Children’s Environments and Health-Related Quality of Life

Evidence Informing Pediatric Healthcare Environmental Design

Abstract

The purpose of this study was threefold. First, we reviewed the literature on effects of the physical environment on health and health-related quality of life (HRQOL) in children in healthcare settings. HRQOL or “patient-reported outcomes” are increasingly used as important indicators of quality healthcare and patient functioning. Given the paucity of research in this area, a second aim was to examine the broader literature on children’s environments to inform the future design and study of pediatric healthcare settings. Third, we proposed a conceptual model to help guide a research agenda, whereby environmental satisfaction, involving both subjective appraisal of an environment and its amenities as well as feelings of control over it, mediates the relationship between the physical environment and health/HRQOL outcomes. The literature search included two leading journals in environmental psychology and keyword searches on major search engines, supplemented with studies and conference proceedings for 1997-2004. 40 articles met review criteria of: 1) pertaining to children or adolescents; 2) measuring health/HRQOL outcomes; and 3) use of experimental or quasi-experimental design, correlational or observational methods. Results suggest beneficial outcomes are associated with access to nature, reduced noise, and reduced crowding. Specifically within healthcare environments, soft and cyclical lighting and access to music promote better functioning