Is it the place or the people? Disentangling the effects of hospitals' physical and social environments on well-being

Abstract

Objective: The hospital environment is an interpersonal context of caretaking and it has itself an impact on patients’ well-being. Whereas quality of the patient-providers relationship is the back-bone of the medical treatment, evidence has been accumulating on the role of the health care physical environment. However, the specific contribution of these dimensions is not clear. The main goal of the first study was to disentangle the independent effect of hospital’ physical and social environments. The objective of the second study was to investigate the inferences people do based on information about one of those dimensions. Design: Two experimental laboratory studies were designed. The first study had 194 participants, and a 3 x 3 experimental between-subjects design, with two manipulated variables: quality of physical (bad, neutral, good) and social (negative, neutral, positive) environments. The second study consisted in six conditions, in which 127 participants were exposed to information about only the physical or the social environment. Main outcome measure: Expected well-being. Results: Hospital physical and social environments have a specific significant effect on patients’ well-being, but the physical environment tends to have impact only when it is bad. People do inferences on expected well-being based on information about only the physical or the social environment. Conclusion: The quality of hospital physical and social environments, and the corresponding well-being are associated in people’s minds. In addition to competent and empathic providers, healthcare physical context needs to fulfil a minimum standard.