Nature through a Hospital Window

Shan Jiang is an Associate Professor of Landscape Architecture at the School of Design and Community Development, West Virginia University. She is also serving leadership roles in healthcare and therapeutic design for professional organizations, including the Council of Educators in Landscape Architecture (CELA) and the American Society of Landscape Architects (ASLA). Dr. Jiang was an AIA AAH Tuttle Fellow, Landscape Architecture Foundation Case Study Investigation (LAF-CSI) Fellow, and the Academy of Architecture for Health Foundation (AAHF) Research Fellow. Her primary research interests include the people–nature relationship, landscape design and human health, the application of biophilic principles to create supportive healthcare environments, and evidence-based design.

CONTENTS

List of figures

List of tables

Acknowledgements

CHAPTER 1. INTRODUCTION1

Scope and Key Concepts 1

Organization 1

References 1

CHAPTER 2. THE HISTORY AND THEORY OF NATURE’S

THERAPEUTIC EFFECTS 1

The Traditional Belief that Nature Heals1

Air, Water, and Places1

Trees, Flowers, and Herbs1

Salubrious Urban Landscape in the 19th Century 1

Nature’s Healing Mechanism: Contemporary Studies and Schools of Thoughts1

Therapeutic Landscapes through the Lens of Medical Geography 1

Evolutionary Perspectives1

Biophilia and Biophilic Design1

Attention-Restoration Theory 1

Stress Reduction and the Aesthetic-Affective Model 1

Toward an Integrative Framework 1

References 1

CHAPTER 3. RECONNECT PEOPLE AND NATURE THROUGH WINDOWS IN HEALTHCARE ENVIRONMENTS 1

Effects of Windows and No Windows1

Windowed versus Windowless Environments1

Window Attributes1

Size and shape of windows1

Distances to the window1

Content and Quality of Window Views1

Views of nature versus built environments1

Complexity of window views1

Windows and Natural Daylight1

Visual and Thermal Comfort1

Windows, Views, and Daylight in Healthcare Environments1

Windows in Healthcare Environments1

Window effects for patients1

Window effects for staff 1

Natural Daylight in Healthcare Environments1

Natural daylight for patients1

Natural daylight for staff1

References 1

CHAPTER 4. HOSPITAL GREENSPACES AND SOME USAGE ISSUES 1

People–Nature Relationship in Hospitals in History1

A General Negligence 1

From Courtyard Hospitals to Pavilion Plans1

Lessons Learned from Tuberculosis Sanatoriums1

Tuberculosis Sanatorium Movement 1

Paimio Sanatorium1

The site1

The windows1

The indoor–outdoor transition1

Greenspaces in Contemporary Hospitals 1

The Revival of Hospital Greenspaces1

Current Usage Issues of Hospital Greenspaces through Post Occupancy Evaluations1

Post Occupancy Evaluation (POE)1

Study Sites1

Findings from the Site Evaluation and Audit 1

Focus Group Results 1

Visual and experiential quality1

Wellness programs and supportive features1

Landscape maintenance and operation1

Garden Locations Matter1

References 1

CHAPTER 5. TRANSPARENCY AND TRANSPARENT SPACES

IN HOSPITAL DESIGN: FROM THEORIES TO PRACTICES1

Phenomenal Transparency and Spatial Continuity as an Urban Approach 1

Transparency: From Rowe and Slutzky (1963) to Hoesli (1997)1

Phenomenal Transparency and Spatial Continuity 1

A Continuum of Indoor–Outdoor Spaces 1

Phenomenal Transparency: An Urban Design Approach 1

Lessons Learned from the Venice Hospital1

A Preliminary Pattern Language of Transparent Spaces in Hospitals1

Pattern 1: Hierarchy of Landscape Realms1

Pattern 2: Courtyards that Breathe1

Pattern 3: Courtyards that Breathe1

Pattern 4: Positive Outdoor Spaces1

Pattern 5: Micro-Landscapes Along Narrow Wings 1

Pattern 6: Cascading Roof Terraces 1

Pattern 7: Transparent Arteries 1

Pattern 8: Landscaped Arrival Zones 1

Pattern 9: Dematerialized Edges 1

Pattern 10: Atrium Gardens and Lightwells 1

Pattern 11: Sequestered Gardens 1

Pattern 12: Therapeutic Viewing Places1

References 1

CHAPTER 6. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAITING EXPERIENCE IN HOSPITAL ENVIRONMENTS 1

Research Questions and Hypotheses1

Research Design1

Study 1: Image Selection1

Study 2: The Survey-Embedded Quasi-Experiment1

Data Analysis and Results1

Stress-Inducing Effect of Watching A Movie Stressor1

Comparison of Psychophysiology Readings1

Comparison of Mood Scores1

Visual Preference Analysis 1

Comparison of means1

Level of transparency and visual preference 1

Seat arrangement and visual preference 1

Correlations among Psychophysiology Readings, Mood States, and Visual Preference1

Factor Analysis1

Six factors1

Between-group comparison of visual preference scores by factors1

Contribution to Existing Knowledge1

Implications for Hospital Waiting Area Design1

Spatial Layout, Amenities, and Aesthetics1

Positive Distractions1

Privacy, Support, and Control1

Seating and Furniture1

Health Information and Resources 1

References 1

CHAPTER 7. THE EFFECTS OF WINDOWS AND TRANSPARENCY ON PEOPLE’S WAYFINDING BEHAVIORS AND NAVIGATIONAL EXPERIENCE IN HOSPITALS1

Large Hospitals and the Wayfinding Issues1

Research Questions and Hypotheses1

Research Design1

Experiment Setup1

Measurements and Data Collection Procedures1

Data Analysis and Results1

Wayfinding Performance and Behaviors in IVE Hospitals 1

Participants’ Mood States Scores 1

Environmental Attractiveness and Atmosphere Metrics Scores1

Level of Presence in IVE Hospitals 1

Preliminary Findings from Interviews 1

Additional Takeaways1

Summary of Findings from the Current Study1

Additional Implications for Healthcare Circulation Spaces Design1

Spatial Configuration and Design Elements1

Environmental Identity, Signs, and Landmarks1

Wayfinding Systems and Technology1

For Specialty Facilities and Vulnerable Patients1

References 1

CHAPTER 8. CASE STUDIES1

Pattern 1: Hierarchy of Landscape Realms1

Pattern 2: Courtyards that Breathe1

Pattern 3: Courtyards that Breathe1

Pattern 4: Positive Outdoor Spaces1

Pattern 5: Micro-Landscapes Along Narrow Wings 1

Pattern 6: Cascading Roof Terraces 1

Pattern 7: Transparent Arteries 1

Pattern 8: Landscaped Arrival Zones 1

Pattern 9: Dematerialized Edges 1

Pattern 10: Atrium Gardens and Lightwells 1

Pattern 11: Sequestered Gardens 1

Pattern 12: Therapeutic Viewing Places1

References 1

CHAPTER 9. TOWARD THE SHIFTED PARADIGMS FOR HOSPITAL ENVIRONMENT DESIGN 1

Patient-Centered Care and User-Centered Design1

Integrating Evidence-Based Research and Design1

The Shifting Paradigms of Hospital Environment Design1

Roles of Landscape Architects1

Trends of Hospital Greenspaces in the Pandemic Context1

Disappearing Waiting Rooms: Wait in a Garden! 1

Expanded Public Spaces with Integrated Nature Experience1

Gardens in Intensive Care Units1

Toward the Concept of Community Wellness Centers1

References 1

INDEX