A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare
Journal article, 2017

Aim: To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties. Background: The physical healthcare environment is regarded as a quality factor for health care. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment. Design: Systematic psychometric review. Data sources: A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990–2016). Review method: Consensus based standards for selection of health measurement instruments guidelines were used to evaluate psychometric data reported. Results: Twenty-three instruments were included. Most of the instruments are intended for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated. Conclusions: Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators are user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required.

systematic psychometric review

physical healthcare environment

evidence-based design


healthcare facilities

older adults

measurement instruments


Marie Elf

Architecture and Civil Engineering

Susanna Nordin

Helle Wijk

Kevin J. Mckee

Journal of Advanced Nursing

0309-2402 (ISSN) 1365-2648 (eISSN)

Vol. 73 12 2796-2816

Subject Categories

Other Medical and Health Sciences





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