have improved blood circulation and improved baby to sleep better by using coconut oil or gingelly which contain no presevative. For the new mother, the massage are done daily by using neem oil,mustard oil and coconut oil (Rushaidah,2018). It being applied on the mother’s abdomen and tight it with a long cloth to strech the flaccid muscle. Thus,the confinement practice for Indian community have similar routine with other culture especially on Malay culture.This had been identifying through the postnatal care and the dietary plan for the mothers.
In addition, spices and herbs have recommended to eat during confinement period. According to Zuraidah (2018), it also depends on the region, condition of the mothers and baby .For examples, shark meat and boiled fenugreek seed ables to help mother to increase milk production for the baby.
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The terms of curing and healing are being used frequently in the previous research ,which indicate distinct definitions of both terms. According to J.L. Beggs (2015) and Dossey et al (2005) , healing is to alleviating emotional stress , establishing a positive state of mind at deeper levels of inner knowing and balance at each aspect. However for curing , based on Oxford (1990) and J.L. Beggs (2015) its a symptoms of a disease or condition that being treat with systematic approach which is by using medicine .The people who works in the particular environmentcuring process (medicine,physician and nursing) play a major role to cure the patient , therefore need a compliance environment to conduct the entire process. The conducive environment can be integrated with the hollistic manners which is included the spiritual, emotional and mental dimension in creating compliance environment (Clarissa, William, Karen, Hawkes, & C. Cherkin, 2008). Holistic means approach by not limiting the physical conditions but spiritually (J.L. Beggs ,2015). According to L.Day (2007), it is important to enhance the feeling to be in relaxed and on the right state and remain calm in a holistic manners which involved calmness of the both the body and mind.This approach benefit the user that experience the environment that helped in spiritual manner.
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The Healing Process The hollistic approach may integrated with the built environment which is to incoporated conducive environment with the higher level of spirituality with the design of the building.Based on L.Day (2007) the process of healing could be incorporated with good design of hospital environment by enhancing the surrounding with safe and relaxed environment. Based on the previous research studies ,healthcare design that incorporates modern medicine with the benefit of the healing environment is a ‘smart investment’ as it can improve patient care and medical outcomes and can decrease medical errors and waste (Marberry , 2007 & Ulrich , 2012). Figure 2.4 shows the curing process through the medical intervention with the healing environment (S.A Tabish , 2011)
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FIGURE 2.50
Furthermore, the element that supported the healing environment are by the physical appearance in the surroundings.Based on Oxford Dictionary, the definitions of physical are real things that can be touched and seen, rather than the ideas or spoken words which can perceived through the sense as opposed to the mind, tangible or concrete. (Cobuild , 2006). The definitions of environment consist of the particular natural surroundings in which you live or exist , considered in relation to their physical characteristics (Cobuild , 2006).
CHAPTER 2
The physical environment has potential to support healing by increase the effectiveness and the productivity for the workers and patients. According to Ministry of Social Development , “..the physical environment includes land , air plants and animals , buildings and other infrastructure and all of the natural resources may provide opportunities in terms of development and growth for an individual” . The conducive or healing environment promoted the self-healing environment for an individual. The act of selfhealing is a process of healing oneself or itself (Meriam –Webster , 2000). The act of self-healing is to remove stress and negativity that affected the individual needs.Based on the previous research framework, physical environment of a building affected the stress level of an individual.
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Nevertheless ,the alteration of physical environment from the designer may benefit the users by the individual needs (Rashid and Zimring ,2008) . However ,according to A. Zetterquist (2009), creating an environment is an afterthought for designer to promote their healthcare and it’s not allowing to interact with people and the surroundings. Therefore designer need to be sensitive in creating spaces that cater the physical, emotional and psychological needs.
The Healing Elements Access to view
FIGURE 2.60
The accessibility of the view affected the healing process for patient and the productivity of the staff. Nature and open garden has been found essential for patient comfort and positive distraction (McCullough, 2010; Ulrich, 2008; Malenbaum, Keefe, Williams, Ulrich, & Somers, 2008).
CHAPTER 2
Window that allowing view outside of the building helps in terms of the healing process and productivity. According to Ulrich et al (2000) , “...patients and staff having a window to view externally from the building are prominently confirmed to reduce level of anxiety and stress among patients and visitors, while staffs can gain a state of gratified thus increase their job performance”. .Based on Soh Oi-Zhen et al (2015) who studied the effect of rooms with outdoor visual versus brick wall view on patient length of stay, patient who is been hospitalized facing the outdoor scene have shorter length of stay and vise versa. Figure 2.5 shows the increasing number of period of stay, negative review from the nurse and the use of strong medication being used for the effect of the brick wall and vice versa. Thus, it shows the essential of accesibility of view in the hospital for the occupant of the building. 29
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Window Placement
The irony to have a positive access from the perspective of patient’s bed, the idea to place the window need to be consider. Based on S.Aripin (2007)- who conducted a pilot test in three Malaysian public hospitals indicated the assessment regarding of window placement in a wards. a) The most satisfied view from the surrounding area when one is at the highest level of the building This is applicable when patients in standing position and not bedridden.- The positive view of the greenary is much more appreciated at the higher level. b)The placement of the bed affected the angle of the view because of the narrow angle from the bed positions. c) Building Configuration are arranged in the form that reflected the building facades on view or a blank wall (a coloured blank wall) that create a strong dissatisfaction from patients. d) The visual comfort regarding between the needs to have a view and avoiding the direct disability glare.
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According to Ulrich (2000) , patient who has direct view of the external natural environment rather than a blank wall has recovered faster . He described the need to have window, as the following :
‘a window is not seen merely as a functional necessity that provides light and ventilation, but also a gateway that has the ability to transport a patient from a harsh reality to a place of contemplation, serving as a temporary escape’ (Ulrich , 2000)
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Building Orientation
Building orientation are one of the important element which affected the amount of sunlight penetrate to the building the outdoor view. Based on S.Aripin (2007) , the orientation of the building affected the quality of daylight which is in terms of glare effect and daylight distribution.He also stated that the orientation of the building is a n opportunity for designer to optimise the surrounding scenery. Hence , building orientation are one of the element that affected daylight and scenery which gave significant impact to the end user ( i.e patient , medical staff and visitors) experience and well being.
Wang et al (2005) also stated that the design implication of window orientation in daylight exposure from east and west in hospitals room decrease pain medication usage and pain medication costs.Based on A. Zatterquist (2009) , “...exposure of daylight directly or indirectly reduces depression , improves sleep , lessen stress,can cause us to experience less pain and create more overall comfort”.Thus, designer need to understand the importance and the impact to the occupant of the building so that maximum benefit from the surrounding environment being implemented.
Nature and Open spaces
Nature or open spaces is an architectural element that contribute to the healing environment.The importance of the greenary gave impact to the occupant of the building.Based on McCullough (2010) , greenary reducing stress by exploring surrounding nature.The studies provided comfort for the users and the positive distraction for the patient and staff (McCullough, 2010; Ulrich, 2008; Malenbaum, Keefe, Williams, Ulrich, & Somers, 2008; Ulrich, Zimring, Quan, & Joseph, 2006 .)
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The threupatic garden are one of the restorative meditative space that act as the healing garden because of the durrounding environment (A. Zetterquist , 2009). Based on Delaney and T. Seam Studio (2009) , Marine General Hospital cancer has developed a healing garden for their patient and it stress –reducing.He said the healing garden benefit through interative of the garden , aesthetic value from the nature, experiencing sunlight, listening to the sounds of the garden and viewing the natural color palette of the garden.
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Access to the garden are one of the ways to create an effective space that surrounded by nature. Most of the open spaces are not being used effectively by the patient especially by the staff. According to Kaseda (2014), ‘...hospital gardens are considered an uneconomical and spatial misuse especially considering hospitals that incorporate garden spaces usually compromise the bed space’ . In terms of bussiness, creating a healing garden considered as costly and inefficient. The negative attitudes towards hospital garden being express by the hospital staff as their claim to break at their lounge rather than the garden (Malenbaum, Keefe, Williams, Ulrich, & Somers, 2008). Legibility of space
Legible access and easily approachable routes are essential element for the occupant of the building. According to the Department of Health Estate and Facilities (2008) , meaning of legibility of place can be referred as how understandable healthcare buildings are to the staffs, patients and visitors who use them. However , 20 percent of the hospitals visitors and patient characterized uneasiness during their visit to the hospital. This created unbalanced emotional state for patients especially who came for the first time.Thus affected the healing process and increased the amount of stress for the visitors or patients.
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However, the use of open spaces or garden is beneficial if the location of the garden is at the strategic place.According to Kaseda (2014) , orientation and appropriate form of the courtyard arrangement minimise the use of the space and accommodate staff in open area to complement with their schedule or routine.The location need to complement with the work space which accomodate minimise effective open spaces for accessibility for the occupant of the building. This will gave advantages and affected the period of stay, the healing process for the patient and the productivity of the staff.
In general , simplifying design is a key to avoid disorientation and confusion (Oueini & Campbell , 2005). Based on S. Oi-Zhen (2015), a large number of users and facilities, healthcare building layout should always be laid out orderly and logically which offer with alternative maps and signage. According to Rousek et al (2011) signage found in the hospitals can be useful through pictograms that give direction to the users but not limited to text sign only. This will benefit the occupant of the building which much more easier to remember by graphic pictogram. Thus the signage within the hospital design should have a clear identity and be able to differentiate from other universal public facilities.
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Privacy of the occupant
Privacy of the occupant relatable to the sound of the surrounding or the environment .It is for situations that patients overheard a private conversation in an open or public area that can be heard by others.According to Barlas et.al (2001) ‘..the experienced are likely to impact the patient trust and their ability to discuss their health problems freely with their physicians’. The lack of satisfaction in terms of privacy mostly occurs in the multi-bed spaces with curtain partitions (Mlinek & Pierce , 2000).Based on Barlas et al (2007) , the patient are likely experienced a lack of auditory and visual privacy if being compared to single bed room that cover with walls. There are a few spaces in healthcare setting that being exposed or can be overhead by others.According to J. Anjali and R. Ulrich (2007) spaces in healthcare setting that possible to be exposed include : 1.Private discussion spaces in public area (admission area ,reception area ,waiting room) 2.Examination area with curtained cubicle - offer visual and auditory privacy 3.Multifunctioning room - discussion with patient can be easily heard by the other patient and their families. Area where there’s a lack of privacy usually located at semi – private area and public area where the function of the space involving participation of other people .According to Bailey and Timmons (2005) cited by J. Anjali and R. Ulrich (2007) , ‘...studies of multi bed rooms shown that most noises stem from the presence of another patient (staff talking, staff caring for other patients, equipment, visitors, patient sounds such as coughing, crying out, rattling bed rails)’ . The control of the space is important if the involvement of people are higher .If there’s no control around the room,it will reduced the satisfaction of patient .The situation will reduced the healing process and the productivity for the workers. The architectural solutions are strongly supported a single patient’s room or room that is enclosed with walls (Barlas et al.,2001). According to the patient satisfaction data by Press Ganey (2006), patient are more satisfied with the noise level around the room compared to those with roommate. The advantage had a privacy is improved the quality of sleep , improve the stabilization of emotional , increase the communication in terms of social support, increase the involvement of family that increase the patient healing and satisfaction of people can be increased (Ulrich et al, (2004) ,Chaundhury, Mahmood, and Valente (2006), van de Glind, de Roode, and Goossensen (2007), Ampt, Harris, and Maxwell (2008).
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Quality of sound and Noise control
There a various of literature studies that reviewing the quality of sound in hospital and shows several possibilities the present of the noise in the hospital. Based on J. Anjali and R. Ulrich (2007), there are two types of noise which is the source of the present and the environmental surfaces in hospital-wall , floor and ceiling. The main contributor to the loud noise comes from the mechanical equipment of the hospital itself which is the alarm, paging systems, telephones ,computer printers, ice-machine, staff conversations and noise that coming from the patient and the visitor itself (Urich et all,2004 : Ulrich ,2003). Most of the research are encourage to implement sound absorbing material at the ceiling to reduce the noise and reverberation . According to Joseph and Ulrich 2007; Ulrich et al. 2008, one of the factors that can reduce the noise levels is by using the noise-reducing finishes absorbing ceiling tiles,single bed patient rooms and short corridor. Particular area such as corridor being consider as it creates most of the noise in the hospital. Based on E.Ruiter(2015) : D.Kenny et al.(2016)Â , noise that basically comes from the conversation and trolley can be reduced by sound absorbing ceiling, smooth floor covering , carpet ,sound insulating doors or arranged the most of the bedrooms off the main transport axes.
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Sound absorbing tiles can reduce the nose and increase the privacy of the hospital. Based on Blomkvist (2005) ,when the sound absorbing ceiling tiles being install, the noise being reduce and the privacy in terms of speech being restored. There is specific spaces need to be consider when designing the healthcare.
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03
CHAPTER 3
precedent and case studies
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Design Thesis Framework An outline of the design thesis framework compromise the relevant chapter in the design thesis as shown in the figure 3.1
FIGURE 3.1
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Introduction
This chapter has two sections namely precedent studies and case studies. Deriving from the objective of this design thesis, precedent studies been selected through identification of the design thesis functionality which were postpartum confinement and pschtrist buiding. This is because there are no studies specifically regarding postpartum depression buiding. For case studies, the selection had been focussing on the healing treatment for the occupant.
Precedent Studies Psyctrist Buiding Nuuk’s Psychiatric Clinic , Greenland
Nuuk Pschtrist clinic situated facing the bay and offers spectacular views of the islands .The building itself strikes with a perfect balance between calm, healing and trusworthy Connection with nature The building design are connected to nature. According to figure 3.1 , to maximise patients contact with nature, the entire ground floor plan is open to landscape. This clear connection generates different experience with spaces provided in the buiding. Outdoor Experience
FIGURE 3.2
FIGURE 3.3
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An atrium with an open-air garden are protected from the wind has an open south-west facing corner where patients can experience the landscape outside. The courtyard creating a protected, flexible outdoor space that invites to different activity; conversations with visitors, exercise in the outdoor gym or a game of table tennis.Based on Figure 3.2 open air garden can be seen through the plan of the buidling 37
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FIGURE 3.4
Natural Daylight The designer are emphasizing the space by the use of natural light in the interior space. According to Figure 3.5 , patient’s quarters were designed with large windows and generous height, that providing breathtaking views of the greenery and an abundance of natural light in most rooms.According to diagram in figure 3.6, shows how the building captured all the natural light in the building
FIGURE 3.5
Natural Materials
FIGURE 3.7 CHAPTER 3
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FIGURE 3.6
Wood is the primary material used here; apart from being a longlasting solution, wood is proven to have a calming and stress-reducing effect. 38
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Precedent Studies Healing Environment Experiential : Healing spaces (Architecture space as regeneration of senses)
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This project focuses on the impact of architectural space on human on their healing.The idea is to create fragmented units as the concept of 'village'This is to make sure the occupancy felt the continuation of the inhabitant area rather than the intervention of single unit.
FIGURE 3.8
The designer divided the place with three categories which were administration, medical sensory stimuli and shelter (residential). According to figure 3.8, it shows a fragmented units of the building that connected to one another.According to Figure 3.9,the highlighted spaces are the recretional area, treatment area,and social or gathering area
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FIGURE 3.9
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Natural Daylight The designer chose different method to enhance natural daylight in the buiding. According to Figure 3.10,the light within the interior of the building creates different kind of mood that ables impact the activities inside room.
The light penetrates from above gives volume and different depth of light
The light penetrates in the form of horizontal stripes to guarantee visual appearance from the outside as well to obtain sunlight from outside
The space all arranged around an enclosed inner courtyard where the light comes from the yard alone.
The cylindrical shape designed to guarantee a continuous movement in the interior spaces to stimuli users senses
Lighting that create feelings of labyrinth to spur exploration of space. FIGURE 3.10
FIGURE 3.11 CHAPTER 3
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Exploration of space The designer chose different method to enhance the exploration of space based on human sensory. According to Figure xx ,shows different spaces with various atmospheric and unique spaces provided at the building.
FIGURE 3.12
The desire to explore different spaces achieved through the terrain from the site selection. The changing perspective from observation gives opportunity for the users to have different experience from one space to another.
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Case Studies
Healing environment - Material Bangunan Dato' Muhamad Ibrahim Munsyhi , Nusajaya,Johor The designer chose aluminium and steel as part of the construction to show the exposed material of the roof. It is to consider the maintenance work for the material itself. The initial cost for the roof material are expensive however, for a long term duration with the consideration of the maintenance work it is economical.
FIGURE 3.13
The designer wanted to emphasize the traditional architecture with a balance contemporary of modern architecture. The natural material that used in the traditional house are emphasize through colour painted timber in aluminium and steel construction.This gives the same atmosphere using natural material but economical. FIGURE 3.14
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Case Studies Confinement Center The table below shows three confinement center that initiate different spaces that are used in the confinement center to cater postpartum mother needs.
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Summary
Precedent and case studies emphasize on this chapter are to support the objective of the design thesis.The framework for the studies are focus on the healing environment components and the confinement center in Malaysia.This is because to cater the needs for postpartum depression mothers. CHAPTER 3
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04
CHAPTER 4
site analysis and synthesis
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Introduction
This chapter is to present the proposed site for the design thesis to be built.The site selection had been justifying through several criteria to fit in the design proposal. The site analysis of macro and micro had been analyzing throughly and efficiently . Then , site synthesis had been evaluating to increase the maximum advantage and opportunity for the proposed building site selection.
Site selection criteria
Based on the findings from literature reviews and case studies selected,the site criteria are listed in Table 4.1.
FIGURE 4.1
FIGURE 4.2
FIGURE 4.3
Table 4.1 Criteria for site selection
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Macro Site Selection - Kulai ,Johor
In Malaysia, Johor is one of the state that shows the highest population that has been affecting by depression. In Sabah and Kuala Lumpur , it has the highest number of adult prevalance regarding depression and continue with Kelantan, Pahang and Johor. Based on figure 4.5, the highest number of ethnic group lead by Chinese and Malay .The Chinese has been living in Kulai and Senai Town while the Malay are mostly in Felda Scheme settlement. For smaller populations like the Indian ,they have been working in factories or running a bussiness. In terms of age group, the population structure shows the highest number in the middle age people especially in the range of 20-40 years old. Thus,the range shows the possibilities of the target users from the selected region.Based on figure 4.5, it shows diagrams of population structure at Kulai,Johor
FIGURE 4.4
Kulai is one of the 10 district in Johor .It is located on the southern part of Johor,Malaysia. Kulai is the capital of Kulai District Johor, Based on Table 4.2, it has been dividing into four mukim which are mukim bukit batu,mukim kulai,mukim senai and mukim sedenak. Table 4.2 Details of Mukim at Kulai,Johor
FIGURE 4.5 CHAPTER 4
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Land use and Zoning
According to figure 4.6 , within 10 km from the site , situated the city of kulai at the southeast area.The area will be surrounded by agriculture, industrial and commercial activities in the future.The developing area shows a higher number at the city.This plan will be helping in terms of privacy for the clients. Next, the area within the site selection will be surrounded by housing development as part of future plan.The nearest city located at the north-west area within 3km from the site .It is called Felda Taib Andak. Even though the surrounding area will be proposed to develop housing area, it will not be affected the privacy of the client.This is because of the contour of the site.The difference level gives different perspective for the client to enjoy the view,
FIGURE 4.6
Economy
Site Description
The locals has been involving in the agriculture sector particularly in the oil palm and rubber estate.Kulai is one of the main producer of palm oil in the country.Moreover, it also has been exporting fresh vegetables in singapore on daily basis. This ables to contribute to supply fresh vegetables for the clients. Next, economy in Kulai has been improving progressively as several factories being set up at Kulai and Senai,Johor. It shows Kulai will be continuing to develop to increase the economy.
Location : Kulai, Johor Site Area : 7.07 Acre / 28,704.03m2 Land Use & Zoning : Community Facilities Center (Government Use) Mukim : Mukim Senai Authority : Majlis Pembandaran Kulai
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Site Inventory ,Survey and Analysis Accessibility
Traffic from the site selection
FIGURE 4.7
FIGURE 4.8
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Neighbourhood context Public Facilities (Religion)
FIGURE 4.9
Public Facilities (Healthcare)
FIGURE 4.10
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Neighbourhood context Target User Attraction (Macro)
FIGURE 4.11
Target user Attraction (Micro)
FIGURE 4.12
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Neighbourhood context Facilities Nearby (Felda Taib Andak)
FIGURE 4.13
Natural features
FIGURE 4.14
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Neighbourhood context Utilities
FIGURE 4.15 CHAPTER 4
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Sensory view from site selection
FIGURE 4.16
Figure 4.16 shows the view from the site selection. The site itself are surrounded by vegetation more specifically on palm oil trees. It gives positive feeling and serenity for target users to heal from their depression. However, the most potential view are located at north-east and north-west view. This is because it is surrounded by the view of the city and the hill.
According to Figure 4.18 , early january and late december shows the coolest weather while at the middle of the month shows the hottest climate compared with other month. Thus the activities for the postpartum mothers will be reduced on outdoor activities and more focussing on indoor activities.
climate
FIGURE 4.18 FIGURE 4.17
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Site Synthesis
Table 4.3Â SWOT of the proposed site
Summary
From the various site selection,the site selected is the most appropriate due to its strategic location and needs for intervention that best fit with the design thesis objective.The proposed site is an opportunity to instill design intervention economically with less disruption on site.
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05
CHAPTER 5
Design Brief
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Introduction
This chapter is to present design brief for for selected design tittle. It is a summary regarding the concept of the buiding with the connection of the target users. Moreover, this chapter also focus on justifying the functional requirement in terms of spaces and architectural aspects needed for the target user. The Client
The client for the design thesis project in general overview is the private sector under Postpartum Support International (PSI). The purpose of the organization is to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum. Design Thesis Summary
The proposed site for the design thesis is at Kulai , Johor which has been extensively elaborated in the previous Chapter 4. In short, a brief of design thesis project are as follows : Name : Recovery Center for Postpartum Depression Building Typology : Healthcare and Institutional Site Location : Kulai , Johor Site Area : 2.86 Hectare / 7.07 acre / 28611.27 m Occupancy : 30 residents + 1 family supporter and 10 staff Target Users / Modality : Postpartum Woman ( Postpartum Blues / Postpartum Depression) Approach : Recovering Center in terms of spiritual, physical and pshcological Target Users
Main Target Users are divided into two as the one that utilize the centre the most : 1) Clients (Postpartum Depression Mothers) + Family Member (1 person) 2) Management Staff ( Nurse , doctors, office workers and workers for treatment in Pshycological and Physical postpartum mothers) In addition , to take into considerations these minor target users as well 1) Medical Staff 2) Visitors (Client's family and relatives)
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Architectural Aspects
The architectural aspects style chosen must help in creating the ambiece needed for postpartum depression mothers for healing while addressing the tropical climate and the essence of the site. Colour : Natural earthern colour (harmony pallete that compliment the colour of the natural surrounding) Materials : Natural material or non-toxic material that have neen certified as non-corrosive materials Special Feature : Maximise the view at the same time increase the level of privacy for the mother and the baby Finishes : Increase the multi-sensory experiences to improve the healing process of the postpartum mothers. Schedule of Accomodation
Table 5.1 Schedule of Accomodation of Recovery Center for Postpartum Depression
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Summary
Design brief formulated in this chapter act as a design guideline during designing phase.It covers from general overview of the project to the list of spaces needed within the building.
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CHAPTER 6
Design Development
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Introduction
This chapter presents the process of the design thesis project ,how it is being developed and translated from thesis background study into a buiding project based on the formulated design brief in the previous Chapter 5 as guide line Development of Theory
Health means a dynamic state of complete physical, mental and spiritual wellbeing. A healthy individual need to shows an increase number of satisfaction through physical, mental and spiritual. Spiritual : The development of spiritual based on how ones perceives the equilibirium of life on the world and the afterlife Mind : A way to strip down the unnessary thought or overwhelmed ideas being centre with one-self. It should provide tranquility and a peace of mind towards individual. Body : Physical movement that benefits individual well being in terms of recovering and comfortable in engaging physical activity.
In order for postpartum depression mothers to get better, components in terms of spiritual,mind and body needed to be emphasize as it part of healing process. FIGURE 6.1
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Design Concept
As to go back to the nature of human life ,important component needed are the spiritual,mind and body.The complementary of three components needed to achieve the higher levele of healing process.Thus, the concept of 'senada' being implement as part of the building . Senada means peace, calm, tranquility, similar and harmony.The harmony of three components are being applied to achieve the objective of the design thesis.
FIGURE 6.2
Design Strategies
From the deveopment of theory and the concept of the design thesis, the development in the site planning are being shown.
FIGURE 6.3
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Design Development
FIGURE 6.5
According to Figure 6.5 , 1 ) Based on the 3 important component from the healing process. 2) Allocate the main components of the building by using the contour of the selected site based on evaluation from site analysis
FIGURE 6.4
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3) Interlink the main components with transitional space and the park to maximise the healing factor in the building.
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Buiding connection between space views from the client's room - bedroom
FIGURE 6.6
Client's Room
The residential area are compromise 30 rooms for for 30 patients at one time.The users are accompany by one supporter from family members or relative. The room itself are surrounded by utilities that needed by postpartum mothers and the baby. Example of utilities such as the mini pantry , fridge ( for the baby's milk) and bathtub ( for the herbal treatment for postpartum mothers.
FIGURE 6.7
The room are designated for 'People with Disabilities' (PWD) as to cater postpartum mothers that needed wheelchair in the room .It also to maximize the users experience to be more comfortable in the room. Utilities of the room for postpartum mother: i -Mini Pantry ii - Bathtub iii - Flexible Chair iv- Lazy Chair
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FIGURE 6.8
Utilities of the room for the baby : i -Fridge (Baby's Milk and Foods) ii - Baby's Crib
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Babies's Room views from prefunction area
views from babies room
FIGURE 6.9
The babies rooms are located at the center of the residential area. It is to minimum the distance between the postpartum mothers and thheir babies. As to compromise a break for postpartum depression mother, the babies are being taken based on the needs based on doctor's consultation. There are fews spaces are being cater for them based on the previous case studies in Chapter 3. For example the breastfeeding area, the babies room and the prefunction room. The residential are are also compromise the doctor's room for consultation for the babies and for postpartum mothers.Â
FIGURE 6.10
FIGURE 6.11
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Finalize Design Scheme
Site Plan Not to scale
Exterior Perspective Not to scale
FIGURE 6.12
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Ground Floor Plan Not to scale
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FIGURE 6.13
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First Floor Plan Not to scale
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FIGURE 6.14
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Second Floor Plan Not to scale
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FIGURE 6.15
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Third Floor Plan Not to scale
FIGURE 6.16
West Elevation
Not to scale
South Elevation
Not to scale
East Elevation
Not to scale
North Elevation
Not to scale
FIGURE 6.17
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Finalize Design Scheme B-B noitceS
elacs ot toN
A-A noitceS
elacs ot toN
FIGURE 6.18
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Finalize Design Scheme Interior Perspective Views view from counselling room
FIGURE 6.19 views from balcony - upper room
FIGURE 6.20
views from balcony - lower room
FIGURE 6.21 views from client's room - bedroom
FIGURE 6.22
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Finalize Design Scheme Exterior Perspective Views views from outside of cafetaria
views from the pathway residential area
FIGURE 6.24 views from the wetland
FIGURE 6.23
views from thereupatic garden
FIGURE 6.25
views from the residential
FIGURE 6.26
FIGURE 6.27 views from wetland
FIGURE 6.28
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Finalize Design Scheme Exterior Perspective Views views from the thereupatic garden
FIGURE 6.29
Summary
Design development is a vital process when designing to evolve the needs and the functionality for the client's. Therefore ,the design always changes in every critique session.Through careful design decisions made, a finalizes design scheme was determined and developed to create a full sets of drawings compromising plans,sections and elevations for the building project .Perspective or the 3D views are shown to understand the experential journey of users,
views from wetland
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CHAPTER 7
Special Studies
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FIGURE 7.1
Introduction
This chapter present the healing component that able to improve healing process for postpartum depression mother.The healing component are divided based human sense which are smell ,sight ,touch and hear.This chapter will go through specific interior and exterior design of the buiding that being used as part of thereupatic environment for the postpartum depression mothers.
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Healing Environment Colour
Healing through sight Colours have more impact in terms of psychological, physiological and social reaction. Colour its more than just aesthetic but often influenced by one's personalities,activities performed or the characteristic of the space itself. Earthen colour or colours that blend in with natural environment ables to improve healing process by having positive impact on the visual cortex. Figure xx shows an example of earthen colour that can be used as part of the exterior of the buiding.The list below shows a choice of colours that able to improvise the mood in the space.
FIGURE 7.3
1) White colour White symboloze clarity and freshness.It is the right colours to be surrounded with in times of stress,to get clarity of one's thought.
FIGURE 7.2
FIGURE 7.4
3) Lavendar colour Lavendar has a blue base,so it make sense that this colour would have a calming effect.Soft violet or lilac are similar in colour balnce and can have an equally stress-relieving effect
FIGURE 7.5
2) Blue - Green colour Peaceful and calm,blue paint colours can calm the mind,lower blood pressure and reduce anxiety and even slow heart rate.It gives effects of stress - free spaces CHAPTER 7
FIGURE 7.6
2) Soft Pink colour Soft dusty shades of pink,which have a heavy dose of white and provides peaceful and calming effect 77
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Vegetation
Gardens or vergetation ables to gives positive outcomes in tems of stress reduction.Acoording Naomi ( 2012),a founder of thereupatic Landscape network, she explain,human ables to derived both passive and active connection to reduce stress. A rehabilition garden or thereupatic garden which ables to promotes physical activities may contribute to the healing process.The vegetation are situated at the wetland spaces and at the threupatic garden at residential block. Healing through sound
Healing through sight Vegetation that applies and eye-catching colour.
bright
FIGURE 7.7
Swiss Chard 'Bright Light'
Brightly coloured stems and foliage
FIGURE 7.10
Quaking Grass 'Briza Maxima'
Annual grass whose nodding flowers rustle in the wind
FIGURE 7.8
Heuchera ' Chocolate Ruffles'
Purple leaves have brown undersides
FIGURE 7.9
Sunflowers ' Helianthus Anuus' A bright, bold-looking flower
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The sound of nature for example or the plants stems rustling in the wind
FIGURE 7.11
Nigella Damascena
Bright blue flowers form puffy seed-heads
FIGURE 7.12
Miscanthus oligostachyus Bamboo-like stripes foliage that creates a rustling noise
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FIGURE 7.13
Healing through touch Vegetation that have furry leaves or spiky stems
FIGURE 7.14
Lamb's Ears leaves that gives different texture
FIGURE 7.17
Curry plant 'Helichrysum italicum' Annual grass whose nodding flowers rustle in the wind
FIGURE 7.15
Silver Sage 'Salvia Argentea' Silvery white leaves
FIGURE 7.16
Jurusalem Sage 'Phlomis Fruticosa'
A soft, downy leaves and yellow flowers CHAPTER 7
Healing through smell Vegetation that provides nice smell from flowers or leaves
FIGURE 7.18
Lavandula angustifolia ‘Hidcote’ Providing classic scent of a summer garden
FIGURE 7.19
Sweet pea 'Lathyrus odoratus'
A pretty flowering climber that gives off a strong sweet scent 79
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Natural Lighting - Light Pipes (Technology)
Healing through sight It also known as sun tubes or sun tunnels. It function to capture , transfer and deliver natural light to places that were once thought impossible.The light diffused through the are without giving any direct or glaze from direct sunlight.
FIGURE 7.21
FIGURE 7.22
FIGURE 7.20
Wetland - Grey Water Treatment System
FIGURE 7.23
The water sources are coming from the building. Example of sources are shower bath,laundry, and bathroom sink. The grey water will go through the pipes to go to the water tank grey system.From the water tank it will pump water to the wetland. The water go through a few phases to be cleaned and filter before being stored under water tank underground storage that will be used for flush and vegetation.
FIGURE 7.24
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FIGURE 7.25
Phase 1 : Vegetation
FIGURE 7.26
Phase 2 : Vegetation
FIGURE 7.27
Water Treatment plant is applied as a treatment strategy to clean and filter grey water .It also to encouraged to experience this process within an experiantial learning approaches in the landscape.The elevated wooden walkways are used as part of the observation and experience path for the users to enjoy. Materials
Healing through smell The building are used non-toxic properties such as non-corrosive metals such as timber and aluminium. Healing through sound The building are using material that sound prove for example concrete masonary unit (CMU)block and sound proof ceiling CHAPTER 7
FIGURE 7.28
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FIGURE 7.29
Healing through sight To maximize the healing process for postpartum depression mothers , the building are design to maximize the view from the surrounding. However , to increase the level of intimacy between the baby and the postpartum mother, the level of privacy need to be build up. The solution for the problem are in terms of the materials and the exterior facade as part of the design. The material that are used at the residential area are divided into two categories which are opaque and semi-transparent materials. The uses of material gives different impact and functionality for the client itself.
The opaque materials lead as part of the shading devices for the balcony. The semi-transparent material are used to protect or to increase the level of intimacy between the postpartum depression mother, their family members and the baby. It also act as part as a protective glass for the users to enjoy the view from the surrounding site. The materials used are explained in Chapter 8 in detail under Structural and Construction
Summary Special study for the design thesis was highlighted in this chapter that explained on how the healing properties in the design thesis objective can be achieved through architecture.
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CHAPTER 8
Construction and Structural Design
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Introduction
This chapter explains the overall structure used for the design thesis project in accordance with its needs. As the design thesis projects attempts to create a healing environment,the design approaches went into the choice of materials and construction methods as well as to support the design thesis objective. Structural System Overview
This section explains the structure system used from the choice of materials,from the foundation level to the roof level with the systems installed. Choice of Structural System Industrialized Building System (IBS)
Industrial Building System (IBS) is a construction process or system which uses standardized building components that are mass-produced in a controlled environment. The building components are then transported and assembled into a building structure using appropriate machinery and equipment with minimal workers on site. Building components which are often used in the IBS projects include panels, slabs, beams and staircase units and roof structures. For the proposed design thesis project, proposed IBS systems are cast in-situ components (strip foundation) , precast concrete components (hollow core slab,staircase and lintels) , blockwork components (walls,beams and column) and prefabricated components (aluminium roof truss,doors and windows)
FIGURE 8.1
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Foundation System
Construction Method : Cast in-situ Construction Materials : Reinforced concrete with Rebar
Strip foundation is a kind of shallow base that i s used to provide a continuous, support to a linear structure such as a wall above, which is constructed centrally. A trench is required for onsite excavation.Grout is used to fill the cells without any voids. Then, concrete is poured into the reinforcement bar to stabilize The advantages using this method are its more economical as less excavation and building material are required.It also reduce construction time as lesser time is required for concrete curing due to the small surface area.
FIGURE 8.2
FIGURE 8.3
FIGURE 8.4
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Concrete Masonary Unit (CMU) - Block
Construction Method : IBS Blockwork System Construction Materials : Concrete IBS Factors : 0.5 (Half IBS Factor)
Concrete masonary unit (CMU) are easy to be installed and cost effective to builder.Its sustainability, elegant quality, needs no more paint treatment, making it easy to manufacture. It is also made from natural green materials or recycled materials which do not involve or have low volatile organic compounds ( VOC).It is made from local materials, and typically transported short distances to a project that leads to green rating system credits. In addition,concrete masonary walls can provide up to a four hour fire rating test,depending on the thickness of the wall and the density of the units and the amount of grout used.It also provide a high level of sound control.It could be one of the benefit for postpartum depression mothers to have intimacy and privacy with the family member and the baby.According to National Concrete Masonary Association (2012) , CMU walls can achieve Sound Transmission Class (STC) ratings of up to 63 depending on the wall thickness, unit size and whether or not they are completely grouted.
For the building, the post and beam structure and the main exterior walls are built using the blocks of concrete masonary units rather than the lightweight concrete blocks. The columns and the beams made of the blocks are the main structural component which will support the entire building load. CMU blocks with higher compressive force make the post and beam structure stronger.
FIGURE 8.5
CMU are modular and the most common size is a nominal 8 by 8 by 16 inches.The finishes are more simplified when using masonary as it can be sealed or painted.It also can be plastered for aesthetic or left exposed in many cases for plain and architectural units. FIGURE 8.6
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Concrete Masonary Unit (CMU) - Block
FIGURE 8.7
FIGURE 8.8
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Precast Concrete Hollow Core Slab
Construction Method : IBS - Precast Concrete System Construction Materials : Reinforced Concrete IBS Factors : 0.8 (Full IBS Factor)
Instead of the traditional precast concrete slab, the hollow core slabs with lightweight materials are chosen to reduce the overall capacity. As the block work from the post and beam system and the block walls are chosen as the main structure, the hollow core slab allows the reinforcement rebars to be inserted which attach to the hollow block walls and columns. The advantages using the Precast Hollow Core Slab are : 1) Fire resistance and sound insulation 2) Lightweight, high-load capacity structure 3) Without intermediate support, long span of up to 15 metres. 4) High performance by reducing the need to drill the electric and mechanical runs into slabs 5) Quick construction compared to wet concrete solutions during installation; 6) Compared with other common precast concrete, less vibration
FIGURE 8.9
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Prefabricated aluminium roof truss
Construction Method : IBS - Prefabricated Aluminium Framing system Construction Materials :Â Aluminium - Galvanised C-channel roof trusses IBS Factors : 1.0 (Full IBS Factor)
Prefabricated aluminum roof truss provides a high-strength, lightweight roof structure that can be easily assembled from suppliers upon arrival on site. Contrary to roof timber trusses, aluminum roof trusses last longer due to their resistance to termite . However , while the initial cost is more costly, the high strength properties require less maintenance compared to timber materials. The advantages using the Prefabricated aluminium framing system are : 1) High strength-to-weight ratio 2) Designed for optimum strength at minimum cost to meet building industrial demand. 3) High tensile strength with extremely lightweight 4) High durability which resistance to termites and resting 5) Non-combustible material that offers continuous fire resistance 6)Energy efficiency by keeping the building cooler.
FIGURE 8.10 CHAPTER 8
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Sequence of Construction
FIGURE 8.11
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Construction Details
The construction details are focus on the curve glulam timber truss roof and the lightweight polycarbonated materials as part of semi-roof for the building.Figure belows shows the construction detail of the facade.
FIGURE 8.12
The construction details are focus on the curve glulam timber truss roof and the lightweight polycarbonated materials as part of semi-roof for the building. Figure belows shows the construction detail of the facade.
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FIGURE 8.13
FIGURE 8.14
FIGURE 8.15 CHAPTER 8
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FIGURE 8.16
IBS Calculation System
The manual for IBS Content Scoring system (IBS Score) was formulated to standardise the measurement of IBS usage in buildings.According to the manual for IBS score (2018) , the IBS score more emphasis on the following attributes : 1) The usage of IBS components 2) The utilisation of standardized components based on MS 1064 3) Repitition of structural layout 4) The usage of productivity enhancing solutions such as volumetric modular units, Building Information Modelling (BIM) and Modular gridlines. Based on the manual, higher IBS score is a reflection of higher efficiency , reduction of site work, reduced wastage ,less products on site, cleaner environment, better quality, neater and better building sites, faster completion of project as well as reduction of overall building costs. The total IBS score for building is capped at 100 points.The IBS scores are divided into three categories : 1) Structural System ( Maximum score is 50 points) 2) Wall systems (Maximum Score is 20 points) 3) Other Simplified construction solutions ( Maximum Score is 30 points) The points are awarded based on the systems that are used in the building. The example and the score for the construction are provided on appendix.
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Summary
The construction system applied is in the line with the design principles consideration on economical to minimize cost by maximising the flexibility and sustainability to reduce the impact on site by using fast build materials,lightweight and natural materials.
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CHAPTER 9
Building Services
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Introduction
Chapter 9 explains on the technical part focusing on the services of the building project that includes (i) water supply and drainage (ii) fire protection system (iii) electrical distribution system (iv) sanitary and sewerage system (vi)telecommunication and control system. In this chapter. the system are described along with how the system are applied.
Water Supply Water Supply and Drainage
The water supply system that is used for the whole building in the centre is gravitational downfeed distribution system. The source of water supply provided by the authority is Ranhill SAJ Sdn. Bhd.The pipes are divided into two which are the direct pipes and the indirect pipes. Direct pipes are connected directly from the main pipe (after the reading meter) to the spaces that need clean water such as the kitchen.This is because the kitchen needs clean water for the purpose of preparing food and for drinking. For indirect pipes, the water is supplied directly to the suction tank. From the suction tank ,the water is distributed to the domestic water tank.
CHAPTER 9
The water supply is tapped along the main ingress and engress of the centre.The main pipeline is connected to the suction tank and then pumped to the domestic water tank. Location of the suction tank is at the lower point of the site which are at the north-west side and the domestic tanks are placed on roof to allow smooth distribution. Water Capacity Calculation
Calculation of the amount of water that needed to be supplied to the proposed recovering centre is calculated below. Calculation for the capacity of water needed is based on : Water Closet Bathtub Tap Basin Shower
: 40 gallon / unit : 42 gallon / unit : 20 gallon / unit : 20 gallon / unit : 20 gallon / unit
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Based on the above standard of water usage , the number of sanitary fittings is tabulated as per Table 9.1 and the amount of water capacity required for those sanitary fittings is calculated as per Table 9.2 TABLE 9.1 The number of sanitary fitting in the building.
TABLE 9.2 The amount of water capacity required for the sanitary fittings.
Therefore,the total water capacity required for the proposed building based on sanitary fittings it supplies is 6576 gallon. Water Tank Calculation
The actual number of water tank required for the proposed building determined based from the water capacity calculation. Below is the process of domestic tank calculation. Total water capacity : 6576 gallon FIGURE 9.1
Therefore Number of Tank required : 6576 gallon / 400 = 16.44 = 16 Tanks
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Rule of Thumb : 1 tank module (1.2m x 1.2m x 1.2m) = 400 gallon
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Water Plumbing Schematic Layout
Sanitary fitting within the new proposed building and how the water is supplied to them is diagrammatized in a schematic layout as in Figure 9.2
FIGURE 9.2
Summary of Provision
Summary of provision for water supply to the proposed building is being illustrated in the diagram form in Figure 9.3
FIGURE 9.3
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Fire Protection System Establish Parameters
To have an overall picture for the fire safety requirements needed to be complied. Designation of Purpose Groups
With reference to the UBBL Fifth schedule , the purpose group of the spaces within the development is determined. The spaces within the action plan are classified under institutional purpose groups.
FIGURE 9.4
Meanwhile, the second table in the Fifth Schedule mentioned the physical dimensional limit parameter for building From figure 9.5, the building could be build in any height as the limitless cubic capacity for the building
FIGURE 9.5
External Fire Hydrant The positioning referred to By Law 225 .The distance between the external hydrants is not more than 91.5 m apart
FIGURE 9.6
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Escape Staircase Based from the Seventh Schedule, the maximum travel distance allowed is 45m
FIGURE 9.7
FIGURE 9.8
Active Provision By referring to the UBBL Tenth Schedule ,The building falls under the purpose group of Institutional , Hospital and Nursing Homes Exceeding 250 sqm per floor (3-4 storey)
Extinguisher System : Hose Reel Fire Alarm System : Automatic Fire Detectors System & Signal Indicator Alarm System Emergency Illumination :Signal Point Units
FIGURE 9.9
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Summary of compliance
FIGURE 9.10
Electrical Distribution System Power Supply system The power supply components for the proposed building are 1) TNB substation (Transformer Gear , Switch Gear Room) 2) Main switch Room 3) Generator Set (Act as Emergency Backup)
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The size of the TNB substation provided is determined through TNB specification based on the area needed to be served.As mentioned in Figure 9.11, in order to cater for the whole development,a double chamber TNB substation is needed.The total floor area for the whole site plan developed is 4532 sqm.
FIGURE 9.11
Building Electrical Load Estimation
The electrical load calculated is just a preliminary estimation of maximum electrical load in watt (W) per sqft following JKR guideline.The maximum electricity demand is as follows.
FIGURE 9.12
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Air-conditioning and natural ventilation diagram
FIGURE 9.13.
Summary of compliance
FIGURE 9.14
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Sanitary and Sewarage System The sanitary and sewer lines will be chanelled to the original sewage line available on site with modifications to accommodate for the new development.Present manholes to connect with sewarage line are pre-determined. Sewer Manhole
Refuse Disposal System
The sewerage system used is the common sewer manhole as previously described. The manhole assists in sewer inspection , cleaning, and maintenance. Until being discharged into public drains, the last manhole will go to the sewerage treatment plant (STP). The maximum distance from each manhole is held < 30 m.
Refuse chamber for the whole development are placed at the loading area near the cafetaria and in between the admission block and the residential block. All the waste from the whole development will be manually collected there. According to Figure 9.16 , shows the services pathway to collect disposal items from each block. .
FIGURE 9.15
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FIGURE 9.16
In terms of loading items from loading bay, Figure 9.17, shows vertical transportation provided in the building with the service pathway that can be used to load the items.
FIGURE 9.17 CHAPTER 9
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Telecommunication and Control system Telecommucation provider is Telekom Malaysia (TM) offering networking to the site. Currently, traditional post and guard methods are being implemented. A control room should be proposed to better track users â&#x20AC;&#x2122; activities. The installation of the CCTV system is wise and will also safeguard staff health.The control room will act as the overall PA system,fire detection and telecommunication line as well. Summary Based from the evaluation on the building services applied and calculation performed,there are rooms of improvements for the current existing centre to improve in term of its operational system to cater for its smoothness in delivery better.
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CONCLUSION By the end of this design thesis project,it is learned how vital a space is for the wellbeing of the users and how important it is for building to be purposely built to its functions to serve its needs more effectively. Architectural Solution and Implementation : Objective 1 : To enhance healing environment for postpartum woman in
term of physical and psychological needs. Objective 1 of the design thesis project which focuses more on the architectural issue was achieved through several case studies of healing environment and interview with psychiatrist to cater an environment that suitable for postpartum depression mothers.Thus,the basic needs with the current issue of the facilities were outlined. Objective 2 : To evaluate proper space and method of confinement using
traditional methods. Objective 2 of the design thesis project pushes the cultural issue regrading the traditional method that is often neglected and not effective to postpartum mother.The objective highlighted spaces needed for recovery by used traditional method as part of treatment.The spaces are studies through out the case studies and interview.Thus,the basic needs and the effectiveness of the confinement spaces are being identified and highlighted. Recommendation:
As a recovery center for postpartum mothers, the design facilities shall be taken into account of the wellbeing of the users. The spaces and environment designed must be able to cater the emotional needs how the users feel when experiencing the spaces. The design shall make them feel better with positive effects on the users behaviours.
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Ghani, R. A., & Salehudin, S. (n.d.). Traditional Belief and Practice on Postpartum Recovery among Mothers in East Coast of Peninsular Malaysia. Retrieved November 13, 2019, from https://doi.org/10.1051/matecconf/201815005067 Ismail, E. (2017). Postpartum depression is real, though not often recognised Star2.com. Retrieved October 13, 2019, from https://www.star2.com/family/2017/05/26/recognising-postpartum-depression/ Johansen, S. L., Robakis, T. K., Williams, K. E., & Rasgon, N. L. (2019). Management of perinatal depression with non-drug interventions. BMJ (Online), 364. Retrieved January 13, 2019, from https://doi.org/10.1136/bmj.l322 Kenney, Lynn & Martin, D. (2016). Improving the Patient Experience Through the Health Care Physical Environment. Health Research & Educational Trust, (March), 1–23. Lynn, V. 2019 . Email to Liyana Yusoff , 26 October Lynn, V. 2017 , A recovery plan after pregnancy (podcast) . Retrieved October 24 ,2019 from https://www.bfm.my/podcast/enterprise/hervantage/ent-hv-arecovery-plan-after-pregnancy-valerie-lynn-the-mommy-plan Lynn,V. (2018 , May 14). The mummy sitters : The woman using ancient practices to care for new mothers. Retrieved from https://babyandchild.ae/formums/all-about-you/article/1301/the-mummy-sitters-the-women-usingancient-practices-to-care-for-new-mothers Manjunath, N., Venkatesh, G., & Rajanna. (2011). Postpartum blue is common in socially and economically insecure mothers. Indian Journal of Community Medicine, 36(3), 231–233. Retrieved from https://doi.org/10.4103/0970-0218.86527 Mariconte, R. Giliberti, C., Cavuto, C., & Strigari, L. (2015). Noise in healthcare facilities. 22nd International Congress on Sound and Vibration, ICSV 2015,2015-Janua(July), 12–16. Retrieved from https://www.researchgate.net/publication/280096374_noise _in_healthcare_facilities Maynard P., Shamp E. & Whaley J. (2005). The healing power of natural light, Douglas Publication . Retrieved from http://hmcarchitects.com/assets/news/publications/pdfs/natural_light.pdf REFERENCE
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Mohamad Yusuff, A. S., Tang, L., Binns, C. W., & Lee, A. H. (2015). Prevalence and risk factors for postnatal depression in Sabah, Malaysia: A cohort study. Women and Birth, 28(1), 25–29.Retrieved from https://doi.org/10.1016/j.wombi.2014.11.002 Mohd Arifin, S., Ahmad, A., Abdul Rahman, R., Loh, H. S., & Ng, C. G. (2014). Postpartum depression in Malaysian women: the association with the timing of pregnancy and sense of personal control during childbirth. International Journal of Academic Research, 6(3), 136– 142.https://doi.org/10.7813/2075-4124.2014/6-3/b.20 Ng, Chong. (2014). A review of depression research in malaysia. The Medical journal of Malaysia. 69 Suppl A. 42-5. Retrieved from https://www.researchgate.net/publication/268878811_A_review_of_depressi on_research_in_malaysia Oi-Zhen, Soh & Choong, Weng Wai & Yu-Tian, Tan. (2015). Quality of Healing Environment in Healthcare Facilities. Jurnal Teknologi. 74. 101-108. 10.11113/jt.v74.4529. Parsia, Y., & Tamyez, P. F. (2018). Role of Healthcare-Facilities layout design,healing Architecture on quality of services, International Journal of Civil Engineering and Technology (IJCIET, 9(4), 598–601.Retrieved from https://www.researchgate.net/publication/325100754_Role_of_healthcarefa cilities_layout_design_healing_architecture_on_quality_of_services Poh BK, Wong YP, & Abdul Karim N. (2005). Postpartum dietary intakes and food taboos among Chinese women attending maternal and child health clinics and maternity hospital, Kuala Lumpur. Malaysia Journal of Nutrition, 11(1): 1-21. Quintero, J. (2014). Postpartum Emotional Psychopathological Outcomes. Journal of General Practice, 02(04).Retrieved from https://doi.org/10.4172/2329-9126.1000162 Raven JH, Qiyan C, Toulhurst RJ & Garner P. (2007). Traditional beliefs and practices in the postpartum period in Fujian province, China: a qualitative study. BMC Pregnancy and Childbirth, 7: 8. doi: 10.1186/14712393-7-8 Ruiter, E. De. (2015).Healing soundscape: hospital acoustics 2.0. Euronoise2015, (June), 2439–2444. REFERENCE
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Salonen, H., Lahtinen, M., Lappalainen, S., Nevala, N., Knibbs, L. D., Morawska, L., & Reijula, K.(2013). Physical characteristics of the indoor environment that affect health and wellbeing in healthcare facilities: a review. Intelligent Buildings International, 5(1), 3–25. https://doi.org/10.1080/17508975.2013.774617 Schreuder, E., Lebesque, L., & Bottenheft, C. (2016). Healing Environments: What Design Factors Really Matter According to Patients? An Exploratory Analysis. Health Environments Research and Design Journal, 10(1), 87–105. Retrieved from https://doi.org/10.1177/1937586716643951 Temperamental | Definition of Temperamental by Merriam-Webster. (n.d.).Retrieved November 19, 2019, from https://www.merriamwebster.com/dictionary/temperamental Joseph, A., & Ulrich, R. (2007). Sound Control for Improved Outcomes in Healthcare Setting,Robert Wood Johnson Foundation,The Center for Health Design .Retrieved January 15, 2019, from https://www.healthdesign.org/sites/default/files/Sound%20Control.pdf Vavili F. & Kyrkou A. (2010) An overview of healing environments. World Hosp Health Serv, 46(2), 27–30.Retrieved from https://www.researchgate.net/publication/47697694_An_overview_of_heali ng_environments Virapongse, Arika & Picheansoonthon, Chayan. (2005). Researching Traditional Medicine: A Review and Evaluation of Objectives and Methodologies. Journal of the Royal Institute of Thailand. 30. 958. Wells YO, Dietsch E. Childbearing traditions of Indian women at home and abroad: An integrative literature review. Women Birth. Retrieved from https://doi.org/10.1016/j.wombi.2014.08.006 Zainal, N. Z., Kaka, A. S., Ng, C. G., Jawan, R., & Singh Gill, J. (2012). Prevalence of postpartum depression in a hospital setting among Malaysian mothers. Asia-Pacific Psychiatry, 4(2), 144–149. https://doi.org/10.1111/j.1758-5872.2011.00173.x Zetterquist, A. (2009). Healing Environments: Elements of Retreat (Master's thesis), Montana State University,Bozeman,Montana . Retrieved from August 16 , 2020 https://scholarworks.montana.edu/xmlui/bitstream/handle/1/2596/Zetterqui stA0509.pdf?sequence=1 REFERENCE
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APPENDIX I
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Thank you.