Do the hospital rooms make a difference for patients' stress? A multilevel analysis of the role of perceived control, positive distraction, and social support

The physical environment of healthcare settings can contribute to preventing or reducing patients' stress. Using Ulrich's theory of supportive design (1991), this study tested whether this relationship occurs because the physical environment promotes perceptions of control, positive distractions, and social support. The research disentangles the contribution of the objective qualities of physical environment to stress, over and above patients' perceptions about the environment. In a multi-site field study (five hospital units from two countries), 57 hospital rooms were assessed in terms of the number of favorable design features, and 187 patients responded to a questionnaire after surgery. Multilevel regression analysis showed that the greater the number of favorable design features, the less the patients' stress, that positive perceptions about the room qualities in terms of how much social support and distraction they provide explain this effect, and that the relative importance of these dimensions may differ between cultures.