To assess how the presence of landscape features influences the visit intent of users in different roles in a hospital setting. People stay or work in a hospital are usually accompanying with lots of emotional and work-related stress. We developed a discrete choice experiment to provide quantitative evidence that indicates the effect and effect size of the landscape features. The objectives of this study are to, firstly, identify the effective landscape features that engage visits; and, secondly, select the choices of landscape features specific to different user groups based on the effect on the engagement of visits. This study implicates the relevant inclusion and priorities of landscape features for the diverse user groups on a hospital property.
In inside architectural design (Fig. 1), there were only card 1 and card 2 have statistically significances in patients group (Table 1). The results showed, schizophrenia patients tend to more like the picture of lamp with giant and bright light, on the other hand, patients with higher score of BSRS tend to prefer the picture of lamp with small and soft light (card 1). In this study, the diagnosis divided into schizophrenia and other minor emotional illness, such as minor depression, bipolar and so on. In fact, BSRS is a measurement related to emotional distress. Thus, it may be concluded individual with emotional distress tend to more like the environment with small and soft light lamp. For card 2, females tend to prefer the picture of small discussion room, however, patients with older age, with higher score of BSRS, higher social adaption status tend to prefer the picture of big conference hall. Cognitively, a big conference hall is like a professional, serious and power center, on the contrary, a discussion room is like a warm, happy and relax room. In traditional Chinese culture, males and older age person are the main authority figures in the family and workplace, although, there is a social change in the modern society. In this study, the mean age of patients were 50.19 years old. They might still retain the traditional concept in the mind. Hence, male patients with older age tend to like a professional, serious and power conference hall. In fact, the place with green plants will be appear more happy and relax [14, 25]. That is, females like to stay in the place around the green plants, that may be causing more happiness and relax.
In the outside landscape (Fig. 2), male and person who have higher educational level tend to prefer the picture with large yellow flower in patients group (card 1). Patients with schizophrenia and person with higher scores of BSRS tend to prefer the picture of unmoved lamp, on the contrary, person with higher psychological well-being tend to prefer the picture of moved bird (card 2). That is, schizophrenia and who with higher level of emotional distress will be like to lamp that cannot be moved. In card 3, person with higher educational level tend to prefer the picture of pavilion without roof. In card 4, person with schizophrenia tend to prefer the picture of space with long fence, however, person with higher social adaption status tend to prefer the picture of space with roof. It seems schizophrenics may like places with more security. In card 5, person with higher level of psychological well-being tend to prefer the picture of square with green meadow. Similar to the previous studies, greenness is related to larger reductions in symptoms of anxiety and depression [20–25]. In card 6, person with higher level of social adaption status tend to prefer the picture of trees with dense leaves.
Multiple logistic regression analysis showed that there were several significant associations between contributing factors and architecture and landscape. However, owing to the limitations of regression analysis, mediating and moderating factors may have been neglected in the analysis. Hence, the further path analysis, using of structural equation modeling, were analyzed the mediating and moderating roles of the contributing factors and architecture and landscape in patients group. For patients group, the model resulted that emotional distress will positively contributing to the social adaption status (Fig. 5). Patients with higher level of emotional distress like to select card 10 in inside architectural design, then further reducing whose psychological well-being. Card 10 in inside architectural design act as the mediating factor between emotional distress and psychological well-being. In addition, who with higher level education like to select card 2 in inside architectural design, and then further increasing contributed to psychological well-being.
Comparing the patients and hospital workers, patients tended to higher social adaption status, but had lower level in psychological well-being. The results are not shown in this study. On the other hand, hospital workers tended to higher educational level, and had likely select card 8 in outside landscape. People who selected card 10 in inside architectural design, tend to lower level in social adaption status and psychological well-being. In fact, the big different age between patients and hospital workers seems as a limitation in the present study. The mean age in patients was 50.19 years old, and the mean age of hospital workers was 39.05 years old. Different generation may cause different cognitive thinking and value. It may also contributed the results between two groups. Hence, the age- and sex-match in two groups need to consider in the future study.