A healing environment is a way to design (public) areas of health institutions in such a way that the well-being of patients, family and health workers is increased and stress reduced. The objective of a healing environment is to ensure a faster recovery of patients or, if this is impossible, to make sure the patient’s situation doesn’t deteriorate unnecessarily.

In medical literature, a distinction is made between a healing and a healthy environment. A healing environment mainly relates to the psychological aspects of being ill and getting well. Think of the stress or anxiety of a sick person. A healthy environment aims to prevent people from getting ill. Think of an environment that encourages health staff to wash their hands so contamination can be prevented (Van den Berg, 2005).

In healthcare, we try to help patients as much as possible, for this reason both concepts are equally important.

How to develop a healing environment?

The idea of a healing environment is to design and decorate areas according to evidence-based design. This means the areas are designed according to scientific research after the effects of the decoration and design of buildings.

How to create a healing environment?

There is evidence – in other words: research shows – that people are most at ease in areas that feel natural. This means, being able to see nature as well as being aware of the presence of daylight, fresh air and a calm atmosphere.

Agnes van den Berg has investigated whether these areas, with a natural feeling, really enhance the patients’ well-being. What are her conclusions?

Seeing and being surrounded by green or nature

Many different studies have demonstrated the link between seeing nature and the improvement of one’s well-being. The way in which patients deal with stress improves and the absolute stress level drops. There also seems to be a direct relationship between seeing nature and experiencing pain. This could reduce the intake of painkillers, for one thing. The explanation of these effects is that seeing nature unconsciously gives a message to the body that it is allowed to relax; this is the so-called restorative effect of nature.

In order to achieve these positive effects on the mental health, ‘real’ nature is not strictly needed. Seeing pictures of nature or realistic fake plants have the same effect as actual nature. (Van den Berg & Winsum-Westra, 2006).

Healing gardens & indoor planting

Healing gardens for patients, family and healthcare staff during their stay in an institution also appear to have a positive effect on the patients’ health. However, more research into the exact effect is necessary.

Isala klinieken Zwolle

Healing environment by Van der Tol B.V for the Isla Klinieken @Norbert Walberg Photography

Although a lot of research has been done toward investigating the impact of plants in healthcare institutions on the general health, the evidence of the link between the two is still none too strong.

Studies looking into the effect of nature on a person’s health have mainly investigated the effect in the experience, or physiological stress. This stress plays an important role in some illnesses, but not in all. The concept of healing environments would gain in strength if a direct relationship between healing environments and getting better from certain illnesses could be proved.

What is the effect of daylight on our health?

People often indicate they prefer daylight to artificial lighting. We also believe that daylight has a positive effect on our health. Can this belief be based on fact?

It seems that daylight has a positive effect on patients, since it can shorten a patient’s hospital stay, reduce the use of medication and lower the number of depressions.

Because research into the effect of daylight on health hardly differs between the light (natural or artificial) that the patient sees and the view he has, or not at all, it can’t be said which of two had a positive effect on the patient’s health. More research is needed to separate these two variables so possible effects can be credited to either one.

There is no evidence for a positive effect of daylight lamps on the health of people. Studies have also been done to determine if a possible effect of daylight lamps depends on the belief of such an effect, but no proof has been found for that either.

That there is no evidence of a positive impact of daylight lamps on people’s health can explained as there being no effect at all. An alternative explanation would be that we don’t properly understand the workings of daylight lamps and, consequently, don’t execute this research the proper way.

What effect does fresh air have on your health?

There is strong evidence that the ventilation of houses, schools and offices with fresh air through a ventilation system has a connection with the reduction of the sick-building syndrome, asthma and an increase in sick leave. Furthermore, the chance of sick-building syndrome symptoms in buildings where the air is re-circulated in a ventilation system is larger than in offices where the air is refreshed in a mechanical or natural way.

In our case about buildings generating their own air, you will read the tale of Kamal Meattle, who used to have a lung disease, and now uses plants to give healthy clean air in buildings. How plants actually clean the air, you can read in the following article: The champion of air purifying

What effect does silence have on your health?

Hard or annoying sounds (or: noise) have a negative impact on patients and institutional staff. There is a link between noise and the need for additional oxygen in newborns, the disturbances in sleeping patterns in children and adults and a heightened stress level.

Unfortunately little research has been done toward the direct connection between noise and health in healthcare institutions.

Also, a lot needs to be investigated still into the effects of specific parts in the environment that spread, resonate or subdue sounds on people’s health. Here as well, more research is needed to better understand the relationship between sound and health.

What is the effect of a healing environment on a person’s health?

Based on the current status of the research, Agnes van den Berg concludes that there is:

  • Strong evidence that ventilating fresh air is linked with improved health, both indicated by the patients and diagnosed by the doctors;
  • Sufficient proof that a view on nature can reduce stress and pain;
  • Feeble evidence that the presence of plants in healthcare institutions can be linked to the improvement of the patients’ mood and reduction of physical ailments;
  • Feeble and contradictory evidence for the positive effect of daylight in buildings on our health;
  • Some proof for the positive impact on our health of silence in buildings;
  • Until now, a lack of evidence for a possible positive effect of healing gardens.

It should be noted that more research is needed in several scientific areas in order to better understand the relationship between one’s surroundings and one’s health.

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