Hospital Healing Garden Design and Emotional and Behavioral Responses of Visitors and Employees

Abstract

Despite the growing interest in healing gardens in hospitals which began in the 1990’s, there has been a major lack of a generalized measure to assess perceptions of specific design elements in healing gardens. Although much speculation exists that a well-designed healing garden may have the ability to bring about positive emotional and behavioral outcomes, few studies have empirically addressed these outcomes. The current study applies recommendations for key healing garden design elements derived from numerous published sources to the development and testing of an instrument which assesses individuals’ perceptions of key healing garden design elements. Further, based on Roger Ulrich’s (1999) Theory of Supportive Gardens, this study establishes a conceptual model that explains the influences that garden visitors’ perceptions of key healing garden design elements have on their satisfaction with the garden, which in turn leads to satisfaction with the hospital and positive behavioral intentions toward the healing garden as well as the hospital. This study empirically tests this model using data collected from a survey with a sample of hospital visitors (i.e., family and friends of patients) and employees recruited from two hospitals in Alabama. Results reveal that hospital visitors’ perceptions of healing garden design consist of four factors: (a) Privacy, Social Support, and Control; (b) Natural Distractions; (c) Movement and Exercise; and (d) Accessibility. Further, visitors’ data supported the conceptual model by demonstrating a significant positive influence of perceived healing garden design, particularly privacy, social support, and control, on hospital visitors’ satisfaction with the healing garden, which in turn positively influenced their satisfaction with the hospital and intentions to revisit and recommend the healing garden and the hospital. Due to the small sample size which weakened the statistical power, the same relationships were not found significant among hospital employees. This study provides key contributions to the literature through the development and testing of a scale which assesses individuals’ perceptions of key healing garden design elements. This study also offers applicable information to healing garden designers by investigating the relative importance of various design elements in healing gardens. Additionally, the study addresses the process by which consumers experience emotional and behavioral responses to the healing garden and the hospital as a whole. The findings of this study provide further support for Roger Ulrich’s (1999) Theory of Supportive Gardens and highlight the importance of the inclusion of healing gardens in hospitals.