Study of obstruction in usage of restrooms in nan hospital’s outpatient department in order to arrange appropriate facilities for elderly patients

Abstract

Nan Province has an elderly population proportion of 26.64%, prompting the provincial government to introduce the “Healthy City” policy as a model for developing public buildings with environments and facilities that are inclusive and suitable for everyone. As people age, their bodily functions deteriorate, leading most elderly individuals to suffer from chronic illnesses and require regular medical visits. This results in a high proportion of elderly patients in outpatient departments. Due to the typically long waiting times during hospital visits, elderly patients often need to use the restroom. However, mobility issues and balance problems common in this age group increase the risk of accidents enroute to the facilities. This study was therefore conducted to investigate the factors that create obstacles in restroom usage among elderly outpatients at Nan Hospital, in order to propose suitable facility arrangements aligned with the physical environment.

The objectives of this research were to identify the barriers elderly patients face in restroom use within the outpatient department and to recommend appropriate supportive facilities tailored to the needs of the elderly. The research question guiding the study was: "What are the appropriate design details for supportive facilities that accommodate restroom use for elderly patients in outpatient departments?" The study was based on the conceptual framework that age-related musculoskeletal degeneration contributes to balance issues. When combined with long walking distances and crowded spaces, these factors can increase the risk of restroom-related accidents. Providing suitable facilities can help mitigate these risks in crowded outpatient areas.

The research employed a mixed-methods approach, collecting both qualitative and quantitative data through a questionnaire administered to 285 elderly outpatients at Nan Hospital. The study was conducted in a natural setting without controlling environmental variables. Descriptive statistics, including frequency, percentage, and mean, were used for data analysis. Additionally, a chi-square statistical method was applied to examine the relationships between variables, leading to evidence-based recommendations for appropriate facility design.

The findings revealed two primary barriers to restroom use among elderly outpatients:
1) Insufficient number of restrooms, especially for women. The number of women's restrooms was half of the required standard, resulting in overcrowding due to the higher proportion of female users.
2) Excessive walking distance between waiting areas and restrooms. In some areas, elderly patients had to walk 67 to 62.00 meters, which is particularly problematic for individuals with mobility or balance issues. Inadequate signage and poor restroom visibility also contributed to confusion and increased risk of falls, especially considering the reduced walking speed among the elderly.

To address these challenges, it is recommended to install additional waiting seats or rest areas near restrooms. These would provide elderly patients a place to sit while waiting to use the facilities during peak times and help relieve muscle fatigue from prolonged standing or walking. Such measures enhance convenience and reduce fall risks. The seating should be robust, corrosion-resistant, moisture-resistant, capable of supporting weight safely, and designed to ensure user safety. Furthermore, walking paths should remain wide and unobstructed to accommodate safe movement.