Positive distraction and the rehabilitation hospitals of joão filgueiras lima.
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OBJECTIVE: This article discusses the use of positive distraction, an evidence-based design approach, in rehabilitation hospitals in Brazil through the work of Joo Filgueiras Lima ("Lel"). BACKGROUND: In many parts of the world architects may not formally incorporate theories of positive distraction and evidence-based design, but there are multiple international examples of health facility architects and designers that use nature, daylighting, art, and social interaction to enhance the healing experience. The work of the Brazilian architect Joo Filgueiras Lima is a particularly salient example. Lima has been a dominant figure in 20th and 21st century Brazilian architecture and the architect of several rehabilitation facilities. METHODS: First positive distraction is defined as it relates to nature and art, and in the context of rehabilitation hospitals. Second, rehabilitation facilities are defined. The discussion then focuses on awareness of evidence-based design in Latin America. Next, Brazilian healthcare architecture is discussed along with the history of the Brazilian Sarah rehabilitation hospitals designed by Lel and Lel's role in the history of Brazilian architecture. Last we look at Lel's use of positive distraction. RESULTS: Despite Lel's recognition in Brazil, his work has not gained much international exposure. Lel played a critical role in the design of the Sarah facilities and served on the board of directors for the Technological Center of the Sarah Network (CTRS) in Brazil from 1992 to 2009. Based on our review of his work it was clear that Lel used positive distraction as a tool for creating healing environments. CONCLUSIONS: In spite of the lack of formal integration of evidence-based design in healthcare architecture in Latin America, many of its basic tenets have been incorporated in Brazilian rehabilitation hospitals. Lel's projects are a clear example of this phenomenon and demonstrate an alignment between research and practitioner objectives. The presence of nature, art, and natural light in his rehabilitation hospitals serves as a model for evidence-based design in facilities throughout the world and presents an opportunity to measure the benefits of positive distraction on rehabilitation patient outcomes.
