Community environmental healing benefits: A systematic review comparing intervening variables, environments, and outcomes.

As the smallest spatial unit in the city, the community should be an important space for healing the urban population. This paper presents a systematic review summarizing studies on community healing environments. The study identified 75 publications. The research findings are as follows: the main intervening variables include restorativeness, emotions and mood, stress, and well-being. Little attention has been paid to the intervening variables including social support, environmental preferences and satisfaction, place attachment, behavior types that respond to personal will, self-fulfillment, and the spirit of personal culture. The various types of natural environments in communities have been given focused attention for a long time. However, the superiority of the natural environment should not be a reason to underestimate the healing benefits of community spaces. The mechanisms by which environmental characteristics are transformed into positive individual influences through intervening variables should be explored.

Increasing the capacity to provide compassionate care by expanding knowledge of caring science practices at a pediatric hospital.

BACKGROUND: The emotional aspects of patient care affect care givers' capacity to remain present, safe and caring. As demands increase and capacity decreases care providers are at risk for compassion fatigue (CF). LOCAL PROBLEM: Our organization treats children with complicated diagnoses. Nurses carry a heavy emotional burden due to prolonged exposure to suffering with chronically ill children, ethical dilemmas, and an onus to also care for the parents. METHODS: Our program highlights theory guided practices that honor the complexities of caring for others and creates opportunity for the care giver to slow down and prioritize how they care for themselves. INTERVENTIONS: Caritas Circles, a small group intervention program, was developed to offer a deeper exploration of Jean Watson's Caring Sciences practice and theory using intentional practices to pause, be present and find peace in the midst of caring for sick children. RESULTS: Quantitative and qualitative measures show improvement in care providers' ability to prioritize their own needs as they care for others. Care providers noted the need to have organizational support for resiliency, a connection to purpose as a care provider, and opportunity to let go of the emotional residue found in their role. CONCLUSIONS: Organizations can no longer afford to ignore the emotional labor that care givers experience. This program highlights the need for hospitals to prioritize this type of experiential intervention and offer time during work hours where providers are honored and cared for, so they can continue to care for patients and families.

Acute effect of orange chromatic environment on perceived health status, pain, and vital signs during chemotherapy treatment.

PURPOSE: The study is aimed at assessing the acute effect of orange color and natural light exposure on cancer patients during chemotherapy sessions. Warmer environments and rooms receiving more sunlight hours were expected to impact vital signs, quality of life, and pain symptoms. METHODS: We used a single-group repeated-measures clinical trial design. For the purpose of the study, chemotherapy rooms were modified based on two experimental factors: color (white vs. orange) and sunlight orientation (south vs. north). On four consecutive sessions, cancer patients were randomly assigned to one of the following conditions: orange-north, orange-south, white-north, and white-south. They received chemotherapy per standard of care. The following outcomes were assessed: blood pressure, body temperature, heart rate, and European Quality of Life Five-Dimension Five-Level Scale Questionnaire (EUROQOL-5D-5L) including the visual analogue scale (EQ-VAS). RESULTS: Statistically significant beneficial effect of orange color room in self-rated health was found (p = 0.036, d = 0.28). Small differences in other parameters (body temperature, d = 0.34; diastolic blood pressure, d = 0.37; systolic blood pressure, d = 0.28) did not reach statistical significance. No differences were found based on room orientation. CONCLUSIONS: Compared with a cool-color design, a warm-color living environment could have a positive effect on patients' well-being during chemotherapy sessions. Although the clinical effect size on perceived health status and vital signs could be considered small, the cost-effectiveness analysis would support the use of the proposed configurations. More research is still needed. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03873519.

The family house-A safe haven: A qualitative study of families' experiences staying in a hospital family house during their children's hospitalisation.

AIMS: To gain knowledge about families' experiences while staying in a hospital family house during their child's hospitalisation. BACKGROUND: When a child is hospitalised with a chronic, serious or life-threatening disease, the entire family is stressed as normal everyday life is disrupted. In Denmark, accompanying the ill child to the paediatric wards is often possible only for one of the parents. DESIGN: This qualitative study takes a phenomenological-hermeneutical approach, exploring the lived experience of families' everyday life in a hospital family house. METHOD: The study comprised semi-structured interviews with 33 family members from 15 families who stayed in a hospital family house. The interviews were made in the summer of 2017. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline "see Appendix S1." RESULTS: The families experienced the house as a home or a haven where they could stay together as a family. The house provided a quiet and peaceful environment with space for family life and playing. Overall, this gave the families a feeling of togetherness. CONCLUSION: The families who stayed in the hospital family house experienced the house as a place to breathe freely, that is, as a safe haven. A place with peace and quietness, without "activity efficiency." In the house, the volunteers offered a very caring and supportive environment including all families in the house and embracing everyday activities. Providing accommodation for the whole family at the hospital family house afforded the family a place where they could stay together and maintain everyday life even though everything around them was, at times, chaotic. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals should use knowledge about the healing environment to help create havens for families to a hospitalised child. Hospitalised children need safe places where no treatment takes place-therefore, family houses should stay treatment free.

A companionship between strangers - the hospital environment as a challenge in patient-patient interaction in oncology wards.

AIM: To present an identification and discussion of the impact of the hospital environment on interaction among people with cancer. BACKGROUND: In recent years, researchers have focused on identifying and describing features of the hospital environment that promote healing, recovery and well-being. It has been discovered that architectural features affect hospitalized patients both positively and negatively. But the research has failed to include fellow patients as part of the hospital environment. DESIGN: A qualitative approach influenced by ethnography. METHOD: Participant observation and individual qualitative interviews were used to collect data. From a total of 85 observed people with cancer 10 men and 10 women were interviewed. Data were collected over 6 months in 2010-2011 and analysed using inductive thematic analysis. FINDINGS: Patients had ambiguous views regarding their fellow patients and the hospital environment. The hospital environment imposed conditions that caused stress factors such as the loss of personal privacy and control, but it also offered the possibility of good company and support from fellow patients. Refuge from fellow patients was hard to achieve and the fact that personal conversations might be overheard by fellow patients caused patients to withhold important information from healthcare professionals. Nevertheless, patients accepted the hospital environment uncritically, with resignation or with silent rebellion. Despite the challenges, 18 of 20 patients preferred multiple-bed rooms with the company of fellow patients. CONCLUSION: The influence of the hospital environment on hospitalized people with cancer and their interpersonal interaction needs to be acknowledged by healthcare professionals. In addition, evidence-based hospital design must include research into patient preferences and arguments. Further investigation is needed.

Impact of On-the-Job Training on Nurses' Performance in Creating a Healing Environment and Clustered Nursing Care for Premature.

Introduction: Premature infants require specialized care, and nurses need to have specific skills and knowledge to provide this care effectively. Objective: To evaluate the impact of an on-the-job training program on the improvement of nurses' knowledge and practice related to creation of a healing environment and clustering nursing procedures. Methods: From January to April 2022, a study utilizing a one-group pre- and post-test design was conducted at NICUs in governmental hospitals. The study participants involved 80 nurses working in these NICUs. Researchers used predesigned questionnaire and checklist practice to collect the data pre and post the intervention. Results: 37.5% of the participants were aged between 25 and less than 30 years, with a mean age of 28.99 ± 7.43 years. Additionally, 73.7% of the nurses were female, with a mean experience of 9.45 ± 3.87 years. Prior to the intervention, the study found that a majority of the nurses (62.4%) demonstrated poor knowledge. However, after the intervention, a significant improvement was observed, with 60.0% of the nurses demonstrated good knowledge. Likewise, prior to the intervention, the study revealed that the majority of the nurses (83.8%) exhibited incompetent practice. However, post-intervention, a substantial improvement was observed, with 81.3% of the nurses demonstrated competent practice. Conclusion: On-the-job training had significant improvements in nurses' knowledge and practices regarding applying healing environments and clustering nursing care. On-the-job training is suggested as an adaptable, effective and low-cost technique to train nurses. To maintain the improvement achieved, ongoing instruction, feedback, assessment/reassessment, and monitoring are encouraged.

Reimagine the ICU: Healthcare Professionals' Perspectives on How Environments (Can) Promote Patient Well-Being.

OBJECTIVE: This study aims (1) to understand the needs and challenges of the current intensive care unit (ICU) environments in supporting patient well-being from the perspective of healthcare professionals (HCPs) and (2) to explore the new potential of ICU environments enabled by technology. BACKGROUND: Evidence-based design has yielded how the design of environments can advocate for patient well-being, and digital technology offers new possibilities for indoor environments. However, the role of technology in facilitating ICU patient well-being has been unexplored. METHOD: This study was conducted in two phases. First, a mixed-method study was conducted with ICU HCPs from four Dutch hospitals. The study investigated the current environmental support for care activities, as well as the factors that positively and negatively contribute to patient experience. Next, a co-creation session was held involving HCPs and health technology experts to explore opportunities for technology to support ICU patient well-being. RESULTS: The mixed-method study revealed nine negative and eight positive patient experience factors. HCPs perceived patient emotional care as most challenging due to the ICU workload and a lack of environmental support in fulfilling patient emotional needs. The co-creation session yielded nine technology-enabled solutions to address identified challenges. Finally, drawing from insights from both studies, four strategies were introduced that guide toward creating technology to provide holistic and personalized care for patients. CONCLUSION: Patient experience factors are intertwined, necessitating a multifactorial approach to support patient well-being. Viewing the ICU environment as a holistic unit, our findings provide guidance on creating healing environments using technology.

Supporting Aging-in-Place: Drivers and Desired Outcomes of a Healing Environment for Older Adults in Block Spaces of High-Density Cities.

Aim: The objective of this study was to develop a comprehensive multidimensional framework by identifying the key drivers and components associated with the health of older people in healing environments, and to apply this framework in high-density city block spaces, creating opportunities for aging in place. Background: Effective theoretical and practical research frameworks are necessary to determine how to best support older adults in high-density city areas as they face aging-related challenges. Methods: The methodological approach involved bibliometric analysis (SciMAT) and systematic literature review of approximately 4446 articles related to rehabilitation settings and older adults. The review focused on literature that developed concepts and research frameworks and provided an empirical foundation. Results: The review identified four types of drivers for a healing environment for older individuals in high-density city blocks (HEOI-HCBs): self-environment, interpersonal, physical, and informational environments. These drivers were linked to eight desirable outcomes: initiative acquisition, shared vision, trust, empathy, integrity, systematicity, networking, and perceived usefulness. Conclusion: The drivers and outcomes formed the HEOI-HCBs framework, each representing a distinct dimension of the HEOI-HCBs concept. This study and the resulting framework facilitate the application and understanding of healing environments.

Effects of COVID-19 Stress on Healing Behavior in Residential Spaces.

This study aims to analyze the effects of COVID-19 stress on healing behavior in residential spaces. Based on the results, the study further examines the residential space as a healing environment according to space use behavior in the post-COVID era. A survey including 2101 Korean people was conducted. The COVID Stress Scale for Korean People (CSSK) was used to identify COVID-19 stress. In addition, using a literature review on healing environment factors and behavioral changes after the pandemic, survey questions were developed to assess changes in healing behavior. A frequency analysis was conducted for sociodemographic factors, and the relationship between COVID stress factors and healing behavior factors in residential spaces was examined using factor and correlation analyses. Multiple regression analysis was conducted to verify the effects of COVID stress factors on changes in healing behavior. The results revealed that COVID stress affected healing behavior in residential spaces; however, there were differences in healing behavior depending on the COVID stress factors. Fear of being infected positively affected infection prevention behavior in homes. Anger towards others negatively affected the establishment of elements that support various activities in the residential spaces and furniture arrangement. Stress from social distancing difficulties affected healing behavior in residential spaces but was not related to infection prevention behavior. Residential spaces can serve as healing spaces when people are provided with various spatial factors that support diverse types of behavior during a pandemic crisis.

Hospitalized Patients' Sleep Quality Compared Between Multioccupancy Rooms and Single-Patient Rooms.

OBJECTIVES: To evaluate patients' sleep quality in a former hospital with two-and four-bedded rooms compared to a new hospital that incorporated evidence-based design features, including exclusively single-patient rooms (SPRs). BACKGROUND: Hospitalized patients often report poor sleep quality due to both patient-related factors and hospital environmental factors. It is unclear if staying in an SPR in a hospital designed as a healing environment is associated with better sleep quality. METHODS: In a before-after study, sleep quality, duration, and efficiency over 72 hr were measured with a sleep diary, GENEActiv accelerometer, and the Richards-Campbell Sleep Questionnaire (RCSQ) with scores ranging from 0 to 100, with higher scores reflecting better sleep. Participants were either staying alone in the former hospital with two-and four-bedded rooms (Group 1), sharing a room with one to three fellow patients (Group 2), or staying alone in a newly designed hospital with 100% SPRs (Group 3). RESULTS: We included 17 patients in Group 1, 32 patients in Group 2, and 56 patients in Group 3. Univariable linear mixed model analysis, controlling for night number, revealed that the RCSQ total score was lowest in Group 2 compared to the other two groups. In the multivariable analysis, the RCSQ score was also the lowest in Group 2, with a significant effect from covariate "use of night medication." CONCLUSION: Self-reported sleep quality of hospitalized patients in a hospital with 100% SPRs designed as a healing environment was slightly better than that of patients staying in multioccupancy rooms with fellow patients.

Utilization of Lyotropic Liquid Crystalline Gels for Chronic Wound Management.

Management of chronic wounds is becoming a serious health problem worldwide. To treat chronic wounds, a suitable healing environment and sustained delivery of growth factors must be guaranteed. Different therapies have been applied for the treatment of chronic wounds such as debridement and photodynamic therapy. Among them, growth factors are widely used therapeutic drugs. However, at present, growth factor delivery systems cannot meet the demand of clinical practice; therefore new methods should be developed to meet the emerging need. For this reason, researchers have tried to modify hydrogels through some methods such as chemical synthesis and molecule modifications to enhance their properties. However, there are still a large number of limitations in practical use like byproduct problems, difficulty to industrialize, and instability of growth factor. Moreover, applications of new materials like lyotropic liquid crystalline (LLC) on chronic wounds have emerged as a new trend. The structure of LLC is endowed with many excellent properties including low cost, ordered structure, and excellent loading efficiency. LLC can provide a moist local environment for the wound, and its lattice structure can embed the growth factors in the water channel. Growth factor is released from the high-concentration carrier to the low-concentration release medium, which can be precisely regulated. Therefore, it can provide sustained and stable delivery of growth factors as well as a suitable healing environment for wounds, which is a promising candidate for chronic wound healing and has a broad prospective application. In conclusion, more reliable and applicable drug delivery systems should be designed and tested to improve the therapy and management of chronic wounds.

Describing Remembrance & Renewal: A Holistic Self-Care Program.

Background: Holistic care interventions include support for healthcare worker grief in a relationship-based care paradigm. Few programs support oncology healthcare worker grief and renewal prior to and during the COVID-19 pandemic. Objective: Describe "knowledge of" and "engagement with" a program about grief and resilience, Remembrance & Renewal (R&R). Method: An anonymous, electronic survey was available to healthcare workers at an academic, comprehensive cancer center. Demographic questions were analyzed against "knowledge of" and "engagement with." Results: Of 105 responding to "awareness of," 81 knew about R&R and 48 had "engaged with" the program. Statistically significant relationships between a characteristic and awareness were found for education (p = .03), setting (p < .01), and the frequency of learning about a death (p = .04). Statistically significant relationships between a characteristic and level of participation were found for profession (p = .02) and length of time in job (p = .03). Open-ended questions asked about impact of patient death (n = 93), barriers to participation (n = 54), and feelings after "engagement with" (n = 45). Responses to impact, barriers, and feelings were respectively: sadness (75.3%); time (77.8%); and calm (75.6%). Conclusion: This study describes "knowledge of" and "engagement with" a holistic grief and renewal program. Further study will add to healthcare worker holistic self-care.

The Healing Environment of Dental Clinics through the Eyes of Patients and Healthcare Professionals: A Pilot Study.

The physical environment of healthcare settings can promote both the healing process and patient feelings of well-being, as well as instill positive emotions in employees. The present study aimed to evaluate the dental work environment of a typical private and public dental clinic to identify key parameters that determine the perception of health facilities by patients and employees. The study was carried out from 1 to 20 December 2021, in two dental clinics in Ekaterinburg (Russian Federation) using 'ASPECT'. The participants were 58 staff and 94 patients. The results showed that, compared with patients, staff reported higher views scores, nature and outdoors scores, and comfort and control scores. The common criterion that distinguishes private clinics from public ones was comfort and control. Compared with patients in state clinics, patients in private clinics reported higher privacy, company and dignity scores, comfort and control scores, interior appearance scores, and facility scores. In general, while views scores and nature parameters can be singled out as a universal absolute value for everyone in a particular environment, staff pay more attention to factors that contribute to long-term comfortable stay and performance of their duties.

Asclepion of Epidaurus: the application of a historical perspective in medical education.

BACKGROUND: The Asclepion of Epidaurus is one of the first healing environments in the world. Descendants of Asclepius, specifically medical students, have been singularly deprived of any information concerning this legacy. This article illuminates the role of Asclepion of Epidaurus and examines the view of medical students upon the subject and the possible benefits of this knowledge in their medical education. METHODS: The participants were 105 senior-year students from the Athens Medical School, who attended a multi-media assisted lecture related to the structure and the role of the Asclepion of Epidaurus. Afterwards, they answered anonymously a questionnaire of 12 pairs of opposite adjectives in order to describe their view regarding the meaning of Asclepion. The method used in the evaluation of their answers was that of semantic differential. RESULTS: The attitude of the students towards the meaning of Asclepion was positive, showing interest and excitement about a powerful, though unfamiliar piece of knowledge. CONCLUSION: Today's novice doctors have welcomed the concept of Asclepion as essential knowledge for the service they will be called to fulfill. The potential benefits of the Asclepian ideals in medical education and ethos are thoroughly discussed.

The outcomes of a healing environment and clustering nursing care on premature infants' vital signs, pain, and sleeping.

Our study aimed to assess the effects of creating a healing environment and clustering nursing care on premature infants' vital signs, pain, and sleeping. The study had an experimental research design for the control and study group, each with 53 premature infants. We collected the data through the Vital Signs Sheet, Premature Infant Pain Profile, and Neonatal behavioral state. We used T-tests and chi-square tests to assess the differences between groups. There was a highly statistically significant difference between the study and control groups concerning respiration (p-value<0.01) and heart rate, systolic blood pressure, and O2 saturation (p-value<0.05). 90.6% of participants in the study group had a mild total premature infant pain profile, while 37.7% of the control group had a moderate total premature infant pain profile score. Applying a healing environment and clustering nursing care significantly improved respiration, heart rate, oxygen saturation, and systolic blood pressure. Furthermore, it increased sleep time and decreased wake state and pain score.

System, Space, Staff, and Stuff framework in establishing a new pediatric critical care unit (PICU) (4S Framework).

By virtue of being in a developing country with ongoing expanding of the healthcare system, establishing or at least renovating a Pediatric critical care unit (PICU) has become a necessity. As intensivists and healthcare providers, we excel at our job as clinicians; however, we perform less than perfect when it comes to participating in establishing new PICUs and deliberately building and designing an EBM and patient-centered PICU with a complete understanding of the technical and non-clinical processes during commissioning or operational phases like construction, physical layout (blueprint), Biomedical engineering aspects, equipment, supply, and work-environment enhancement. If all healthcare providers -and especially intensivists- avoid being involved actively in PICUs designing process at their institution, they will miss an opportunity to gain a new perspective as well as they might contribute to a fragmented process of ICU design and a suboptimal result that might impact the PICU environment, patient journey and eventually the quality of care in that ICU. The PICU designing processes should be handled via a multi-professional team approach in an integrated -not parallel- manner that includes clinical and non-clinical personnel. Therefore, the processes will be more integrated, and they will finish the project efficiently, effectively, safely, and patient-centered way. This paper is an expert opinion and literature review that describes a conceptual framework to guide simple and practical mental processes in establishing and designing processes for new PICUs in developing countries. We called this preparedness tool: the 4S framework (system, space, staff, and stuff). It is a well-known preparedness tool that is commonly used in planning new projects by project leaders. Therefore, we utilized it in establishing a new PICU intended to meet the national and international accreditation standards and requirements. This unique preparedness tool will help establish an easy conceptual framework for all healthcare providers to grasp the complex -clinical and non-clinical- processes of establishing new PICUs and develop a holistic approach to this complex project. Note: The authors had leading roles in establishing or renovating many PICUs in Saudi Arabia, in both private and governmental hospitals, and would like to share their novel conceptual framework for establishing new PICUs in developing countries.

Mechanism of the Huangguoshu waterfall forest environment's promotive effect on human health in Guizhou, China.

Background: The aim of this study was to investigate the specific mechanisms underlying the human health-promoting effects of the forest environment at Huangguoshu Falls, Guizhou, China. Methods: Ninety-five participants were recruited and an eye tracker was used to record fixation and sweep indices. A questionnaire was also used to evaluate the effects of different subject environments on human emotions, perceived recovery and preferences. Thereafter, 24 participants with chronic fatigue syndrome (CFS) were recruited and the participants' fatigue and stress-related scale indices and inflammatory factor levels were examined. Serum metabolites of the participants under different time waterfall forest interventions were detected by ultra performance liquid chromatography-quadrupole-time of flight mass spectrometry (UHPLC-Q/TOF-MS). Results: Eye tracking paradigm analysis showed that the "waterfall" element was the most interesting element for participants and that the "charm" of the waterfall forest environment could be well perceived by participants. Scores on the Fatigue Scale, Anxiety Scale and Depression Scale decreased as the duration of treatment in the waterfall forest environment increased. Levels of inflammatory factors decreased after treatment in the waterfall forest environment. At the same time the level of antioxidants, represented by L-ascorbic acid, increased significantly. Conclusions: The charm of the Huangguoshu waterfall scenery could be perceived by the participants and have a positive modulating effect on mood and cognitive function. In addition, the unique mixture of negative oxygen ions in this environment can increase the content of endogenous antioxidants and balance the metabolism of choline and amino acids.

Cardiorespiratory Interaction and Autonomic Sleep Quality Improve during Sleep in Beds Made from Pinus cembra (Stone Pine) Solid Wood.

Cardiorespiratory interactions (CRIs) reflect the mutual tuning of two important organismic oscillators-the heartbeat and respiration. These interactions can be used as a powerful tool to characterize the self-organizational and recreational quality of sleep. In this randomized, blinded and cross-over design study, we investigated CRIs in 15 subjects over a total of 253 nights who slept in beds made from different materials. One type of bed, used as control, was made of melamine faced chipboard with a wood-like appearance, while the other type was made of solid wood from stone pine (Pinus cembra). We observed a significant increase of vagal activity (measured by respiratory sinus arrhythmia), a decrease in the heart rate (as an indicator of energy consumption during sleep) and an improvement in CRIs, especially during the first hours of sleep in the stone pine beds as compared to the chipboard beds. Subjective assessments of study participants' well-being in the morning and sub-scalar assessments of their intrapsychic stability were significantly better after they slept in the stone pine bed than after they slept in the chipboard bed. Our observations suggest that CRIs are sensitive to detectable differences in indoor settings that are relevant to human health. Our results are in agreement with those of other studies that have reported that exposure to volatile phytochemical ingredients of stone pine (α-pinene, limonene, bornyl acetate) lead to an improvement in vagal activity and studies that show a reduction in stress parameters upon contact with solid wood surfaces.

Research on Constructing a Healing Environment for the Street Spaces of a High-Density City: Using Street Spaces in Macao's Old City Area.

It is commonly recognized that street spaces in high-density cities are able to cause negative impacts in terms of residents' physical and mental health. This research intends to investigate and analyze how residents use street spaces in a high-density city in order to construct a healing environment for these street spaces. The research was conducted in Macao's old town by using spatial syntax methods to define the research areas, and implemented on-site observations that evaluated the age of the residents in the space and the conditions of their usage of the space. The study collected data through expert grading and employed the Analytic Hierarchy Process to calculate the weight of each indicator in order to attain accurate and objective research outcomes. The evaluation results indicate that the current Macao street spaces are poor healing environments. By analyzing the effective factors for constructing a healing environment in these street spaces, so that residents can get more space for healing when they use it, the paper aims to provide a model example for those who are involved with city governance, planning and design.

Stroke Patients' Experiences in an Adaptive Healing Room in a Stroke Rehabilitation Unit.

OBJECTIVES: This study evaluated the user experiences (UX) of stroke patients residing in the adaptive healing room (AHR) and compared them to the UX of patients residing in standard private rooms (SPRs). BACKGROUND: Healing environments in healthcare settings can promote patients' healing processes, outcomes, and psychological well-being. The AHR was designed as a healing environment for stroke patients and has been previously evaluated in laboratory settings. This study was the first to evaluate it in its intended context-a stroke rehabilitation unit. METHODS: The UX of 10 patients residing in the AHR and 15 patients residing in SPRs were collected via structured interviews with a set of open-ended questions and analyzed using quantitative and qualitative methods. RESULTS: The AHR design features (orientation screen, skylight, and nature view) were rated positively by most patients. The skylight emerged as the least favorable. Responses to open-ended questions revealed that UX may be further improved if patients have more control over some of the settings (e.g., light intensity and nature views), and if the system allowed for more stimulation for patients at later stages of their recovery. Additionally, the results suggest that patients in the AHR have better UX than patients in the SPRs. CONCLUSION: The AHR has the potential to improve UX in the stroke rehabilitation unit. Patient feedback can be used to refine the AHR before carrying out clinical trials to assess the effect of the AHR on patient outcomes (e.g., sleep, mood, and length of stay) and stroke recovery.