Aakash Johry

Pediatric healthcare environments in India are often overcrowded and noisy, creating stress for children and parents/caregivers. Since parental behavior strongly influences children’s healthcare experiences, understanding human-environment interactions in pediatric settings is essential for evidence-based design. This study, in the waiting-space of a pediatric hospital in India for 4 months, explored human-environment interactions of parents/caregivers through 56 hr of observation and 1,134 behavioral descriptions. Findings revealed that parents/caregivers were active participants who sought information, navigated healthcare systems, assuaged children’s discomfort, negotiated institutional regulations and adapted environmental resources during prolonged waiting. The waiting space not only functioned as a transitional area but also as a temporary space for caregiving and coping. Key design challenges included prolonged waiting, overcrowding, unclear wayfinding, inadequate seating and absence of designated rooms for breastfeeding and diaper-changing. The study highlights the need for evidence-based design that recognizes parents/caregivers as active-users of pediatric healthcare environments rather than as passive-attendants.

Objective: The study aimed to examine empirical studies published between 2003 and 2025 to identify elements of physical environments influencing health outcomes and experiences of children and families. Background: In the past 40 years, research has shown that the physical environment influences the health and well-being of patients in the healthcare environment. However, similar research in the context of “pediatric inpatient wards” remains underexplored. Methods: PubMed, Embase, Scopus, and Web of Science were used to identify relevant articles. All extracted articles underwent a three-step screening process using PRISMA. A total of 30 eligible articles were used for the analysis. The protocol is registered at PROSPERO (CRD42023408997). Results: Key findings reveal positive and negative impacts of identified elements. Positive-effect elements include play spaces, space for parents, natural light, connections with nature, and so on, which promote comfort, healing, and emotional resilience. Conversely, negative-effect elements, such as noise, artificial lighting, uncomfortable temperature, and so on, contribute to stress and disrupted sleep. Mixed effects were observed for elements like art and television, which underscore the complexity of designing environments that address the diverse needs of different age groups and genders. Conclusions: The review findings highlight significant knowledge gaps. The study also tries to bridge existing gaps between research and practice by systematically identifying environmental elements, offering actionable insights to architects, designers, healthcare providers, and policymakers. Future research must adopt rigorous, culturally inclusive approaches to advance the field of pediatric healthcare design and ensure equitable care across diverse sociocultural contexts.