Review Article
Environmental Design Strategies to Enhance Infection Prevention and Control in Hospice Facilities: A Scoping Literature Review
Sharmin Kader*
Issue:
Volume 15, Issue 5, October 2026
Pages:
168-186
Received:
24 August 2026
Accepted:
7 September 2026
Published:
15 September 2026
Abstract: Infection prevention and control (IPC) is a critical component of healthcare delivery, particularly for vulnerable populations at increased risk of healthcare-associated infections. Hospice patients may receive care in dedicated hospice facilities, long-term care facilities, or other healthcare environments, where infection prevention must coexist with broader therapeutic goals, including comfort, privacy, family involvement, and a home-like atmosphere. Although environmental design has been widely investigated in relation to IPC in healthcare settings, much of the existing evidence focuses on hospitals, with comparatively limited attention to hospice and long-term care environments. This study aimed to identify environmental design strategies that may enhance IPC in hospice facilities and examine their applicability within a hospice-specific therapeutic framework. A scoping literature review was conducted using PubMed and CINAHL for English-language studies published between 2015 and 2025. Following three rounds of screening, 30 studies were included. Data were extracted using standardized matrices documenting study characteristics, environmental and behavioral variables, outcomes, and key findings. Environmental findings were coded, compared, and analyzed using the environmental therapeutic goals and design criteria of the Hospice Environmental Assessment Protocol (HEAP) as an analytical framework. Three overarching themes and 14 subthemes emerged: ventilation and airborne infection control, including ventilation, filtration, airflow, and supplemental air disinfection; spatial planning, zoning, and circulation, including separation, shared spaces, circulation, access control, and room configuration; and environmental hygiene, surfaces, and cleaning, including high-touch surfaces, antimicrobial materials, environmental cleaning, disinfection technologies, and hand-hygiene-supportive design. The findings demonstrate that IPC in hospice environments extends beyond clinical safety and intersects with multiple therapeutic goals, including privacy, social interaction, autonomy, family accommodation, and staff support. Integrating IPC evidence with HEAP provides a framework for designing hospice environments that support infection prevention while preserving their therapeutic, residential, and family-centered qualities.
Abstract: Infection prevention and control (IPC) is a critical component of healthcare delivery, particularly for vulnerable populations at increased risk of healthcare-associated infections. Hospice patients may receive care in dedicated hospice facilities, long-term care facilities, or other healthcare environments, where infection prevention must coexist ...
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Research Article
Effectiveness of Cognitive Processing Therapy for Emotional Trauma in Cervical Cancer Patients at Referral Hospitals in Western Kenya
Milkah Obwenyi Angachi,
Josephine Muchiri*,
Lucy Njiru,
Sam Ojuade,
Peter Muhandale Itsura
Issue:
Volume 15, Issue 5, October 2026
Pages:
187-197
Received:
17 September 2026
Accepted:
30 September 2026
Published:
20 October 2026
DOI:
10.11648/j.ajap.20261505.12
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Views:
Abstract: Cervical cancer patients often experience significant psychological distress, including symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression. Cognitive Processing Therapy (CPT), a structured trauma-focused intervention, has shown promise in reducing such distress, but evidence in oncology settings remains limited. This study evaluated the effectiveness of CPT in alleviating psychological distress among outpatient cervical cancer patients attending two referral hospitals in Western Kenya. A quasi-experimental pretest-posttest design was employed with 68 participants (mean age = 42.6 years, SD = 8.9), recruited through purposive sampling and assigned to experimental and control groups. Key clinical characteristics such as cancer stage and treatment status were documented to contextualize findings. The experimental group received CPT, delivered in 12 weekly sessions of approximately 90 minutes each, while the control group received treatment as usual (standard medical support). Psychological distress was assessed using the Harvard Trauma Questionnaire (HTQ), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II) at baseline, 3-month follow-up, and 6-month follow-up. Results showed significant reductions in PTSD, anxiety, and depression symptoms in the experimental group compared to the control group. Mean scores decreased from baseline to 6-month follow-up for PTSD (M = 2.35 to 1.12), anxiety (M = 21.35 to 5.03), and depression (M = 21.10 to 7.86), while no meaningful changes were observed in the control group. Analysis of variance (ANOVA) confirmed statistically significant differences between groups post-intervention (after 12 weeks) and 6-month follow-ups (p < 0.001). Difference-in-Differences (DiD) estimators revealed mean declines of 0.97 (95% CI: 0.80-1.15) for PTSD, 16.78 (95% CI: 14.17-19.38) for anxiety, and 14.44 (95% CI: 11.64-17.25) for depression. Effect size analysis using partial eta squared (η2p) revealed medium effects for PTSD (η2p = .067) and depression (η2p =.064), and a medium-to-strong effect for anxiety (η2p =.073). These findings suggest that CPT is a promising intervention for reducing psychological distress among cervical cancer patients. Given the quasi-experimental design and relatively small sample, conclusions should be interpreted with caution. Nevertheless, integrating CPT alongside medical care could enhance quality of life outcomes in this population.
Abstract: Cervical cancer patients often experience significant psychological distress, including symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression. Cognitive Processing Therapy (CPT), a structured trauma-focused intervention, has shown promise in reducing such distress, but evidence in oncology settings remains limited. This study e...
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