Using visual simulation to evaluate restorative qualities of access to nature in hospital staff break areas

Contact with nature has been found to produce multiple health benefits in diverse work environments. However, in healthcare workplaces, few studies have addressed this topic, and no studies were found comparing the restorative qualities of visual vs. physical access to the outdoors. This study used visual simulation methods to assess the restorative potential of specific design features in hospital staff break areas, investigating nature-related indoor decor, daylight, window views, and direct access to outdoor environments. The study hypothesized that staff would perceive break areas with higher levels of nature based content as being more restorative, and that direct outdoor access would be rated as more restorative than window views. Two sets of visual assessments were developed and distributed as part of an online survey to members of the Academy of Medical-Surgical Nurses in the United States; 958 completed responses were collected and analyzed. On a scale of 1-10, nurses evaluated the restorative qualities of (a) direct access to the outdoors through a balcony, (b) an outdoor view through a window, (c) a nature artwork, and (d) an indoor plant, all depicted on images of the same two staff break areas. Statistical analyses showed that ratings increased significantly based on higher levels of nature content, from no added amenities, to indoor plants, to nature artwork, to window views, to direct access to the outdoors through a balcony. This study supports the proposition that higher levels of access to nature, daylight, and outdoor environments are perceived to have significantly more restorative potential in healthcare workplaces. (C) 2015 Elsevier B.V. All rights reserved.