Determination of biophilic design strategies that affecting the patients’ health in hospitals

This research proves the need to modify and develop the design of hospitals to play a perceptible role in treating and accelerating the recovery of patients. Many investigations on the influences of nature on health reveal that the relationship with nature in built environment  has a noteworthy effect on the treatment and reduction of the recovery time of patients. One of the solutions suggested in this field is biophilic approach in architectural design, which has been offered by Kellert and states that humans require linking with nature in the man-made environment to preserve and promote their health and well-being. Hence, it is supposed that employing the principles of biophilic design in hospitals influences treatment and recovery time. In the study procedure of this paper, two questions were answered; Are biophilic design approaches efficient for therapeutic spaces to be healing? and What are the practical approaches for efficient biophilic design in health care spaces?

In this study, according to the purpose, the research method is applied, and the study method is descriptive-analytical. First, literature related to biophilic design and health were analyzed and reviewed with a systematic review technique. Then, the most relevant papers in the field of nature and health were selected, and theories and features of health influenced by the association with nature were presented.

Connection with nature influences the physical, psychological (mental and emotional), social, and spiritual dimensions of health. The most significant theories in this field are stress reduction theory (SRT) and attention restoration theory (ART). According to stress reduction theory, the amount of stress decreases subconsciously and spontaneously in people facing nature and being in nature, and as stress is the reason for many diseases and abnormalities, it plays a starring role in people's health, especially emotional health. Attention restoration theory reveals the ability to link with nature in subconsciously renewing and restoring attention by promoting cognitive function, which improves individuals’ productivity and mental ability, and has positive impact on the mental health of individuals and on diseases related to this field such as Autism, Alzheimer's, Parkinson's, Obesity, Schizophrenia, Blood pressure, Hyperactivity (ADHD) in children, etc. In the continuation of the research, 14 biophilic design patterns in 5 hospitals, Östra Hospital in Sweden, Khoo Teck Puat Hospital in Singapore, Ng Teng Fong Jurong Hospital in Singapore, Dell Children Hospital in Austin Texas, and The Royal Children Hospital in Melbourne Australia, are compared and assessed in 3 levels of the general aspects of building and its site plan, building organization and planning, and finally interior design of patients' rooms.

As a result, according to the evidence-based results, the design model of the biophilic hospital and the most practical biophilic design approaches in each of the hospital wards were obtained for the use of the design community and to improve the healing quality of the therapeutic spaces. Based on the recommended model, in the eight main internal wards of the hospital including hospitalization, intensive care, medical emergency, surgery, medical diagnostic laboratories, clinics, waiting area of patient companions and services, due to high stress and overcrowding, as well as no need to comply with certain health standards associated with other spaces, the waiting space of patient companions have the greatest potential to apply biophilic strategies. In fact, 12 of the 14 patterns of biophilic design can be applied in this area, and meaningfully can decrease anxiety and stress, increase social interactions, satisfaction, and peace of individuals. Hospitalization rooms can accelerate patients recovery and treatment time by applying 8 biophilic design patterns included patterns number 1, 2, 3, 4, 6, 8, 9, and 11. Surgery, intensive care and emergency areas should obey some special design standards, so only some biophilic design patterns such as; visual connection with nature, dynamic and diffused light and material connection to nature, are compatible with these zones design. Also, in general level using different courtyards and view to nature are the main design principles in architectural planning of biophilic hospitals, and in interior level view of nature, presence of natural light, natural air and natural materials are the most practical strategies in biophilic rooms of healthcare spaces. Nevertheless, empirical and practical assessment of the influence of biophilic patterns and their continuous development is still required.