Understanding the Links between Thermal Comfort and occupant Adaptive Behaviors in Naturally Ventilated Multi-Patient Wards in a Post-Epidemic Context

Abstract

To date, we lack comprehensive evidence about the dynamic links between the environmental, spatial, and socio-cultural aspects of adaptive thermal comfort in clinical settings. This paper reports for the first time on the entangled interactions between the adaptive behaviors among one of the largest samples of hospital occupants (750) and environmental, spatial, seasonal, temporal, and operational conditions, and personal factors as they unfolded in occupied naturally ventilated multi-patient wards in one of the worst Ebolaaffected countries. The analysis of a multidisciplinary dataset, which consisted of indoor and outdoor environmental measurements, window-opening behaviors, and adaptive thermal comfort perceptions, attitudes, and preferences, was conducted through the application of descriptive and inferential statistics and narrative analysis. Comparisons between modeled, reported, and observed thermal adaptability indicated that although occupant-controlled window operation was irresponsive to environmental changes, all occupant types were willing to adapt their metabolic rates, move to cooler places, and interact with building controls. At the same time, nursing practices integrated actions for the restoration of thermal comfort among patients. Established adaptive thermal comfort indexes with applicability in hot-humid clinical spaces overestimated the experienced discomfort. In contrast, reported thermal comfort was defined by lower tolerance levels to elevated temperatures during the warm season (28.20°C–29.38°C) and higher relative humidity levels during the rainy season (66.25%–67.50%). However, seasonal differences were not found in the occupants’ preferences for higher indoor airflows with the acceptable levels standing at 0.90 m/s. These results will help healthcare professionals to prevent indoor overheating in naturally ventilated wards.