Interdisciplinary approach to evaluate environmental users’ perceived restoration in hospital public spaces.
Paper i proceeding, 2019

Objective – The study aims to: 1) assess the relationship between the quality of hospital's public spaces expressed in
terms of accessibility and visibility of art and greenery and users' restorative experiences; 2) highlight how physical
environment may promote health and wellbeing of patients and staff/user.
Background – The issue of public spaces in hospitals is very debated today: the direction taken by a few decades is
to implement these spaces giving them a humanization feature to promote the well-being of patients and staff.
Architectural trends have developed around the creation of halls, mostly glazed, with more volumes appearing, and
large dimensions. The importance of restorative spaces as a mediator factor for health outcomes among the users is
increasingly recognized.
Research questions – 1) Which public spaces are perceived to be more restorative? 2) Does familiarity with a place
affect the users’ perception of restoration in hospital public spaces? 3) To what extent does the perception of
restoration vary across settings that support similar functions but present varying levels of art and greenery? 4) How
does the combined use of Technical Environmental Analysis (TEA) and Observed Based Environmental Assessments
(OBEA) measures support our understanding of perceived restoration across different public spaces in hospital
Methods – A cross-sectional investigation was performed in seven public spaces of the Santa Maria Nuova Hospital
(IT) by adopting TEA and OBEA tools.
Technical Environmental Analysis:
• Visits on site to evaluate the quality of the space, to assess the presence of artworks and/or greenery and to describe
the historicity of the space
• Spatial analysis: Space Syntax evaluation parameters (Hillier, 2007) to evaluate the integration of the space (e.g.,
visibility, accessibility) and to quantify the presence of artworks and green view (% isovist area from key points),
performed by Visibility Graph Analysis (VGA) and Isovist Analysis.
Observed Based Environmental Assessments:
• This type of assessments implies an evaluation of public spaces done by the users (n = 327) (i.e., outpatient, staff,
relative, volunteer and social services). Their recruitment was done in place.
• Adapted version of the Perceived Restoration Scale (PRS) (1-5 Likert scale).
Results – Overall the results seem to suggest that the public spaces had relatively high restorative qualities. However,
significant higher perceived restoration was also found for the Medicherie cloister, suggesting that some architectural
and natural features affected the result. In order to gain a better understanding of what aspects of the physical
environment of hospital public spaces might have had an impact on users’ perception of restoration TEA and OBEA,
data were merged together and their interaction was discussed.
Conclusion – New insights about the concept of restoration and its interaction with physical characteristics of
hospital’s public spaces is put forward. Furthermore, the methodology proposed by linking TEA and OBEA data
contributes to a more reliable understanding of the influence that existing buildings might have on users’ well-being.

physical environment influence

evaluation tools

spatial layout

users’ perception

Hospital public spaces


Nicoletta Setola

Universita degli Studi di Firenze

Elena Bellini

Universita degli Studi di Firenze

Elizabeth Marcheschi

Chalmers, Arkitektur och samhällsbyggnadsteknik, Byggnadsdesign

Centrum för vårdens arkitektur (CVA)

ARCH19 – Proceedings from the 4th Conference on Architecture Research Care & Health

978-82-536-1718-3 (ISBN)

Architecture Research Care and Health (ARCH19)
Trondheim, Norway,


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