# Thermal Comfort Applied in Hospital Environments: A Literature Review
## 4 Discussion  
RQ1: Considering Studies in Thermal Comfort in Hospital Environments, What Are the Main Aspects That Are Taken Into Account: HealthyWellbeing, Productivity or Energy Saving? Table 7 shows, for each study, which main aspect was taken into account by the authors that published the paper: \begin{table}
\begin{tabular}{c c} \hline
**Journal** & **Articles** \\ \hline _Building and Environment_ & 14 \\ _Energy and Buildings_ & 8 \\ _Applied Ergonomics_ & 2 \\ _Applied Sciences_ & 2 \\ _Indoor Air_ & 2 \\ _Indoor and Built Environment_ & 2 \\ _Journal of Hygiene_ & 2 \\ \hline \end{tabular}
\end{table} 
Table 6: Most relevant sources. Figure 4: Authors with more publications. Of the 60 research articles, only in [37] was it not possible to determine which aspect the work focuses on, leaving 59 articles. Although the energy-saving aspect is quite relevant and can be considered a research trend in the area, it corresponds to only 17% of the research on the theme that relates thermal comfort and hospital environments. Most works (81%) focus on the health/wellbeing aspect, and this research returned only one work that relates productivity and thermal comfort in hospital environments. Two possible explanations are raised in order to answer why only one study was performed taking into account the productivity aspect: according to [75, 78], temperature control is vital in hospitals, as it can indirectly influence the condition of the patient in addition to contributing to the onset of infections. Thus, research that attempts to ascertain the influence of thermal comfort on employee productivity becomes impracticable as it would be necessary to change these factors. Further, the difficulty in establishing parameters to measure the productivity of a team of doctors or nurses may be another reason. RQ2: Considering Studies of Thermal Comfort in Hospital Environments, Which Relate PMV and Real Thermal Sensation, Studies Indicate That PMV Predicted Well, Underestimates or Overestimates the Real Thermal Sensation? Over the 50 years after the publication of [PERSON]'s original research, this study found 24 studies that specifically applied PMV in hospital environments: [16; 17; 18; 20; 21; 45; 47; 48; 50; 51; 54; 56; 57; 59; 61; 64; 66; 67; 69; 71; 75; 77; 84]. Considering these 24 studies, 12 of them compared the real thermal sensation vote (TSV), which is the subjective vote obtained through a specific questionnaire, and the calculated PMV. Table 8 shows the results of these studies that performed a comparison:  
The PMV predicted well the real thermal sensation in [21; 69], whereas in the other studies, the PMV was somehow unable to accurately measure the actual mean vote reported by people. Thus, 10 out of the 12 studies concluded that, in some way, PMV was not suitable, either overestimating or underestimating when applied in hospital environments. A possible solution would be the use of adaptive comfort models to assess thermal comfort in hospital environments, in order to obtain better results when comparing real and calculated votes of thermal sensation. However, it is necessary to take into account that the sample is considerably small and more studies are required. \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Main Aspect** & **Articles** & **Total** & **\%** \\ \hline Health/Wellbeing & [14; 15; 16; 17; 18; 19; 20; 21; 26; 27; 35; 36; 39; 40; 43; 44; 45; 46; 47; 48; 50; 54; 56; 57; 58; 59; 61; 62; 64; 65; 66; 67; 68; 69; 71; 73; 76; 78; 79; 81; 83; 84] & 48 & 81\% \\ Productivity & & [77] & 1 & 2\% \\ Energy Saving & & [38; 41; 42; 52; 53; 55; 60; 63; 72; 82] & 10 & 17\% \\ \hline \hline \end{tabular}
\end{table} 
Table 7: Division of the main aspects.