Design Characteristics for Sustainable Pediatric Healthcare Environments: Stakeholder’s Perception

Abstract

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