Twenty-three instruments were included. Most of the instruments are intended for healthcareenvironments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated.
CONCLUSIONS:
Although we found many instruments for measuring the quality of the physical healthcareenvironment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeuticenvironmentscreening have been used and tested most frequently. The Perceived hospitalqualityindicators are user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required.