A investigation on the impact of a model of healing architecture with the integration of biophilic and patient-centered design on user satisfaction in city hospitals in Türkiye

Although the combination of biophilic and patient-centered approaches in hospital design offers great potential to meet the physical and psychological needs of hospital users, it remains unclear how to combine these two approaches into a coherent model. In this study, we identify a model and parameters for patient-centered biophilic hospital design and investigate how this model can contribute to the satisfaction of hospital users. Biophilic design and patient-centered approaches are not sufficiently implemented as a result of increasing the satisfaction of hospital users and supporting recovery processes. The new model aims to integrate elements such as biophilic design, ergonomics, building materials, healing architecture, accessibility and technology integration. However, there is a lack of understanding of how these elements should be optimized together. This study aims to improve the patient recovery process, increase healthcare efficiency and user satisfaction by creating a biophilic and patient-centered design model. In line with the patient-centred biophilic hospital design, model components were designed to meet the needs of hospital users and to increase their satisfaction. Model components are biophilic design, healing architecture, healing gardens, building materials and ergonomics, accessibility, technology and energy use and efficient health services. Parameters related to patient-centred biophilic hospital design model components were created. In order to reveal the effectiveness of biophilic design in scientific studies, bibliometric analyses of academic studies conducted between 2006-2023 were performed. Bibliometric analysis was performed by using the most frequently used keywords with biophilic design in the web of science database. As a result of the analysis, it was determined that the number of scientific studies on the subject has recently increased and the interest in the subject has increased. Visual analysis was performed to investigate the extent to which the model component parameters are applied in hospital structures and statistical analysis was performed to determine the satisfaction of hospital users. For this purpose, three city hospitals were selected to represent other city hospitals. The selected city hospitals are Çam Sakura, Kayseri and Erzurum City Hospitals respectively. As a result of the visual analysis, the use of elements such as gardens, natural wood, patterns, colours, lighting, ventilation, nature-themed paintings and plants in and around the hospital supports the biophilic design, healing architecture and healing garden model components of the hospitals. When the accessibility of the interior spaces of the hospitals was examined, it was determined that there are direction signs in the corridors, and in terms of external transportation, air transportation thanks to heliports, railway transportation with metro and railway trains and public transport vehicles serve. In the context of technology use, it has been determined that advanced health technologies such as robotic surgery and earthquake seismic isolators as well as self-powered systems and solar energy panels are used in hospitals. The developed model components increase hospital user satisfaction. As a result of the evaluation of these hospitals in terms of accessibility, technology, use of natural materials, ergonomics and biophilic design, very positive results were obtained. A questionnaire was developed to determine the needs and satisfaction of hospital users, the necessary legal permission was obtained and applied to 2320 participants. The applied questionnaire was organised according to a 5-point Likert scale. The reliability of the questionnaire used in the research was determined. In order to determine the reliability of the questionnaire, Cronbach's Alpha value was calculated as 0.965. This shows that the questionnaire is 'highly reliable' reliability. The survey data were analysed using the SPSS statistical computer program and the results of the survey analysis related to the model parameters were obtained. As a result of statistical analysis, it was determined that the model parameters significantly increased user satisfaction. As a result of bibliometric, visual and statistical analyses within the scope of the study, patient-centred biophilic hospital design model and parameters were determined; the effects of this model contributing to user satisfaction and recovery processes were revealed in detail.