No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Evaluating a children's hospital garden environment: Utilization and consumer satisfaction
Abstract
The Leichtag Family Healing Garden at Children's Hospital and Health Center, San Diego was planned and built as a healing environment space for patients, families, and staff. A Post-Occupancy Evaluation (POE) was conducted to determine whether the garden was meeting the goals of reducing stress, restoring hope and energy, and increasing consumer satisfaction. Results from behavioral observations, surveys, and interviews indicated a number of benefits of the garden. The garden was perceived as a place of restoration and healing, and use was accompanied by increased consumer satisfaction. However, the garden was not utilized as often or as effectively as intended. Children, parents and many staff members recommended changes for the garden, such as the inclusion of more trees and greenery, and more interactive ‘things for kids to do’. In addition, the majority of family members surveyed throughout the hospital did not know about the garden. Based on the findings, recommendations for changes were developed to promote better use of the garden. These research findings can be used to guide the future planning, design, building, and subsequent evaluation of garden environments in children's hospitals and pediatric settings.
... Studies have shown that properly designed hospital gardens offer comfortable landscape views for users, as well as opportunities for privacy and socialization, and have a stress-reducing effect on clinical results and the hospital environment [9]- [16]. Topics such as providing family atmosphere [15], [17]- [21] and designating volunteers to bring patients and visitors into the garden [18], [20], [21] will increase the comfort of garden use. ...
... Studies have shown that properly designed hospital gardens offer comfortable landscape views for users, as well as opportunities for privacy and socialization, and have a stress-reducing effect on clinical results and the hospital environment [9]- [16]. Topics such as providing family atmosphere [15], [17]- [21] and designating volunteers to bring patients and visitors into the garden [18], [20], [21] will increase the comfort of garden use. ...
... Different types of users need to be considered when designing hospital outdoor spaces. Studies found that adults and staff tended to seek places to sit and relax in the gardens, while children tended to be active, seeking to interact with the garden [20], [21], [28]. The results of the study by Georgi and Petros show that hospital users emphasized that they attach importance to roads, recreational areas, social and public areas, personal areas, water views, and a dominant, limited colour range in planting in landscaping [29]. ...
This study aims to evaluate hospital outdoor design landscaping requirements. In addition to taking into account user groups such as adult and child patients, hospital staff and visitors, also such elements as hospital entrances and exits, parking areas, hospital roads, children’s playgrounds, rest areas, water elements, art elements, field furniture, planting and maintenance subjects were determined to be important in a successful hospital garden design. A checklist has been prepared that includes these identified issues. The checklist was tested on five selected hospitals in Baku, Azerbaijan. According to a comparative analysis of hospital outdoor designs, it was determined that the Liv Bona Dea Hospital topped the list, followed by the National Oncology Hospital as having the most successful open space hospital designs.
... The term "restoration" should involve positive impact on the HRQOL domains, as demonstrated by Han (2003) in his Restoration Scale which measures the impact of observing a landscape on emotional, physiological, cognitive, and behavioral dimensions. Although most studies have not utilized randomized controlled experimental designs to test cause-effect relationships, the findings from the research literature, using mostly quasi-experimental, observational, and correlation designs, suggest that access to windows with views of nature, art that is naturefocused and engages the imagination, cleanliness of facilities, spaciousness of rooms, a sense of control over the environment, and a sense of privacy are important elements that contribute to positive perceptions of HRQOL in children and adults (e.g., Beauchemin and Hays 1996;Rubin et al. 1998;Ulrich 1984;1991;Ulrich et al. 2004;Varni et al. 2004;Whitehouse et al. 2001;Tse, Ng, Chung and Wong 2002). ...
... Studies on the hospital physical environment have demonstrated significant associations not only with health outcomes (Ulrich 1984;1991), but also with greater satisfaction with general healthcare services (Pilpel 1996;Verdeber and Reuman 1987). This relationship has also been found with parents of pediatric patients (Varni et al. 2004;Whitehouse et al. 2001). In a study assessing the healthcare built environmental satisfaction among parents of severely developmentally disabled children in a residential convalescent hospital, Varni et al. (2004) found large significant positive correlations between parents' built environment satisfaction and their satisfaction with healthcare services. ...
... Results from studies of pediatric healing gardens in children's hospital settings are consistent with nature's restorative properties (see the next section). In one study of a pediatric healing garden, patients reported that the garden improved their mood and satisfaction with the hospital, and that it was important to "get away" from the hospital built environment (Whitehouse et al. 2001). In another pediatric healing garden study, a small sample of patients, visitors and staff in the three gardens surrounding a pediatric cancer center showed a consistently better, though non-statistically significant, pattern of improved present functioning (e.g., less sadness, anger, anxiety, worry, pain, and fatigue) on a number of affective scales than a similar sample that was inside the hospital built environment (Sherman et al. in press). ...
... Mikropların kırılmasını ve hastanın direncinin artırılmasını sağlayan etkenler arasında, hastaların tedavi olduğu ünitelerin steril ve düzenli yerler olması gerektiği ortaya konulmuştur. Mühendisliğin de ilerlemesiyle beraber çok katlı hastane yapılarının inşa edildiği ve bu hastanelerde ki hastaların iyileşme oranlarının arttığı ama aynı zamanda stres seviyelerinde de artış olduğu belirlenmiştir (Whitehouse et al., 2001). ...
... Özellikle farklı hasta gruplarını tedavi eden; hastane, yaşlıların kaldığı bakımevi, zihinsel ve fiziksel özürlülerin tedavi gördükleri rehabilitasyon merkezleri, psikiyatri merkezleri vb. kuruluşların bahçelerinin tasarımlarını bu yönde incelemişlerdir (Whitehouse et al., 2001). ...
... Yakın zamanda gündeme gelen iyileştirme bahçeleri ile ilgili yapılan araştırmalar sonucunda insan mekanizmasının tabiatla birebir ilişkili olduğu bulunmuş olup, yaşam stresi ve psikolojik sarsıntılarla doğa arasında bir bağlantı kurulmuş ve doğanın insan yaşamında bir tampon görevi üstlendiği anlaşılmıştır (Sherman et al., 2005). Ayrıca doğanın ve iyi düzenlenmiş dış mekan alanlarının insanlar üzerindeki stresi azalttığı ve ruhsal durumlarını olumlu yönde etkilediği belirlenmiştir ( Whitehouse et al., 2001). ...
Tarih boyunca insanların doğayı sağlık bulma yönünde çeşitli amaçlarla kullandığı bilinmektedir. Doğanın bir parçası olan bahçeyi; insanların dinlenmek, eğlenmek, kendilerini iyi hissetmek, aktif veya pasif aktivitelerde bulunmak için seçtikleri güvenilir alanlar olarak tanımlamak olasıdır. İlerleyen mühendislik ve teknoloji, artan nüfus yoğun bir şehircilik anlayışını da beraberinde getirmiştir. Tabiattan gittikçe uzaklaşan, daha çok betonun hakim olduğu bu şehirlerde insanlar çağın vebası olarak kabul edilen depresyon ve buna bağlı bir çok psikolojik rahatsızlıklara maruz kalmışlardır. Günümüzde birçok bilim adamı doğal veya düzenlenmiş çevrenin sağlıklı kalma ve iyileşme üzerine katkılarını araştırmakta olup bu konuda önemli sonuçlara ulaşılmıştır. Bu çalışmanın amacı rehabilitasyon merkezlerinde tedavi edilen zihinsel ve fiziksel özürlü çocukların, huzurevlerinde kalan yaşlıların ve hastanelerde tedavi gören hastaların psikolojik ve fiziksel sağlıkları ile sosyal yaşantıları üzerine sağlık bahçelerinin olumlu etkilerini ve bu etkilerin oluşmasındaki tasarım ilkelerinin belirlenmesini konu alan araştırmaları incelemek ve bu araştırmaların sonuçlarını ortaya koymaya çalışmaktır. Anahtar kelimeler: iyileştirme bahçeleri, bitkisel terapi, açık alan_______________________________________________________________________ It is known that throughout his history human being has used the nature for different aims to keep his fitness. It is possible to define gardens that are the part of the nature as the secure areas that people choose for recreation, entertainment, active or passive activities. Advanced engineering and technology and overpopulation have caused an understanding of dense urbanisation. In these cities very far from the nature and where mostly concrete is revalent, people are exposed to the psychological disorders such as depression which is said to be the plague of our age. Today many authors have researched the contributions of an environment that is natural or designed naturally on the health and found considerable important evidence. The aim of this study is to review the papers dealing with the favourable effects of the health gardens and their design factors on the children treated in the rehabilitation centres, the old in the charity houses and psychologically treated patients in hospitals and their social lives; and to interpret the outcomes of these studies. Keywords: Healing gardens, horticultural theraphy, outdoor space
... Walking meditations in natural environments, like the 'soundwalks' mentioned above, and adventure therapy or education in nature fulfill the double function of improving youth well-being through emotional engagement and, in turn, increasing PEB (Barrable, Booth, Adams, & Beauchamp, 2021;Mansfield, Cotton, & Ginns, 2020;Rosa, Larson, Collado, & Profice, 2021). Providing natural spaces using design recommendations for therapeutic outdoor environments and trauma-informed approaches is likely relevant for supporting active emotional engagement and biophilic nature connection in learning environments (Camponeschi, 2022;Tamblyn et al., 2022;Whitehouse et al., 2001). In children's hospital gardens, for example, Whitehouse et al. (2001), recommend incorporating features with running water, giving the space a sense of enclosure (e.g., with trees, tall grasses, or shrubs), and having plants and artwork that stimulate multiple senses (e.g., lavender flowers, edible plants, and labels for them). ...
... Providing natural spaces using design recommendations for therapeutic outdoor environments and trauma-informed approaches is likely relevant for supporting active emotional engagement and biophilic nature connection in learning environments (Camponeschi, 2022;Tamblyn et al., 2022;Whitehouse et al., 2001). In children's hospital gardens, for example, Whitehouse et al. (2001), recommend incorporating features with running water, giving the space a sense of enclosure (e.g., with trees, tall grasses, or shrubs), and having plants and artwork that stimulate multiple senses (e.g., lavender flowers, edible plants, and labels for them). ...
This chapter first summarizes how the consequences of global climate change (GCC) can harm young people's well-being through physical health impacts and awareness of GCC. We then outline how youth may cope with GCC by denying the problem, distancing themselves from it, or taking individual actions. However, the coping strategy shown to have the best mental well-being outcomes relates to collective actions and agency. Next, an examination of school-based GCC interventions reveals that engaging, participatory approaches may be more effective in promoting positive outcomes for youth and climate action. Our main contribution is a discussion of how the evidence-based design of learning environments presents an undeveloped but potentially effective way to enhance interventions for the development of constructive GCC coping strategies among youth. Utilizing environmental affordances and design as scaffolding can guide the design of learning environments that give youth opportunities for active cognitive, emotional, and physical engagement with climate change education. Natural environments may be particularly effective in supporting active engagement and pathways to constructive coping. More research is needed to understand what design features underly these pathways to improved well-being and GCC coping strategies that may have positive implications for youth climate action.
... This trend was followed by monasteries in Egypt before spreading to Western Europe in the 5th century A.D. [3]. In the Middle Ages, cloisters were used as primary settings for patients to be treated by monks within monasteries [4]. They contained herbaceous planting which was thought to be medicinal. ...
... Past debates argued that gardens put economic pressures on hospitals and financial resources are better spent on direct patient care or the advancement of technologies within hospitals [4,106]. In response to this, there is evidence that access to views of nature can speed up recovery rates and result in fewer requests for pain relief medication, thus reducing costs for hospitals in the long term and freeing up bed spaces faster [107]. ...
Despite the well-known benefits of healing gardens for children in healthcare facilities, policies and guidelines for their implementation are lacking, leading to their undervaluation by policymakers. This literature review investigates the advantages of healing gardens for children's health and wellbeing, with a focus on public-funded healthcare facilities. The review explores the definition of a healing garden, theories, the value of play, the impact on children's development, and the environmental benefits of healing gardens. Additionally, the review presents successful examples of healing gardens in practice, while acknowledging potential arguments against them and associated risks. During the literature review, research gaps were identified, and areas for future research were also examined. Finally, this review calls for evidence-based guidelines for policymakers and designers to incorporate healing gardens into healthcare facilities, providing a comprehensive argument for their adoption and regular access for children.
... Urban life is known to cause many public health problems [1,2]. Experts state that people should be close to nature due to diseases arising from this confusion [3][4][5]. The need for individuals to provide therapy has increased with the increase in busy living conditions. ...
... If you perform the activities you chose in question 18 in this park and this park was the style you wanted, would you consider spending time here more often? Please, answer according to the values between the statements Strongly Disagree (1) and Strongly Agree(5). ...
One of the biggest problems of societies living in modern world cities is the stress brought by a fast lifestyle. Stress affects individuals psychologically, physically, and socially. With the increase in the factors that cause stress, the need for places that individuals can use as therapy areas has also increased. Especially in this period when the 2030 100 EU (European Union) Cities Mission is determined, it is very important to design urban green spaces where the environmental and social criteria of sustainability are met, as places where society can breathe and where the society gets away from stress. In this study, based on the experiential quality criteria in outdoor therapy gardens, and the results of the evaluations made by experts and users, suggestions are made to improve the conditions of Birlik Park, located in the Gaziemir district of Izmir, one of the cities selected for the 100 EU Cities Mission, and to use it as an open space therapy garden.
... Other studies show the importance of creating a 4-5 December 2022 / Full Text Book www.icontechsurveys.org relaxation area by combining indoor space with the exterior green space, healing gardens, courtyards, and green elements that provide a healing environment for patients, the goal of the Healing Environment is to turn the hospital setting into a place to support families in the physical, emotional, and spiritual healing process (Sandra Whitehouse, 2001). On the other hand, Ulrich et al, (2004;21) showed that physiological changes, such as a decrease in blood pressure and heart activity, have been shown to occur as a result of viewing nature in laboratory and clinical studies. ...
... Some studies reported that the decline of job satisfaction contributes to shortages of qualified staff which jeopardizes the quality of care that patients receive (Ulrich, 2002). Also, evidence emphasized that hospital gardens increase job satisfaction which may help in maintaining staff qualifications (Whitehouse et al., 2001). In addition, reports showed that nurse and staff rooms with view over the greenery increase the workplace staff satisfaction and leads to well performance (Sadler, 2001). ...
Recently, many scientific papers discussed the importance of green spaces in designing hospitals and its impact on mental and physical well-being of hospital attenders. The natural environment around hospitals plays an important role in boosting the psychological well-being of patients and staff. The current study attempts to examine the impact of green spaces by providing a case study of evaluating and assessing outdoor and indoor gardens and their impact on patient outcomes and staff performance in Shar hospital in Sulaymaniyah, Iraq. In order to assess the green spaces in Shar hospital, the research adopted a qualitative and quantitative approach enhanced with field observation. The approach is oriented towards hospital attendees and their personal observations. In addition, the study concentrates on analyzing and assessing different key areas in Shar Hospital; outdoor gardens, main reception hall, waiting area, corridors, doctor rooms and patient rooms and wards. Then the important findings were derived in the design of outdoor and indoor greenery and its effects on hospital occupants. The research finds that gardens and plants have positive effects in reducing negative effects such as stress and fatigue on patients and staff. The research also finds that greenery beneficial in creating a healthy environment, and recommends that interior and outdoor green spaces should be designed and operated as therapeutic and healing spaces for all hospital occupants. Keywords: greenery in hospitals and healthcare facilities, benefits of green spaces, positive effects of gardens on patients and staff, natural environment improves physiological and psychological effects.
... Numerous studies have highlighted the impact of nature on patients' and hospital staff's health outcomes, satisfaction, and well-being [9,20,[58][59][60]. Natural features in-clude a view through a window, indoor and outdoor plants and gardens, representational visual media of nature, etc. [61][62][63][64]. ...
... According to Park and Mattson [64], placing indoor plants in patients' rooms accelerated patients' recovery while also improving satisfaction with their rooms. Hospital gardens provided stress reduction and psychological relaxation to adult patients, family members, visitors, and nurses [63,[67][68][69] as well as hospitalized children [60]. The visibility and physical access to the pediatric hospital gardens were examined and design recommendations were suggested to enhance visitation and physical activities in the hospital garden concerning access, function, visibility, and amenities [70,71]. ...
This study presents architectural designers’ perception of the importance of healthcare environmental criteria in the implementation of user-centered, therapeutic hospital design. Architectural designers with over three years of professional experience (N = 182) in South Korea were surveyed using an empirical questionnaire. The extensive interviews of 15 hospital design experts followed to interpret the survey results and discuss the barriers and suggestions for the successful delivery of therapeutic healthcare design practice. Among the 27 variables selected from the preliminary literature review, factor analyses revealed seven important therapeutic environmental criteria (i.e., management, interior design, spatial quality, service, nature and rest, ambient indoor comfort, and social program and space; χ2 = 1783.088, df = 300, p < 0.001). Analyses of variance revealed the level of importance among these criteria related to respondents’ personal and professional characteristics. Significant differences were found for the variables from the management, interior design, and spatial quality factors in relation to the respondents sex and age. For the successful delivery of therapeutic healthcare design, the design experts highlighted the implementation of evidence-based design practice that integrates local and international knowledge from various hospital users and multi-disciplinary specialists participating in the healthcare design process.
... The place at which patients and physicians meet plays a special role in the interaction between patients and doctors, that is, the medical clinic or the hospital (dental office in the case of dentistry). Today, healthcare facilities are considered among the most complex institutional structures, not only in terms of complicated medical supplies, but also in terms of some sensitive problems, such as the psychological needs of users [1][2][3]. ...
... It presents a profile that indicates the strengths and weaknesses of a design or an existing building and can be used as a standalone form or for evaluation workshops. Each indicator can be weighted as high (2), normal (1), or zero (0) and is evaluated with a six-point Likert scale. The evaluated indicators include privacy, compatibility, and dignity (patients' privacy and dignity must be maintained while in health facilities); views, nature, and outdoor (the degree to which patients can see outside and around the building); comfort and control (hospital layout should minimize unwanted noise in patient areas and patients should also be able to easily control internal temperature and lighting); legibility of the place (building layouts should be clear and easy to understand, so patients can easily find their way with ease); and interior appearance (patient spaces should feel homely, while interior spaces should feel light and airy; have a variety of colors; and look clean, tidy, and cared for) [38]. ...
The physical environment of healthcare settings can promote both the healing process and patient feelings of well-being, as well as instill positive emotions in employees. The present study aimed to evaluate the dental work environment of a typical private and public dental clinic to identify key parameters that determine the perception of health facilities by patients and employees. The study was carried out from 1 to 20 December 2021, in two dental clinics in Ekaterinburg (Russian Federation) using ‘ASPECT’. The participants were 58 staff and 94 patients. The results showed that, compared with patients, staff reported higher views scores, nature and outdoors scores, and comfort and control scores. The common criterion that distinguishes private clinics from public ones was comfort and control. Compared with patients in state clinics, patients in private clinics reported higher privacy, company and dignity scores, comfort and control scores, interior appearance scores, and facility scores. In general, while views scores and nature parameters can be singled out as a universal absolute value for everyone in a particular environment, staff pay more attention to factors that contribute to long-term comfortable stay and performance of their duties.
... Further design considerations are brought to light in the Whitehouse et al. (2001) study, where, it was observed that a design skewed toward hardscape elements, led to suggestions from users for more diverse vegetation, including shade-providing trees. Younger users expressed a desire for more activities within the garden, such as gardening tasks and plant identification opportunities. ...
It has been documented that patients with mental or physical disabilities can benefit from being placed within the setting of a natural environment. Consequently, the concept of creating spaces that can enhance health preservation or patient recovery, while also augmenting environmental and aesthetic value, has merged as a contemporary discourse. Green areas around hospitals can offer a great opportunity to incorporate healing gardens to benefit their patients and not only. The aim of this paper is to propose a design for a sensory-therapeutic garden based on key principles derived from selected academic literature, focusing on the application of these principles in a healthcare setting in Cluj-Napoca, Romania. The design was informed also by onsite data collection and analysis, and it aims to create a healing landscape that addresses the needs of patients, healthcare providers, and visitors. This study seeks to augment the discourse in the field by demonstrating the practical application of key therapeutic garden design principles in a specific context and how these principles impacted the design process.
... pacientes, acompanhantes e funcionários (Pasha & Shepley, 2013) e maior aderência aos planos de tratamento por parte dos pacientes pediátricos (Curtillo et al., 2015). (Whitehouse et al., 2001). Assim sendo, espaços destinados a esses usos também devem ser idealizados. ...
Pesquisas pertinentes apontam que estímulos arquitetônicos contribuem com a restauração do equilíbrio do corpo e, consequentemente, com o bem-estar. Para mais, tais estudos compilam vantagens para o tratamento de pacientes hospitalizados, principalmente, advindas do contato com ambientes naturais, o que pode ser elucidado pela Teoria da Biophilia. Por intermédio de revisão bibliográfica e análise de pesquisas aplicadas em hospitais nacionais e internacionais, extraídas de bases de indexação da produção científica no período de 2000-2020, contatou-se que as áreas verdes em ambiências hospitalares [a] promovem estímulos que potencializam emoções e sentimentos positivos; [b] agem na diminuição dos níveis de estresse e ansiedade; [c] reduzem a dor, a ingestão de analgésicos e o tempo de internação; e [d] aumentam a satisfação do paciente. Com a divulgação destes resultados, almeja-se, além de evidenciar a indispensabilidade de mais estudos a respeito, e da real conexão de disciplinas afins para análise profunda e holística da relação corpo-mente-espaço, indicar perspectivas às ambiências hospitalares.
... Insufficient greenery, shading, and seating are some of the factors that prevent people from visiting gardens in hospitals (Pasha, 2013). Whitehouse et al. (2001), propose recommendations for overcoming the barrier to garden visitation as (1) staff members must be updated on the garden's intent, and how to integrate it into the patient and family care (2) colorful brochures with images that provide details about the garden and directions to get there (3) flyers about the garden could be put in lifts and other high activity areas to improve the visibility of garden details. ...
Aim: This study identifies, evaluates, and synthesizes the recent literature related to the pediatric healing environment and presents the impact of physical environments on the health outcomes of pediatric patients, families, and staff. Background: Recent studies have shown that the physical environment has an increasing impact on health outcomes, however, the effects of the physical environment of the pediatric healthcare settings on health outcomes of patients, families, and staff have not been extensively investigated. Methods: A multi-phased approach was adopted to review literature, including a literature search, screening, and selection of literature, its appraisal, and discussion. Electronic databases: Scopus, PubMed, and Web of Science were searched to find peer-reviewed articles between 2000 to 2020. Finally, a total of 38 peer-reviewed articles were examined and discussed. Results: The findings suggest that design strategies, such as improved layout, proper rooms, orientation, adequate light & ventilation, positive distraction, and play can help patients achieve better outcomes. The result is grouped into seven research themes. (1) architectural features; (2) interior design features; (3) environmental attributes; (4) access to nature; (5) artwork & thematic design; (6) interactive technologies and positive distractions; (7) family and peer support. Conclusion: The result indicates that an appropriately designed pediatric healthcare environment has several positive effects, including lower levels of anxiety and fear among patients, improved family experience, and improved staff satisfaction with the work environment.
... Friedrich (1999) valued aesthetically pleasing art as it boosts patients' healing process. Since healing environments include physical and cultural surroundings supporting patients and families, various hospital rooms, outdoor areas of hospital buildings, and artworks can contribute to patients' healing process (Harris et al., 2002;Whitehouse et al., 2001). As Gesler et al. (2004) suggested, hospital design should be comprehensively planned by combining physical, social, and symbolic attributes of environments that potentially provide positive experiences to patients. ...
Although health professionals have recognized critical connections between health outcomes and physical hospital settings, research data on adolescent patients’ age-appropriate hospital design is insufficient, especially for activity rooms. To explore age-appropriate spatial needs and hospital room design attributes for adolescent patients, the present study examined their spatial needs in hospitals and their perceptions of hospital activity room photos. Thirty-two adolescent outpatients from a university hospital in Kentucky, aged between 15 and 18, completed the survey. Adolescents’ spatial needs during their hospital stays were surveyed on a 5-point Likert scale, and the highly rated need was to have privacy control, followed by the need for quiet places and activity places. The participants’ perceptions of the four hospital activity room photos were collected using twenty-two adjective words on a 5-point scale. The finding revealed that adolescent patients need activity rooms to meet and socialize with their peers during their hospital stays. The statistical analysis revealed enjoyable, controllable, and adult-like as the dominant design attributes of age-appropriate activity rooms for adolescent patients. Unlike activity areas in pediatric hospitals, adolescent hospital activity rooms should be enjoyable to adolescents and allow them to control privacy while providing opportunities to meet their peers.
... Research finds that life events sometimes lead to lower satisfaction, especially if a transition is unexpected. For the elderly (Lawther, 1980), children (Whitehouse et al., 2001), the psychiatrically treated (Broz, 1996), those marrying (Russell & Lyster, 1992), the disabled (Wilhite & Sheldon, 2008), and others who perceive their life events as uncertain or stressful, life satisfaction may be elusive. In fact, based on Van Gennep's work on rites of passage, one of the critical stages of transition, liminality (i.e. an uncertain feeling), has been an important focus of examination in consumer literature (Gentry et al., 1995;Hopkins et al., 2014;Kennett-Hensel et al., 2012;Thyroff et al., 2018;Van Gennep, 1960). ...
... A study by Harris et al. [64] indicated that art therapy in hospital environments is a key indicator of hospital satisfaction. This viewpoint has been supported by subsequent studies [65,66]. Zhang [67] demonstrated the significant impact of decorative art in creating emotionally therapeutic landscapes in public spaces and satisfying individuals' spiritual pursuits. ...
The COVID-19 pandemic has had a significant impact on the global tourism industry, leading to a decrease in peoples’ willingness to travel and a sense of insecurity regarding tourist destinations. Therefore, restoring people’s willingness to travel is the greatest challenge faced by this industry in the post-pandemic era. The tourism industry requires innovative solutions to achieve sustainable recovery. While there is a considerable amount of research on its recovery during the pandemic, there are few studies exploring people’s willingness to travel to encourage sustainable and resilient recovery in the post-pandemic era. This study employed a quality model to examine the satisfaction and intention of tourists towards the application of online digital art exhibitions under the influence of COVID-19. The aim was to investigate the promoting role of online digital art exhibitions in the sustainability and resilient recovery of the tourism industry. To achieve these objectives, this study focuses on the online digital art exhibition of Song Dynasty figure paintings launched by China Central Television (CCTV), with post-exhibition surveys conducted and 512 valid questionnaires collected. The research model and hypotheses are tested using structural equation modeling. The results of this study indicate that travelers’ intentions to engage in on-site visits through online digital exhibitions are determined by three factors: perceived value, satisfaction, and art therapy. Furthermore, online digital art exhibitions not only represented the most important form of tourism during the pandemic, but they also provided significant psychological healing. They have become a driving force for the transformation of the current culture and tourism industry and the promotion of its sustainable development. This research provides a benchmark for future research on the tourism industry, and it offers new research directions in the field of sustainable tourism.
... Connecting nature in hospitals is another way to provide opportunities for patients to move out in the lap of nature as nature is any ways healing and soothing for the mind and body. Whitehouse et al. (2001), suggested that integration of nature improves mood and hospital satisfaction 4) Sensorial dimensions:Finding from the survey shows that 38.5% does not like noise, 61.5% does not like smell, and 46.5% does not like crowd. Therefore while designing care has to be taken for smell and noise reduction. ...
The thought of spending time in a hospital as a patient or visitor is stressful and scary for anyone, and more so for children. Children’s hospital should be child friendly and safe, thus creating a “small world in itself”. The aim of this paper is to understand how children’s hospitals can be designed to make the hospital experience for children less stressful, while attempting to accomplish a building more pleasant and child-friendly. The research explores ways to integrate elements and principles in children’s hospitals by studying child psychology to create a child friendly environment where the children will forget their pain and will not be scared of hospitalization. The first part of the research is based on literature review, exploring the Children psychology according to age and their perspective towards built environment. In second stage, a set of guidelines were compiled addressing the factors that influence healing environments. In a third stage, three case studies are being done.Survey has been done of Primary users (children between 6 to 18 years) Secondary users (Parents of children below 6 years), as this age group are unable to express or answer and understand the questions. Data collected has been analyzed and parameters found, sense of control, social support, positive distractions, sensorial dimensions and age appropriate environment to determine the elements and spaces for children’s hospital environments that can be used to strengthen the designs.
... There are many studies showing the relationship between natural green space and human health [7][8][9][10] . Some research reveals the ecological benefits [11] , recreational benefits [12] , psychological benefits [13][14][15][16] , environmental benefits [17] , and economic benefits [18] of open green spaces. ...
The aim of the study is to show which areas mainly prefered when the people want to carry out recreational activities in the Kastamonu city center and determine the appropriateness of this area for recreative activity. A questionnaire study was conducted with 100 randomly selected people in order to determine the most frequently used open green area in terms of recreational activity in Kastamonu and the results showed that 89% of the participants prefer the Clock Tower. Thus Clock Tower was determined as a research area in this study. It is revealed the current state of the Clock Tower in scope of the study, plants are used in this area and the purpose of use of these plants is determined and how frequently users use this area and the reasons for not frequent use. In addition, activities that are effected in the area and changes in mood after using the area. The second survey study was conducted on users of the area consisting of 118 people. It is revealed space features existing at Clock Tower and events area identified after that space features that users want to be in this area and events areas. Thus, the aim of the area is to determine the users' expectations and the deficiencies and problems in this area.
... In this regard, American researchers conducted a semistructured interview and found that natural elements had positive effects on sick children in a hospital (11). In 2005, Hutton also conducted qualitative research on seven sick teenagers and asked them to do drawing of their favorite room meeting their needs (12). ...
Objectives: According to the available evidence, changes in the design of medical centers, which can create a more comfortable, pleasant, and natural environment, have reduced the patient tensions and increased their satisfaction with the quality of treatment in the given centers. The present study aimed to investigate the effect of the architecture and design of a supportive care environment on the treatment process in hospitals adopting a qualitative study design. Materials and Methods: This qualitative study with a phenomenological approach was conducted to investigate the effect of an optimal supportive care environment in hospitals based on the experiences and opinions of experts, university professors of architecture, and doctors in hospitals. To this end, experts were interviewed qualitatively and, then, eight main themes as well as 22 sub-themes were classified by performing content analysis. Furthermore, the effect of the environment on the patients, treatment control length, blood pressure control, and subjective nature of the disease’s impact, as well as the effect of social relations on the vital signs, comprehensiveness and acceptability, place of using the supportive care model and a completely mechanical attitude towards humans in the modern period were all evaluated. Results: The effect of the optimal supportive care environment on the patients’ treatment processes was confirmed by qualitatively reviewing the experts’ viewpoints and collecting comprehensive information from other sources. Conclusions: In sum, it was recommended that that the heads of the hospitals should consider the concepts of optimal supportive care environment when designing and/or reconstructing hospitals.
... Moreover, people have used nature for healing purposes for long years. Green fields are characterized as a part of nature and are defined as sites where people engage in active or passive activities (Whitehouse et al, 2001). ...
... Consideramos um ambiente confortável quando nos sentimos em estado de neutralidade térmica em relação a ele. Nos ambientes hospitalares, em especial, a satisfação térmica de pacientes em recuperação é fator importante e colaborativa no processo terapêutico no momento em que age positivamente no inconsciente A presença do componente vegetal na forma de jardins planejados oferece notável conforto visual e emocional pelo microclima agradável que proporciona aos ambientes contíguos em cuja humanização estimular uma benéfica interação social através de atividades geradas no entorno destes lugares(WHITEHOUSE et al., 2001). Quando concebidos como parte integrante da arquitetura, o Paisagismo aqui visto como processo consciente de recriação e planejamento de áreas livres pode ser uma peça-chave para qualificação do projeto hospitalar no contexto de Disponível em: https://www.nucleodoconhecimento.com.br/arquitetura/areas-verdestambém ...
Atualmente, um tema bastante abordado na área da saúde é sobre a humanização do ambiente hospitalar, que trata não somente das questões relacionadas ao acolhimento do paciente, mas também de questões relacionadas à qualidade do ambiente físico e seus impactos no bem-estar de seus usuários. Diversos trabalhos científicos observaram que estes espaços podem se tornar estressantes e inadequados em razão da falta de alguns elementos que podem impactar de forma direta na qualidade destes locais. Neste sentido, áreas verdes, quando tratadas de maneira adequada, podem proporcionar grande melhoria na qualidade do ambiente hospitalar, exercendo ainda influência positiva no conforto ambiental ao proporcionar melhorias no microclima. Diante do exposto, a questão norteadora desta pesquisa é: áreas verdes interferem na qualidade ambiental e no bem-estar das pessoas que vivenciam ambientes hospitalares? Assim sendo, o presente estudo parte da hipótese de que áreas verdes hospitalares contribuem para o bem-estar de seus usuários, tendo como objetivo principal, a verificação da interferência da presença de áreas verdes na qualidade ambiental de uma unidade hospitalar. Para tanto, foi feita uma análise da configuração e das características físicas das áreas verdes existentes entre as alas de internação da Irmandade Santa Casa de Valinhos/SP-Brasil. Para a avaliação do microclima, variáveis climáticas (temperatura, umidade relativa do ar e velocidade do vento) foram aferidas a fim de comparar as áreas analisadas. Verificou-se que a temperatura e umidade relativa do ar apresentaram variações devido à presença ou não de vegetação, fato que pode impactar de forma direta no conforto térmico e, consequentemente, interferir no bem-estar de todos que vivenciam nesses espaços. Pode-se concluir, portanto, que áreas verdes podem interferir de forma positiva no bem-estar de seus usuários, seja físico ou psicológico, uma vez que o verde também transmite um desejável sentimento de empatia e agradabilidade, indicando que maior atenção deva ser dispensada a estas áreas ao se projetar unidades hospitalares.
... Several studies reported that the implementation of biophilic design principles into the interior spaces of healthcare settings reduced mental/psychological stress, increased pain tolerance, improved mental fatigue, shortened hospital stays, enhanced immune function, re-lieved mental anxiety and/or facilitated faster and more complete physical and psychological healing among patients [11][12][13].These biophilic environments have been additionally recognized as contributing to enhanced perceptions of medical care among patients, increased levels of satisfaction with the care received and, eventually, a higher loyalty toward the healthcare provider [14]. Other research also showed that patients who are satisfied with medical care during their hospitalization tend to follow medical regimens, recover faster from illness and are more likely to return to that healthcare provider for other medical investigations [15][16][17][18][19]. ...
Background: Existing studies revealed that exposure to green spaces within healthcare establishments has multiple physical and mental health benefits to patients. In this context, the concept of biophilic design has received growing attention among environmental psychology researchers. Several studies indicated that the positive effect of green environment may be different for males and females. Therefore, the present study sought to investigate the influence of biophilic design elements (i.e., green items and natural light) on patients'self-rated mental health value, satisfaction with medical care, and loyalty toward the healthcare establishment. The study also investigated the possible influence of gender differences in the relationships between the variables. Methods: A structural equation modeling was employed as a data analysis technique. Results: Our empirical result indicated that biophilic design elements significantly improved the patients' self-rated mental health value, and this dimension had a positive effect on their satisfaction with medical care and loyalty toward the health care facility. Our findings indicated that the relationships among biophilic design elements, self-rated mental health value, satisfaction with medical care, and loyalty toward the healthcare establishment were substantially different across male and female groups. Moreover, self-rated mental health value and satisfaction with medical care acted as significant mediators between bio-philic design elements and loyalty. Conclusions: Results of this study offer healthcare practitioners and researchers valuable strategies to effectively incorporate biophilic design elements into the interior spaces of a healthcare establishment. Keywords: biophilic design; healthcare facility; gender; self-rated mental health value; satisfaction; loyalty
... Garden visibility, accessibility, and the provision of child-sized furniture are all essential factors in encouraging garden use [8]. The garden visibility can be improved by placing colorful brochures in high traffic areas [9]. In addition, the outside views from the window can increase patient satisfaction [5]. ...
By investigating specific therapeutic goals and design considerations, this paper aims to develop a framework for the design of a pediatric healthcare-built environment. Growing body of research indicates that the characteristics of pediatric healthcare facilities differ from those of adult healthcare facilities, therefore the findings of adult healthcare facility design cannot be generalized to pediatric healthcare facility design. Moreover, the studies specifically focusing on the built environment in pediatric healthcare are also sparse. Literature studies were conducted to extract therapeutic goals and design considerations. Two rounds of the Delphi technique were used to extract the Indian experts’ opinions, and to make a consensus among the experts on each goal and design considerations. SPPS software was used to calculate statistical output i.e., mean, standard deviation (SD), Interquartile range (IQR), coefficient of variation (CV), and boxplots. Results were drawn with the help of statistical data and boxplots. Finally, eight therapeutic goals and 33 design considerations emerged which may contribute towards designing pediatric healthcare environments. The design considerations will aid architects and facility planners in making design decisions for new or renovated pediatric healthcare facilities.
... Research in this field has focused mainly on the study of healing gardens in hospitals and on optimizing their positive impact on patients, visitors, and staff. In particular, POE enables to evaluate users' utilization of gardens, determine barriers to use, and investigate perception differences of garden features between users or the impact on their emotional state (Whitehouse et al., 2001;Sherman et al., 2005). A review carried out by Ulrich et al. (2008) has collected a few studies showing how gardens can be an effective restorative setting for stressed patients, families, and staff, fostering an improvement in their emotional well-being. ...
Natural environments have a restorative effect from mental/attentional fatigue, prevent stress, and help to revitalize psychological and physical resources. These benefits are crucial for promoting active aging, which is particularly relevant given the phenomenon of population aging in recent decades. To be considered restorative, green spaces have to meet specific requirements in ecological and psychological terms that can be assessed through Post-Occupancy Evaluation (POE), a multimethod approach commonly used by environmental psychologists and landscape architects after construction to evaluate the design outcomes from the users' perspective. Generally, POEs consist of surveys and/or interviews accompanied by more or less structured observations of onsite users' behavior. Despite this, various practical constraints can prevent physical access to the renovated area (e.g., weather conditions, time/resources limits, health issues, bureaucratic constraints). Exploiting digital tools for such an assessment can be a crucial support in such circumstances. The current study presents the visual POE of a restorative garden for older adults in Milan, Italy. We developed a web application, that includes the exp-EIA© patented method, which allows participants to virtually explore a visual simulation of the environment and provide their feedback. We identified 3 representative viewpoints in the redeveloped garden differing from each other for the functions and the design principles that inspired the transformation. For each point of view, we created 360° Virtual Reality photographs, that can be navigated by looking around, i.e., panning, from the standing point of each view. In connection to each virtual scene, a survey was conducted (N = 321). The focus was the psychological experience related to each viewpoint, assessed with two psychometric scales investigating the constructs of emotions (pleasure and arousal) and restoration (fascination, being away, coherence, scope, and environmental preference); such information is integrated with behavioral aspects, including the main activities prefigured by participants TYPE Original Research PUBLISHED Frontiers in Psychology 02 frontiersin.org and their visual exploration of the VR photography. The results of the virtual exploration show that the garden is perceived as restorative, with a more intense effect in a spot purposely designed. The emotions experienced in the garden are positive and a mild level of arousal is observed. The behavioral dimension is characterized by predominantly contemplative activities and contact with nature. A cartographic representation of the psychological and behavioral data is developed, to support the maintenance of the garden.
... Many nurses cite uniformity in the workplace and mere communication with other staff as the reason for their resignation. Also, the presence of plants in space due to proximity and contact, more than plants outside, has a positive psychological effect on the person; Even if this observation is through seeing the image of nature on the wall, it still has the same effect as the presence of plants in space (Schweitzer et al., 2004;Whitehouse, et al. 2001). ...
It has been observed that hospital environments cause negative physical and spiritual effects by increasing the tension on users due to negative effects such as limitation, lack of privacy, light and noise on patients during the treatment process. Health institutions include the natural spaces they have created in order to relieve these negative effects from the situation they are in. It has been the subject of many studies that natural areas have beneficial effects on different types of patients, but the effects of hospital gardens, especially on cancer patients, have not been studied yet. Today, medical centers and hospitals have a major and sensitive role in maintaining and restoring the physical and mental health of individuals in a society and creating physical and mental balance, so it is necessary to apply certain subtleties in the design of such centers. The most effective methods today for the patient's body is the use of nature therapy methods. In this research, the nature therapy method was explained. At the end of the research, the proposed solutions for creating a space with a nature therapy update are explained. By observing these points, we increase the quality of the treatment environment and reduce the patients' stress.
... For most patients, strict control over time and activity during hospitalization can have serious psychological consequences, such as loss of confidence or a sense of control, as well as increased stress. According to research [21][22][23], high blood pressure and cardiovascular activity caused by stress can be reduced when patients are exposed to nature scenes, because such scenes take their attention away from problematic thoughts, assisting in their recovery. Patients prefer well-designed hospital landscapes because of their favorable psychological consequences and the ability to spend time there, according to a study done by the Bow Center in London, which used flower beds and cuttings for horticultural treatment. ...
... The themes of pictorial intervention are always studied with great sensitivity according to the specific patients to whom they are addressed, in order to trigger a psycho-sensorial reaction that, integrating with the rest of the environment, could favor a reassuring and restorative experience [54,55]. In a hospital context, the beneficial effect of this intervention on patients' well-being could be associated not only with a distraction effect, but also with the activation of the "cognitive refocusing" coping strategy [56][57][58]. Indeed, the presence of a painting may sustain patients' attention and interest, helping them to feel more comfortable and familiar in an unknown place [59,60]. ...
Pictorial humanization is a useful intervention for the improvement of hospitalized patients’ affective states. Despite benefits in many hospital wards having been well documented, so far, no attention was paid to the Neonatal Intensive Care Unit (NICU). The aim of the present study was to evaluate the levels of distress and the affective perception of the environment experienced by parents of infants hospitalized in a NICU after the implementation of an intervention of pictorial humanization. A sample of 48 parents was recruited, 25 before the intervention was performed (Control Group), and 23 after its implementation (Pictorial Humanization Group). All parents completed the “Rapid Stress Assessment Scale” and “Scales of the Affective Quality Attributed to Place” questionnaires. Despite results showing no significant differences on parental distress, after implementation of pictorial intervention parents reported a perception of the NICU as significantly more pleasant, exciting, and arousing, and less distressing, unpleasant, gloomy, and sleepy. A higher level of distress and a perception of the environment as less relaxing was predicted for the Control Group condition. The present study suggests that the pictorial intervention represents a useful technique to create more welcoming hospital environments and to reduce the negative effects associated with infant hospitalization.
... Research published in refereed journals between 1999 until 2016, which focus on children involvements in retail or shopping environments is selected and reviewed to ensure all information used are recent and may contribute to the current state of knowledge within the research area. (Whitehouse et al., 2001;Thomson and Laing, 2003). Based on the selection criteria, the researcher reviewed seventeen studies. ...
Shopping centres are no doubt one of the many modern-day necessities, providing everything one might need all under one roof. To encourage customer visits, prolong time spent, and potential purchases, the environment of a shopping centre is often designed in a specific way to affect customer’s shopping values, enticing both their emotional and physiological sensations. A well designed shopping centre is a combination of modern architecture, as well as the integration of the right shopping atmospheric variables such as wall decoration, lighting, sound effects, music as well as retail layout. In today’s society, parents and children visit shopping centres for multiple purposes including retail therapy, entertainment, socialising and many others. Most of the time, parents intend to complete a purchase and at the same time to enjoy the hedonic aspects of the shopping environment with their children.
In the shopping journey between a parent and their accompanying child, children play a significant role in determining the family’s shopping expenses, one that is as important as an adult. However, research within this area also found that having a child companion can reduce positive shopping values due to the child’s behaviour. As a result, this will lead parents into making hasteful
decisions such as shortening their shopping visit or even making a turning back home. Although numerous efforts have been made by scholars to understand the effects of shopping atmospheric variables on the customer, only a few research is conducted to understand how these variables affect small children’s emotional response and shopping behaviour during their shopping journey. Therefore, this research focuses on ‘how to improve children aged between three to seven years shopping experience through the shopping atmospheric variables when accompanying parents during shopping activities?’.
The qualitative methodology using ethnography studies is employed in this research to develop an in-depth understanding of children customer shopping experience. Research data is collected using ethnography cultural probes (children shopping experience diary), digital ethnography observations and face-to-face semi-structured interviews. Results from this study are used to help the researcher develop a theoretical framework to identify atmospheric variables that are salient to young children customers, which may later provide vital insights in improving their shopping journey. Based from the findings, this research found that children emotional response, shopping behaviour and experience are influenced by four key factors. Each key factor explained how children react towards shopping atmospherics variables they engaged with, including their self-role and characteristics as a young customer, in-store decorative elements and electronic devices, categories for merchandise and snacks and other human variables while shopping with parents. The findings help to clarify children’s attitude towards each shopping atmospherics variable, and factors that might potentially influence their response towards them. To continue, the findings also highlighted important insights that will be useful for the shopping centre’s managerial team, designer and retailer who aim to improve children’s shopping experience. The improvement made based on these insights may also potentially help businesses create a more pleasant shopping environment for children as well as increase store and brand loyalty. Moreover, the findings may also benefit parents, since a positive children’s shopping behaviour may contribute towards a more positive family’s shopping vibes.
... Reducing stress Improving mood [10]. Improving the quality of life [11]. ...
There were emergences trends towards achieving sustainability in landscape. But the study of the role of healing gardens in
the landscape sustainability for the public gardens had not been studied previously in recent literatures. The research
hypothesis is that healing gardens have a role in the landscape sustainability for public gardens. The research depends on a
descriptive analytical study for public garden samples, which applied the design principles and elements of healing gardens
(accessibility, Sense of control, Flexibility, etc). These gardens also relied in their designs on the basic principles of
sustainability. The results showed that healing gardens effectively contribute achieving landscape sustainability for public
garden through the use of natural materials, the cultivation of local plants, consistent with the local climate, and enhancing
social interaction and sensory interaction with the landscape.
... Reducing stress Improving mood [10]. Improving the quality of life [11]. ...
There were emergences trends towards achieving sustainability in landscape. But the study of the role of healing gardens in the landscape sustainability for the public gardens had not been studied previously in recent literatures. The research hypothesis is that healing gardens have a role in the landscape sustainability for public gardens. The research depends on a descriptive analytical study for public garden samples, which applied the design principles and elements of healing gardens (accessibility, Sense of control, Flexibility, etc). These gardens also relied in their designs on the basic principles of sustainability. The results showed that healing gardens effectively contribute achieving landscape sustainability for public garden through the use of natural materials, the cultivation of local plants, consistent with the local climate, and enhancing social interaction and sensory interaction with the landscape.
... If nature exposure can increase resilience through buffering from stress and/or increased happiness, we might just keep our essential healthcare workers from burning out. The presence of nature has been linked to higher levels of satisfaction for staff, patients, and visitors (Pasha, 2013;Sachs, 2017;Whitehouse et al., 2001). Greater satisfaction in staff keeps productivity high and turnover down; in patients and visitors, it breeds customer loyalty (Rodiek et al., 2013). ...
Palyatif bakım, terminal dönem hastaların, kalan hayatlarını daha az sıkıntılı ve daha konforlu geçirmeleri için özelleşmiş bakım şeklidir. Sağlık hizmeti veren yapılarda ya da evde bakımda hastanın ihtiyacı olacak bakım şartlarının uygulanması için özel tasarlanmış mekanlara ihtiyaç vardır. Palyatif bakım, hastanın hastalık sürecinde değişen insani gereksinimlerini ve yakınlarının ihtiyaçlarını karşılamak üzere multidisipliner olarak hazırlanmış bütüncül bir sağlık planı içermelidir. Bu doğrultuda, çalışma kapsamında doğa ile birlikte tasarlanmış iç ve dış mekanların hastalar ve yakınları üzerinde olumlu etkileri olabileceği hipotezi ortaya konmuştur. Çalışma aynı zamanda palyatif bakım merkezlerinde doğa ile bütünleşmiş mekân tasarımlarının palyatif bakım altında olan hastalar ve hasta yakınları üstündeki çoklu etkilerini ortaya koymayı hedeflemiştir. Literatürde bu bağlamda kabul görmüş üç ayrı araştırmacının birbiri ile ilişkili teorileri; ‘Psiko-evrimsel Teori’, Stresi Yenme Teorisi ve Dikkat Yenileme Teorisi dikkate alınarak mekânsal öneriler sunulmuştur. Yapılan araştırma sonucunda elde edilen veriler ışığında, palyatif bakım merkezlerindeki iç mekân- dış mekân birlikteliğinin doğa elemanlarının olumlu etkileri bağlamında süreklilik içinde tasarlanması gerekliliği ortaya çıkmıştır. Tasarlanan mekanların sadece niceliksel değil, kapsam ve bireylerin gereksinimlerine uyumluluk açısından değerlendirilmesinin palyatif bakımda olumlu etkiler yaratacağı vurgulanmıştır.
Objectives, Purposes, and Aims
Principles of behavioral economics are now being used across fields in changing human behavior toward perceived benefit. We studied the effectiveness of simple, cost-effective design cues based on these principles, in encouraging use of a neglected outdoor space in a hospital.
Background
Benefits of access to nature and green spaces are established in healthcare; however, we found utilization of an outdoor space to be suboptimal. Presenting choices in different ways is known to influence user choice.
Methods
We designed four design interventions based to nudge relative-caregivers waiting outside the operation theater toward utilizing an adjoining outdoor balcony. These included making the terrace prominent, reducing indoor sensory stimulation, adding stereotypical elements, and improving usability. We measured usage via video camera data and satisfaction using questionnaires.
Results
The number of users and average time per person spent on the balcony increased over the consecutive intervention periods as compared to baseline (trend p < .01 for both), mainly driven by the addition of stereotypical elements. There were no adverse events in the balcony. There was no difference in the satisfaction related outcomes on questionnaire; a larger percentage of positive comments tended to be related to the balcony in the final intervention.
Conclusions
Cost-effective design cues nudged patient-caregivers toward spending more time with nature, thus changing behavior toward that with perceived benefits.
An Internet survey was conducted from 28 May to 8 June 2008 to investigate consumer awareness and interest in attending programming offered at The Scott Arboretum of Swarthmore College (Swarthmore, PA). The study was designed to investigate what traditional and non-traditional programs might attract community members to the arboretum and to identify potential barriers, perceived or real, that might discourage community members from visiting the arboretum. Among demographic groups, more females were interested in “hands-on workshops” (42.5%) and “fact sheets, instructional bulletins, and how-to guides” (37.4%) than males (26.8% and 26.3%, respectively). In examining events and activities, significant differences were found for “wine tasting and tours” and “outdoor concerts and live performances” based on household income; however, no significant differences were found among age groups and other demographics tested. Differences in interest in other activities were apparent based on number of adults and number of children in the household. Public gardens and arboreta can use this information as the foundation for modifying programs and services offered, though input from the community and trialing of alternative programs should be considered before completely changing programs and services offered.
Based on survey data conducted in Guangzhou in 2021, this study employs canonical correlation analysis (CCA) to evaluate the relationship between neighborhood green space, residents' green space use behavior, and their mental health. The results show that compared with the objectively measured accessibility, residents' subjective perceived accessibility of neighborhood green space plays a greater role in promoting green space use behavior and mental health. Meanwhile, the plant diversity, safety, and the number of recreational facilities in a green space can promote the frequency of green space use, improve residents' mental health status and reduce their perceived stress. Although perceived accessibility is more related to green space use behavior than green space quality indicators, green space safety and recreational facilities have many more benefits on mental health than perceived accessibility. In addition, residents' green space use behavior, especially green space visit frequency, can promote mental health and reduce perceived stress.
With vast influences of Chinese industrial transformation, also largely impacted by the global challenges, such as climate change and pandemic, the home becomes as a place for occupants to perform their work tasks. To that end, this study concentrates on the effects of residential indoor environments, especially the factor of indoor environment quality (IEQ) and indoor greenery (IG), on occupants’ residential satisfaction and performance. By conducting a post-occupancy evaluation (POE) survey with the perspective of user experience (UX), 764 samples were collected, of which 528 are valid for statistical analysis. The method of structural equation modeling (SEM) was adopted to test the hypotheses. The results show that both indoor environment quality and indoor greenery have a positive effect on residential satisfaction and occupant performance, however, the former is more influential. In addition, residential satisfaction is a partial mediator, which demonstrates the mechanism: residential indoor environment mainly affects satisfaction, then occupant performance. The findings of this study provide important evidence from China in the period of the post-pandemic era that combines the unique characteristics of urbanization, gaining more insight for researchers to understand the relationship between the built environment of homes and their occupants, revealing specific design implications for practitioners.
Artan nüfus ile beraber insanların doğayla etkileşimde bulunma ihtiyaçları giderek atmaktadır. Kent parkları bu ihtiyaçları gidermek için en çok kullanılan rekreasyon alanlarıdır. Bu alanların kullanıcıların ihtiyacına göre düzenlenmesi, kullanılabilirliği ve kullanıcıya terapik fayda sağlaması ve çok önemlidir. Bu çalışma yardımıyla Kastamonu merkezde bulunan ve sıklıkla kullanılan Cevizli Park’ın eski ve yeni tasarımlarının kullanım ve terapi sağlayıcı etkileri açıdan karşılaştırılması yapılmıştır. Parkın geçmiş ve günümüzde hangi özelliklere sahip olduğu, ne oranda kullanıcılara terapi sağladığı, ne kadar sık kullanıldığı, sık kullanılmama sebepleri, bu alanda hangi etkinliklerin gerçekleştirildiği ve alanların etkinliklere uygunluğu, bu etkinlikleri gerçekleştirdikten sonra ruh hallerinde meydana gelen değişimler ve pozitif ruh haline sahip olmalarına yardımcı olan alan özellikleri belirlenmeye çalışılmıştır. Parkın terapik açıdan değerlendirilmesi hem uzman hem de kullanıcı grubu tarafından ayrı ayrı yapılmış ve iki grubun da değerlendirme sonuçlarının birbirine benzerlik gösterdiği çalışma sonuçları ile ortaya konulmuştur. Bu değerlendirme sonucunda Cevizli parkın yeni tasarımının eskiye oranla terapi sağlayıcı etki ve kullanım açısından daha başarılı olduğu ancak iki tasarımın da yetersiz olduğu ortaya çıkmıştır.
Research supports the essential nature of play as directly impactful of children's overall development and wellbeing. However, the meaning of play, play materials, and access to play are not uniform across cultures or communities. Biopsychosocial factors such as development, health, mental health, trauma, racism, gender, gender identity, family structure, socioeconomics, geography, and religion influence how and why children play within their daily lives. Children in healthcare settings can face additional obstacles to play engagement thereby minimizing the therapeutic and healing impact of play. This chapter seeks to highlight the need for healthcare providers, particularly play specialists, to improve their understanding of biopsychosocial factors to promote more thorough assessments of patient coping, facilitate beneficial play engagements, and address areas of intrinsic bias in pursuit of optimal outcomes and well-being for children in healthcare settings whether hospitals, community clinics, hospice, or residential care.
Background: The therapeutic environments of children and adolescents differ from those of adults, and are complex entities. Though studies have been conducted on the built environments of adult healthcare facilities, the impact of therapeutic environments on the health outcomes of pediatric patients is yet to be explored. Objective: The purpose of this study is to investigate design characteristics for creating a pleasant, comfortable, and child-friendly physical environment in children's healthcare settings. Method: After extracting features that influence pediatric healthcare design from the relevant literature, a survey questionnaire, consisting of 45 items from 14 domains, was conducted. Principal component analysis (PCA) using varimax rotation was used to explore the intrinsic concept in an Indian sample (N= 224). Results: PCA with varimax rotation yielded 4- factors: (1) child-centred design characteristics; (2) indoor ambient environmental quality; (3) positive distraction strategies; and (4) sense of autonomy and control, accounting for 78.14% of the explained variance. A factor loading range of 0.41 to 0.93 was found across the four variables, indicating construct validity, and all the factors were found to be significantly related to each other. Conclusions: This study concludes that the built environment of pediatric healthcare settings impacts patients’ health outcomes and behaviour, with decreased patient stress & anxiety, and better family experience. The findings suggest the need of providing comfort to the children through several rejuvenating elements such as positive distraction strategies, play opportunities, family and peer interaction, child-friendly design, age-associated characteristics, etc. It also suggests various design characteristics that help contribute the positive patient health outcomes. Keywords: pediatric therapeutic environment, healthcare design, child-friendly design, therapeutic play, family-centred care
Although the water formations were used functionally to cover the needs of ancient societies, the aspect of these formations that cool, psychologically relax, and rest people has been noticed in our today’s world, and has become an indispensable element in recreation areas. It was noticed that different waterscapes create different effects and attract people to the area, and water composition preferences have come to the forefront depending on the place and the activity performed in that particular place. Which water compositions are desirable or undesirable to perform eating and drinking activities were investigated in this study besides the functional use of the water element along with how it affects people in psychological terms. A total of 20 different images of waterscapes in the city of Trabzon were used in the study, a questionnaire was applied to 100 people, and the relations between the characteristics of water and eating and drinking activities were uncovered. It was found that waterscapes with high visual quality were preferred more for eating and drinking activities in the study. Landscape attributes of the waterspace, which have a positive and negative effect on visual quality, were revealed. And common characteristics of waterscapes that were preferred for eating and drinking activities were determined.
Adopting an evidence-based approach, this book uses two state-of-the-art experimental studies to explore nature’s therapeutic benefits in healthcare environments, emphasizing how windows and transparent spaces can strengthen people–nature interactions. High-quality, supportive, and patient-centred healthcare environments are a key priority for healthcare designers worldwide, with ageing populations creating a demand for remodeled and updated facilities. The first study demonstrates individual psychophysiological responses, moods, and preferences in simulated hospital waiting areas with different levels of visual access to nature through windows, while the second experiment uses cutting-edge immersive virtual reality techniques to explore how gardens and nature views impact people’s spatial cognition, wayfinding behaviors, and experience when navigating hospitals. Through these studies and discussions drawing on architectural theory, the book highlights the important benefits of having access to nature from hospital interiors. This concise volume will appeal to academics and designers interested in therapeutic landscapes and healthcare architecture.
Şifalı Bahçeler İçin Peyzaj Tasarımının Temel İlkeleri Açıklanmıştır
İnsan, bulunduğu alanda kendini huzurda hissetmediğinde orada kalmak istemeyecek; kişilerin mekânda yapacakları ve performansı azalacaktır. Mekânda rahatlamayı sağlayan ve duyusal uyarımı uyandıran elemanlar; sanat çalışmaları (heykel, oturma duvarları vb.), akustik deneyimler (müzik, su, yaprak sesi), su akışı, doğal ışık, kullanılan malzeme, bitkiler ve yeşil alan, hayvanlar, temiz hava, güneş ışığı ve rüzgârı hissetme, doğal ve yapay elemanların oluşturduğu kapalılık hissi gibi elemanlar olmuştur. Bahçeler; güneş ışığını hissettirmesi, ağaçları ve çiçekleri seyretme imkânı sağlaması, su ve kuş seslerini dinletebilmesi, bahçeyi süsleyen bahçe bileşenlerini fark ettirmesi gibi özellikleriyle kullanıcılar üzerinde iyileştirici ve tedavi edici etkiler bırakabilir. Son senelerde insanların fiziksel ve ruhsal iyileşmelerini sağlayan tasarımlar ön plana çıkmış; bu çalışmalar "iyileştirme bahçeleri" kavramını ortaya çıkarmıştır. İyileştirme bahçeleri daha çok farklı hasta bireylerini ele alarak rehabilitasyon merkezleri, psikiyatri merkezleri, toplum ruh sağlığı merkezleri, bakım evleri vb. sağlık kurumlarının çevresinde uygulanmaya başlanmıştır. İyileşme terimi geniş kapsamlı bir terim olup sadece bir hastalıktan kurtulup sağlığa kavuşma anlamına gelmemektedir; aynı zamanda fiziksel iyileşmenin yanında ruhsal ve mental iyileşmeyi de kapsamaktadır. Doğal alanların kullanıcılar üzerindeki stresi azalttığı ve ruhsal durumlarını pozitif yönde etkilediği kanıtlanmıştır. Bir bahçenin iyileştirici olması için o alanın bireyler üzerinde tedavi edici etkilerinin olması şarttır. Bu etkiler; kullanıcılarda stresin azaltılması, olumsuz düşüncelerden uzaklaşma, dinlendirme, sıkılmayı engelleme, rahat ettirme, ilişki kurmayı sağlama ve eğlendirme olarak sıralanabilir. Genellikle hastane ve klinik binalarında cerrahi müdahale, ilaçlar ve uzmanların desteği ile oluşan iyileşme; bahçe ve doğal alanlarda hasta ve doğal çevre arasındaki direkt etkileşimle ortaya çıkacaktır.
Objectives
This pilot study aimed to explore the perceived benefits of a new children's sensory garden in a healthcare centre in south-eastern Melbourne that provides specialised care, support and guidance to parents.MethodsA mixed-method research design was employed in this study comprising a combination of quantitative (surveys) and qualitative (interviews) data collection methods. A total of 19 staff and 36 parents completed surveys relating to their experiences in the new garden.ResultsThe staff members and parents surveyed were found to use the new children's garden on a regular basis and suggested that the new garden provided them with an opportunity to escape and feel calmer and had positively impacted on their interactions with their child. Interviews were also undertaken with four staff members who indicated that they believe the new garden is affording them perceived personal wellbeing benefits and that the activities in the new garden led to better perceived outcomes for families.Conclusion
The perceived benefits reported provide support for the development of sensory gardens at other similar healthcare facilities.
Healthcare buildings are complex as their occupants may have different health conditions. In this context, building performance evaluations can help to achieve better performance perceived by occupants. Thus, this paper has developed a systematic literature review (SLR) on performance evaluation in healthcare buildings to understand their intrinsic characteristics, in addition to developing an overview of the subject. The objective was to identify the purpose of the evaluations, the criteria evaluated, the evaluation methods, the type of healthcare facilities evaluated, as well as the temporal and spatial distribution of papers. The research was conducted using three electronic databases, and eighty-three papers were examined according to the 5W1H tool. As a result, the buildings assessed covered health services at all stages of life, physical and mental issues. Six groups of criteria were identified, highlighting: spatial, lighting, acoustic comfort, energy issues, and the materials and finishes used. Moreover, relationships were established between the types of buildings, evaluated criteria, and tools used. Finally, the SLR collaborated with the understanding of performance in healthcare buildings, identified that these buildings are being evaluated, contributing to the health, well-being, and satisfaction of occupants as buildings that perform better tend to be better places of healing and work.
Human visual preferences for slides of five natural landscapes or biomes-tropical rain forest, temperate deciduous forest, coniferous forest, savanna, and desert-were examined. Subjects were third graders, sixth graders, ninth graders, college students, adults, senior citizens, and a group of professional foresters. A series of 20 slides, 4 examples of each biome, was shown twice to each group of subjects. On one pass through the slides, subjects judged how much they would like to live in an area similar to the one represented; on the other pass, subjects rated the slides for how much they would like to visit an area similar to the one shown. Judgments were made on a 6-point Likert scale. Elementary schoolchildren showed a significant preference for savanna over all other biomes. From midadolescence and through adulthood, more familiar natural environments were equally preferred to savanna. Results were interpreted as providing limited support for the hypothesis that humans have an innate preference for savanna-like settings that arises from their long evolutionary history on the savannas of East Africa.
Evolution has given human beings strong perceptual and informational biases that affect aesthetic preferences for landscapes. A model of visual landscape preference developed largely from these biases forecasts high preference for scenes (a) that have various attributes facilitating perception and comprehension, or (b) that convey to the observer an explicit anticipation that additional information can be gained by changing the vantage point. These information properties are conceived as independent dimensions underlying preference and are represented in the model as several component variables: complexity, focality, ground surface texture, depth, and mystery. The performance of the model is tested by its application to preference data obtained from groups of Americans and Swedish Ss. Results support the model's accuracy and strongly suggest that the formulation identifies major determinants of preference. One implication is that much previous work on aesthetic preference for landscapes has overstated the importance of culture and neglected the role of informational determinants. (52 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Different conceptual perspectives converge to predict that if individuals are stressed, an encounter with most unthreatening natural environments will have a stress reducing or restorative influence, whereas many urban environments will hamper recuperation. Hypotheses regarding emotional, attentional and physiological aspects of stress reducing influences of nature are derived from a psycho-evolutionary theory. To investigate these hypotheses, 120 subjects first viewed a stressful movie, and then were exposed to color/sound videotapes of one of six different natural and urban settings. Data concerning stress recovery during the environmental presentations were obtained from self-ratings of affective states and a battery of physiological measures: heart period, muscle tension, skin conductance and pulse transit time, a non-invasive measure that correlates with systolic blood pressure. Findings from the physiological and verbal measures converged to indicate that recovery was faster and more complete when subjects were exposed to natural rather than urban environments. The pattern of physiological findings raised the possibility that responses to nature had a salient parasympathetic nervous system component; however, there was no evidence of pronounced parasympathetic involvement in responses to the urban settings. There were directional differences in cardiac responses to the natural vs urban settings, suggesting that attention/intake was higher during the natural exposures. However, both the stressor film and the nature settings elicited high levels of involuntary or automatic attention, which contradicts the notion that restorative influences of nature stem from involuntary attention or fascination. Findings were consistent with the predictions of the psycho-evolutionary theory that restorative influences of nature involve a shift towards a more positively-toned emotional state, positive changes in physiological activity levels, and that these changes are accompanied by sustained attention/intake. Content differences in terms of natural vs human-made properties appeared decisive in accounting for the differences in recuperation and perceptual intake.
This paper provides a historical context for the Probe studies reported in this special issue by describing the stalled development of post-occupancy evaluation (POE) in Britain since the 1960s. It charts 40 years of continuing academic, professional and commercial neglect of POE as a mainstream activity in the procurement of buildings in Britain. It notes the current resurgence of interest in the "customer care" focus of the Egan Report. And it closes by identifying a re-emerging research agenda for POE in Britain. This could include its use for benchmarking progress in the transition towards more sustainable production and consumption of the built environment.
Records on recovery after cholecystectomy of patients in a suburban Pennsylvania hospital between 1972 and 1981 were examined
to determine whether assignment to a room with a window view of a natural setting might have restorative influences. Twenty-three
surgical patients assigned to rooms with windows looking out on a natural scene had shorter postoperative hospital stays,
received fewer negative evaluative comments in nurses' notes, and took fewer potent analgesics than 23 matched patients in
similar rooms with windows facing a brick building wall.
Anthropologists have long recognized that cultural evolution critically depends on the transmission and generation of information. However, between the selection pressures of evolution and the actual behaviour of individuals, scientists have suspected that other processes are at work. With the advent of what has come to be known as the cognitive revolution, psychologists are now exploring the evolved problem-solving and information-processing mechanisms that allow humans to absorb and generate culture. The purpose of this book is to introduce the newly crystallizing field of evolutionary psychology, which supplied the necessary connection between the underlying evolutionary biology and the complex and irreducible social phenomena studied by anthropologists, sociologists, economists, and historians.
... And analysis of this body of research is at least suggestive that a cause-ef- fect relationship exists between some health - care environmental factors and therapeutic ... xx An Investigation to Determine Whether the Built Healthcare Environment Affects Patients' Medical Outcomes ...
In order to get an idea of special places for children, it is important not only to learn more about the places children like, but also about the places children dislike or even fear. As part of a longitudinal research project about children and their outdoor environment in The Netherlands, data on these issues were collected by means of interviews and mapping techniques. The whole project consisted of a pilot study involving 36 children ages 6 to 12 years and a main study involving 140 children of the same ages. These children were asked which places in their direct neighborhood they liked, disliked, or feared and what reasons they had for their preferences. This article reports on the results of the study, giving the main categories and figures of the responses and discussing the qualitative information from the reasons the children gave for their preferences.
The utility of different theoretical models of restorative experience was explored in a quasi-experimental field study and a true experiment. The former included wilderness backpacking and nonwilderness vacation conditions, as well as a control condition in which participants continued with their daily routines. The latter had urban environment, natural environment, and passive relaxation conditions. Multimethod assessments of restoration consisted of self-reports of affective states, cognitive performance, and, in the latter study, physiological measures. Convergent self-report and performance results obtained in both studies offer evidence of greater restorative effects arising from experiences in nature. Implications for theory, methodology, and design are discussed.
An empirical investigation focused on person-window transactions in the physical medicine and rehabilitation environment. Attributes of windows, view, daylight, and spaces perceived as insufficient in these respects were studied in six hospitals. Preference, environmental documentation, and behaviorsassociated with windows and windowless rooms were the subject of a two-part interview and questionnaire. The respondent group numbered 250 persons. Nonmetric multidimensional scaling (MDS) was utilized, yielding an array of 21 cognitive dimensions. From evaluations of 56 photographs that sampled a broad spectrum of spaces ranging from highly windowed to windowless, 8 visual dimensions were identified; and 13 nonvisual dimensions distilled from 89 written response items were identified that addressed degree of satisfaction and associated behaviors. Among the findings, ideal window and view conditions frequently contrasted the actual conditions in one's hospital setting; informative views of urban life and nature beyond the hospital, accessible from one's typical viewing angle and position within the room, were desired; minimally windowed rooms wereequated with architecturally windowless spaces, and window-view substitutes in windowless rooms were distinguished from similar rooms without such compensatory measures. Implications for hospital planning and design are discussed.
In an attempt to move beyond traditional design guidelines to develop and design healing gardensfor Alzheimers disease facilities, the author presents his theory of remembrance therapy. Using Sedgewood Commons, a). Alzheimer'sfacility designed by the!.Mthor and located in Falmouth, Maine, as a prototype, this paper examines the design of built gardens that support the theory of remembrn nce therapy. Simply stated, remembrance therapy is based on the theory lriat each stage of Alzheimer s diseast--mild, moderate, and severe-ixs associated with a correspondib-g emotional stage of normal human development-adult, child, and infant. Thus, the author describes built ga rden types that are designed to respond to the emotional equivalent of each corresponding stage of normal human development. This paper concludes with a brief discussion and inquiry into the role of post-occupancy evaluation, research, and data gathering. This is done in an attempt to validate or refine remembrance therapy as a landscape planning awd design method for Alzheimer's Facilities.
Contrasts the naturalistic research paradigm with the scientific model, noting that the naturalistic paradigm assumes multiple reality, subject-object interrelatedness, and contextuality. Skills required for the pursuit of naturalistic inquiry are described. (JEG)
Explored the relationship of well-being to physical settings in workshop visualizations and artwork by adults asked to depict settings where healing occurs. Characteristics of natural spaces such as motion, control, light, privacy, and beauty are discussed for their healing properties. Adults' strong images of the healing capacity of natural spaces argues for increasing children's contact with nature as a critical resource for healthy growth and development. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The dearth of theoretically driven research on the predictors of pediatric chronic pain may unwittingly contribute to needless suffering in children and adolescents by underinvestigating a potentially treatable condition. The objective of the present study was to investigate the hypothesized predictive effects of perceived stress on pediatric chronic pain intensity in 148 children and adolescents. Consistent with thea priori Biobehavioral Model of Pediatric Pain, higher perceived stress was predictive of greater pediatric pain intensity. The results are discussed with regard to the implications for cognitive-behavioral pediatric pain treatment.
A group of members and volunteers at the Morton Arboretum near Chicago rated their preferences for photographs of landscapes in the arboretum, wrote open-ended descriptions of their favorite arboretum settings, and described the thoughts, feelings, and memories they associated with those settings. Most participants rated densely forested, natural landscapes highest in preference, but some also liked either open, natural fields or maintained, formal landscapes. The open-ended descriptions revealed a variety of significant meanings and experiences, some of which appeared to be associated with specific kinds of environments. The combination of quantitative and qualitative research methods yields a more complete understanding of how people experience arboretum landscapes, than would either method used by itself.
Environmental design research and participation can enable groups with different environmental values to negotiate critical design decisions. This article presents findings and techniques from two open space projects—one a neighbourhood playground, the other an elementary schoolyard—found to be useful in clarifying differences in open space values and preferences. Specific differences between child and adult views of these places are reviewed. How participation and research was utilized to help resolve basic open space differences is discussed. The article concludes with a brief review of future issues facing research and design participation.
nand urbanization: the dirt, dilapidation, overcrowding, and unsanitary conditions of industrial cities. It is our view that the uncritical continuation and extension of these policies as priorities for twentieth century problems is inappropriate be cause these policies do not take into account new information. First, sani tary programs in the nineteenth century were primarily directed toward, and had a major impact on, the infectious diseases that decimated popula tions at that time. These diseases are no longer the main causes of morbidity and mortality in industrialized nations of the world. The main causes of disease today include conditions not related directly to sanitation, such as coronary heart disease, stroke, cancer, mental illness, accidents, and sui cide. Second, the development of modern industrialized communities has generated a range of new disease-producin g agents also not related directly to sanitation, such as toxic chemicals and waste, increased levels of ionizing radiation, vehicle exhaust and other new synthetic products that pollute air, water and food. Third, as will be seen, new evidence indicates that disease occurs more frequently (a) among those with fewer meaningful social rela tionships, (b) among those in lower hierarchical positions, and (c) among those disconnected from their biological and cultural heritage.
The role of the health care physical or tangible environment, including the facility, is essentially an unstudied area. This article identifies and defines components of "atmospherics" concerning health care (Healthscapes), to assess their strengths and predictiveness in the relationship between patient and other customer outcomes, satisfaction, quality assessments, intention to return, and willingness to recommend a health care provider to others and to propose much needed research in the area.
Medical care cannot be separated from the buildings in which it is delivered. The quality of space in such buildings affects the outcome of medical care, and architectural design is thus an important part of the healing process. This article explores the relation between spatial design and healing by focusing on recent developments in the design of hospitals in the United States. The number of U.S. hospitals grew steadily from 6125 in 1945 to 7174 in 1974, an increase of 17 percent.1 Since 1975, however, there has been a continuous decline in numbers, to 6467 in 1993, while the average . . .
Conceptually-driven investigations on the potentially modifiable predictors of individual differences among children with newly-diagnosed cancer may facilitate the identification of pediatric cancer patients at risk for maladjustment during the profound adversity associated with this life-threatening disease and aversive biomedical treatment. Within a risk and resistance theoretical framework, perceived stress and social support were investigated concurrently and prospectively within an exploratory design as predictors of negative affectivity (anxiety and depressive symptoms composite construct) in newly-diagnosed pediatric cancer patients at Time 1 (within one month after diagnosis), Time 2 (6 months postdiagnosis), and Time 3 (9 months postdiagnosis). Hierarchical multiple regression analysis findings indicate that perceived stress and social support have direct and independent effects on negative affectivity principally at the 9-month time interval. These findings are discussed in terms of the cognitive-behavioral treatment implications for enhancing child adjustment during the transition from the initial cancer diagnosis and aversive biomedical treatment to subsequent school and social reintegration.
Greater fear or distress prior to surgery is associated with a slower and more complicated postoperative recovery. Although anxiety presumably interferes with recuperation through both behavioral and physiological mechanisms, the pathways have been unclear. Recent work in psychoneuroimmunology (PNI) has demonstrated that stress delays wound healing. In addition, a second line of research has illustrated the adverse effects of pain on endocrine and immune function. A biobehavioral model is described that is based on these and other data; it suggests a number of routes through which psychological and behavioral responses can influence surgery and post-surgical outcomes. Clinical and research implications are highlighted.
Cognition and Environ-ment: Functioning in an Uncertain World Psychological in-£uences on surgical recovery: Perspectives from psy-choneuroimmunology
- R Kaplan
- S Kaplan
- J K Kiecolt-Glaser
- G G Page
- P T Marucha
- R C Lum
- R Glaser
Kaplan, R. & Kaplan, S. (1983). Cognition and Environ-ment: Functioning in an Uncertain World. New York, Praeger Publishers. Kiecolt-Glaser, J. K., Page, G. G., Marucha, P. T., MacCal-lum, R. C. & Glaser, R. (1998). Psychological in-£uences on surgical recovery: Perspectives from psy-choneuroimmunology. American Psychologist, 53, 1209^1218.
Healing by design: To the editor
- Forman
Forman, A. D. (1996). Healing by design: To the editor. The New England Journal of Medicine, 334, 334^335.
Nature as a refuge in children's environ-ments. Children's Environments Quarterly, 6 The evolutionary importance of people-plant relationships
- M Kirkby
- C Lewis
Kirkby, M. (1989). Nature as a refuge in children's environ-ments. Children's Environments Quarterly, 6, 7^12. Lewis, C. (1994). The evolutionary importance of people-plant relationships. In J. Flagler & R. P. Poincelot (Eds), People-plant Relationships: Setting Research Priorities. Binghamton, NY: The Hawthorne Press, Inc. pp. 239^254.
Healing gardens and Alzheimer's dis-ease The Healing Dimensions of People-Plant Relations: Proceed-ings of a Research Symposium Healing by design
- R C Hoover
Hoover, R. C. (1995). Healing gardens and Alzheimer's dis-ease. In M. Francis, P. Lindsey & J. S. Rice (Eds), The Healing Dimensions of People-Plant Relations: Proceed-ings of a Research Symposium. Davis, CA: University of California, Davis Center for Design Research. pp. 283^299. Horsburgh, C. R. Jr. (1995). Healing by design. The New England Journal of Medicine, 333, 735^740.
Healing gardens for children Healing Gardens: Therapeutic Bene¢ts and Design Recommendations
- R C Moore
Moore, R. C. (1999). Healing gardens for children. In C. Cooper-Marcus & M. Barnes (Eds), Healing Gardens: Therapeutic Bene¢ts and Design Recommendations. New York: John Wiley & Sons. pp. 323^384.
Stress recovery during exposure to natural and urban environments Places children like, dislike, and fear
- R S Ulrich
- R F Simons
- B D Losito
- E Fioreto
- M A Miles
- M Zelson
Ulrich, R. S., Simons, R. F., Losito, B. D., Fioreto, E.,
Miles, M. A., Zelson, M. (1991). Stress recovery during
exposure to natural and urban environments. Journal
of Environmental Psychology, 11, 201^230.
van Andel, J. (1990). Places children like, dislike, and fear.
Children's Environments Quarterly, 7, 24^21.
The periodic rediscoveries of re-storative gardens: 1100 to the present The Healing Dimensions of People-plant Relations: Proceedings of a Research Symposium
- S B Warner
- Jr
Warner, S. B. Jr. (1995). The periodic rediscoveries of re-storative gardens: 1100 to the present. In M. Francis, P. Lindsey & J. S. Rice (Eds), The Healing Dimensions of People-plant Relations: Proceedings of a Research Symposium. Davis, CA: University of California, Davis, Center for Design Research. pp. 5^12.
The therapeutic garden Conclu-sions and prospects Restorative ef-fects of natural environment experiences
- M Griswold
- T Hartig
- M Barnes
- C Cooper-Marcus
- T Hartig
- M Mang
- G W Evans
Griswold, M. (1995). The therapeutic garden. Landscape Architecture, 85, 66^69. Hartig, T., Barnes, M. & Cooper-Marcus, C. (1999). Conclu-sions and prospects. In C. Cooper-Marcus and M. Barnes (Eds), Healing Gardens: Therapeutic Bene¢ts and Design Recommendations. New York: John Wiley & Sons, pp. 323^384. Hartig, T., Mang, M. & Evans, G. W. (1991). Restorative ef-fects of natural environment experiences. Environ-ment and Behavior, 23, 3^26.
Nature as healer Evolved responses to landscapes The Adapted Mind: Evolutionary Psychology and Generation of Culture
- A R Olds
- Orians
- G Heerwegen
Olds, A. R. (1989). Nature as healer. Children's Environ-ments Quarterly, 6, 27^32. Orians, G. & Heerwegen, H. (1995). Evolved responses to landscapes. In Barkow, J., Cosmides, L. & Tooby, J. (Eds), The Adapted Mind: Evolutionary Psychology and Generation of Culture. Oxford: Oxford University Press.
The promotion of wellness Psychological reactions to medical illness and hospitalizationEds) Psychological Care of the Medi-cally Ill: a Primer in Liaison Psychiatry Ap-pleton-Century-Crofts Social class, susceptibil-ity, and sickness
- M Stevens
- Strain
- J J Grossman
Stevens, M. (1995). The promotion of wellness. Landscape Architecture, 85, 64^67. Strain, J. J. & Grossman, S. (1975). Psychological reactions to medical illness and hospitalization. In Strain, J. J. & Grossman, S. (Eds) Psychological Care of the Medi-cally Ill: a Primer in Liaison Psychiatry. New York: Ap-pleton-Century-Crofts. pp. 23^36. Syme, S. L. & Berkman, L. (1976). Social class, susceptibil-ity, and sickness. American Journal of Epidemiology, 104, 1^8.
Dimensions of person-window transactions in the hospital environment. Environ-ment and Behavior Designing and building healing gardens at health care facilities The Healing Dimensions of People-plant Relations: Proceedings of a Research Symposium
- S F Verderber
- C E Ware
Verderber, S. F. (1986). Dimensions of person-window transactions in the hospital environment. Environ-ment and Behavior, 18, 450^466. Ware, C. E. (1995). Designing and building healing gardens at health care facilities. In M. Francis, P. Lindsey & J. S. Rice (Eds), The Healing Dimensions of People-plant Relations: Proceedings of a Research Symposium. Davis, CA: University of California, Davis, Center for Design Research. pp. 323^333.