ICU Patient Family Stress Recovery During Breaks in a Hospital Garden and Indoor Environments
Journal article, 2020

Objectives: Measure the immediate change in intensive care unit (ICU) family members’ state stress levels from the beginning to the end of a person’s visit to a hospital garden and compare the changes produced by the garden with those associated with spending time in indoor hospital environments intended for respite and relaxation.

Background: No previous research has compared the efficacy of different physical environments as interventions to foster stress reduction in family members of ICU patients, a group of hospital visitors known to experience high levels of distress.

Method: A convenience sample of 42 ICU patient family (from 42 different families) completed the Present Functioning Visual Analogue Scales (PFVAS) before and after each visit (128 total visits) to a garden, an atrium/café, or ICU waiting room.

Results: Stress scores significantly declined (i.e., improved) from the start to the end of a break on all PFVAS subscales (p <.0001) in both the garden and indoors locations. However, it is noteworthy that garden breaks resulted in significantly greater improvement in the “sadness” scale than breaks in indoor locations (p =.03), and changes in all five other PFVAS scores showed somewhat more reduction of stress for breaks spent in the garden than indoors, although these differences were not statistically significant.

Conclusion: Creating an unlocked garden with abundant nature located close to an ICU can be an effective intervention for significantly mitigating state stress in family members of ICU patients and can be somewhat more effective than indoor areas expressly designed for family respite and relaxation.

hospital garden


stress recovery

ICU patient family

waiting room


Roger Ulrich

Chalmers, Architecture and Civil Engineering, Building Design

Makayla Cordoza

University of Pennsylvania

Stuart K. Gardiner

Legacy Health

Bette J. Manulik

Legacy Clinical Research and Technology Center

Paul S. Fitzpatrick

Legacy Clinical Research and Technology Center

Teresia M. Hazen

Legacy Health

R. Serene Perkins

Legacy Clinical Research and Technology Center


1937-5867 (ISSN) 21675112 (eISSN)

Vol. 13 2 83-102

Subject Categories

Other Health Sciences

Anesthesiology and Intensive Care






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