Sounds of Surgeries

Abstract

Noise in orthopedic operating theaters The medical staff working in orthopedic operating theaters are often exposed to significant noise generated by many simultaneous sound events (e.g. powered tools, alarms) that pose a risk to their health and well-being. This thesis focuses on their health behaviors associated with the sound situation. Existing literature provides evidence that noise in some orthopedic surgeries can cause health issues ranging from increased stress levels to noise-induced hearing loss. Nevertheless, literature research also shows that the field of sound and health assessment has not been widely explored. Consequently, this thesis has two aims: Firstly, understanding the soundscape, its entailing health risks and the motivations of current health behaviors of the medical staff in relation to the soundscape. Secondly, contributing to an improved sound situation and reduced health risks for medical staff applying design.  Sound perception and health behavior Applying the user research method “context mapping” (design method making people reflect on personal experiences) current health behaviors of the medical staff (e.g.surgeons, anesthesiologists) were investigated. In particular psychological consequences of noise are often underestimated. Sound levels in seven orthopedic surgeries (with varying surgical approaches) were assessed. Although the evaluation showed differences in sound levels, average sound levels did not exceed current legislation. Further investigations on sound characteristics(through psycho acoustic analysis) show that sound perceptions (e.g. pleasant or unpleasant sound experiences), causing psychological health impacts, are not sufficiently explained by loudness (i.e. especially average decibel levels).   Based on the research findings, that some sound situations in operating theaters are in parts hazardous and that the behavior of the medical staff is often non-precautionary, a theoretical framework (based on Social-Ecological Model (SEM)) was developed. It showcases the stakeholders directly or indirectly involved in potential behavior change processes towards an improved sound and health situation in operating theaters.This framework formed the core guideline for the consecutive design process,aiming to explore how behavior concerning the soundscape can be improved. The key discovery: There is a lack of awareness and knowledge of health consequences posed by sound within medical staff, as well as on other social-ecological levels (e.g. hospital management).  Design towards sound and health awareness The final design outcome, a website, targets a wide healthcare audience. The website initiates greater engagement concerning sound improvements through increasing awareness of the current sound situation in operating theaters. It caters to varying awareness levels: General information on sound and health in operating theaters (to increase knowledge and initiate awareness) and concrete action advice to transform awareness into action for sound improvement and risk reduction.  Reflecting on the final outcome and future research This thesis showed that sound perception in operating theaters is still not sufficiently explored. The initial evaluation with medical and non-medical staff participants indicates that the website successfully improves knowledge, triggers reflection and thereby sparks awareness. By further extending the websites’ sphere of activities, it has the potential to contribute to the achievement of better sound quality in operating theaters. This thesis concludes with suggestions on future sound and health behavior research.