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Doctoral thesis2015Open access

From experiences of the outdoors to the design of healthcare environments. : a phenomenological case study at nursing homes

Bengtsson, Anna


This thesis strives to create opportunities within landscape architecture to promote the development of the outdoors as a resource for health and well-being in healthcare settings. The overall aim is to describe users’ experiences of contact with the outdoors in healthcare environments, and from this generate frameworks and tools for use in the design processes of such environments. The work is built on theoretical frameworks including person-environment fit and universal design, together with theories on restorative and supportive environments. In the background, evidence-based design is described in relation to outdoor environments in healthcare and this leads to the identification of four zones of contact that are used as part of a holistic approach to explore the experience of contact with the outdoors. The result reflects two different parts of the working process. The first part describes the users’ contact with the outdoors, as experienced by staff, next of kin and residents. These descriptions portray a variety of universal wishes, needs and opportunities in relation to the outdoor environment in healthcare settings. Such universal needs and wishes became the main perspective in the second part of the work, as the empirical results were interpreted from a researcher’s and designer’s point of view. The main contribution of the present work is the generation of frameworks and tools useful in design processes that correspond to users’ wishes and needs in healthcare settings. The quality evaluation tool (QET) is the final manifestation of these frameworks. In all, these frameworks consist of 19 environmental qualities, the three design concepts of comfortable design, inspiring design, and the gradient of challenge, and the principal model of the four zones of contact with the outdoors. The frameworks also offer explanations of the ways in which the 19 environmental qualities relate to theories on different resources of the outdoors. These frameworks are designed to help designers to be comprehensive and aware in their work, and not overlook important qualities and aspects of the outdoors in a healthcare context. Furthermore, they are designed to be useful in participatory design processes. Keywords: case study, evidence-based, healthcare architecture, instorative, landscape architecture, nursing home, person-environment fit, phenomenology, place attachment, restorative, salutogenesis, supportive environment, universal design.


case study; evidence-based; healthcare design; landscape architecture; phenomenology; universal design

Published in

Acta Universitatis Agriculturae Sueciae
2015, number: 2015:66ISBN: 978-91-576-8330-4, eISBN: 978-91-576-8331-1
Publisher: Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences