Aims
The sound environment, or soundscape, of intensive care units (ICUs) can be stressful for patients. Soundscapes are defined as acoustic environments as perceived by people. Single-patient rooms mitigate noise, but may deprive patients of essential auditory cues. This might harm basic psychological needs, such as safety. Experiences, needs and emotions regarding soundscapes of single-patient ICU rooms remain unexplored. We aimed to understand how patients experienced these soundscapes.

Methods
This mixed-methods, single-center study involved semi-structured interviews and questionnaires five days after ICU discharge. Patients experienced the soundscapes during their ICU stay, shared experiences in interviews, and selected one to rate on need fulfilment (with a researcher-developed questionnaire), and emotions (with a validated questionnaire). Using thematic analysis, we analyzed interview transcripts by labelling sound-related experiences, sounds, and emotions.

Findings
We interviewed 26 patients. We labelled 259 sound-related experiences, 264 sounds, and 281 emotions, from which six themes emerged: Orientation through sound; Coping with disruptions; Human auditory presence; Monotony and variation; Associations and hallucinations; Communication behind closed doors. Eight patient-selected experiences involved positive emotions. Need fulfilment scores varied: scores were low for communication-related experiences, but relatively high for those involving human presence.

Conclusions
Our findings demonstrated that experiences with single-patient ICU room soundscapes can be positive or negative. For future implementation of such rooms, three insights merit consideration: positive sounds originating from corridors may be unnecessarily removed; alarms in single-patient rooms serve key supportive functions for patients; there is a lack of accessible and appropriate auditory stimulation. We recommend that these insights are taken into consideration to ensure more positive and restorative ICU stays.

Implications for Clinical Practice
In ICUs, balanced approaches that consider both positive and negative aspects of soundscapes may benefit patients in future interventions for noise mitigation. Diversifying the variety of sounds inside patient rooms could further support well-being.

We explored the underpinnings of providing positive listener experiences for intensive care unit (ICU) patients with compositions of added sounds. Our objective was to derive an approach to such interventions based on soundscape perception and need fulfillment. In one study, we gathered qualitative empirical data about imagined soundscapes where nine fundamental needs were fulfilled. Hierarchical clustering and thematic analysis showed that imagined soundscapes clustered into four types of sonic ambiances, i.e., affective connotations with soundscapes: Comfortable, Pleasurable, Motivating, or Stimulating ambiances. We derived four design parameters to achieve these ambiances with sound compositions: eventfulness, sonic ambiance qualities, narrative structure, and sound distribution. A sound artist was asked to use these parameters to create sound compositions. In a listening experiment, we examined their effects on the perceived pleasantness and eventfulness of soundscapes and on listeners' experienced pleasure and arousal. Soundscapes were perceived as pleasant with varying eventfulness in line with our structured approach. We found a strong correlation between pleasantness and with listener's pleasure and a moderate correlation between eventfulness and with listener's arousal. Finally, we suggested that in future research, three sonic ambiance types should be considered rather than four. Concluding, we showed that our need-driven approach could form a promising way to support ICU patients.

Nature experiences, especially the visual aspects of nature, have been widely used to facilitate relaxation. Fueled by digital technology, simulated visual nature experiences have gained popularity in creating healing environments that induce relaxation. However, while easily applicable, not all nature-imitating visuals lead to relaxation. How to effectively design relaxing visual nature experiences remains largely unexplored. This paper investigates how different nature qualities facilitate relaxing visual experiences and the roles of two personal characteristics (mood and nature-relatedness) play. Through an online survey and interviews, we assessed 16 nature video clips, representing eight distinctive nature qualities, and compared perceived experiences while considering the influence of personal characteristics. The results indicate four types of visual qualities (engaging, instinctive, ambient, and derivative) underlying nature-induced relaxation, and show that nature relatedness influences the degree to which nature video clips elicit relaxation. We discuss design implications for creating personalized digital nature.

Psychological needs of users as a basis for design are at the core of design practice, yet the importance of fundamental human needs when designing soundscapes has not been studied specifically. This paper investigates the relationship between nine fundamental human needs and the affective qualities and categories of soundscapes. In a free-labeling survey study, we collected descriptions of imagined sound environments for the fulfilment of the needs, as well as ratings of the perceived affective quality of these environments. We found that needs were associated with pleasant soundscapes, while their eventfulness varied. ‘Human’ sounds were a common category for each of the nine needs considered in this study, but systematic variations of the categories were found dependent on the need. Results suggest that designing categorically different soundscapes dependent on the users’ needs will have beneficial effects.

Light takes just a short moment to travel from one point to another and to reach our eyes. Always immersed in the experience of light, we tend to take this for granted.