Quantifying the relationship among hospital design, satisfaction, and psychosocial functioning in a pediatric hematology-oncology inpatient unit.

BACKGROUND Studies show that hospital built environments can affect physical and psychological outcomes and healthcare satisfaction in adults, but pediatric research is sparse. OBJECTIVE To investigate the effects of the built environment on hospitalized pediatric hematology-oncology patients and their parents by testing the hypothesis that perceived built environment satisfaction mediates the relationship between the objective built environment and psychosocial functioning, as well as parental healthcare satisfaction. METHODS The hospital built environment was evaluated subjectively through the PedsQL™ Hospital Healing Environment Module satisfaction questionnaires and objectively by quantifying environmental features. Outcomes for patients and parents included present functioning and affect. Healthcare satisfaction was also assessed for parents. Structural equation modeling (SEM) was used to test the mediational hypothesis. SUBJECTS Participants were 90 hospitalized pediatric hematology-oncology patients and 149 parents of pediatric hematology-oncology patients. RESULTS For both parents and children, analyses revealed a significant positive relationship between the quality of the objective built environment and built environment satisfaction. For parents, significant relationships emerged in the expected direction between built environment satisfaction and present functioning, healthcare satisfaction, and negative affect. CONCLUSIONS Both pediatric hematology-oncology patients and their parents can reliably report their own perceived built environment satisfaction, which is significantly related to the quality of the objective built environment. For parents, results support the mediational hypothesis, highlighting the importance that perceived built environment satisfaction plays in psychosocial functioning and healthcare satisfaction.