A Multidimensional Conceptual Framework for Supportive Outdoor Environments in Healthcare Settings

The integration of supportive outdoor environments (SOEs) in healthcare settings has gained increasing attention for their potential to enhance patient recovery, support staff well-being, and contribute to holistic therapeutic outcomes. This scoping review examines design recommendations for inclusive outdoor environments in healthcare settings that impact user health and experience. Guided by the Joanna Briggs Institute (JBI) framework for scoping reviews, a comprehensive search was conducted across five databases (Google Scholar, PubMed, ScienceDirect, JSTOR, Sage), yielding 697 records. Following screening and applying the inclusion and exclusion criteria, 18 articles were selected for analysis. This scoping review identified consistent evidence linking outdoor environment qualities with improved psychological and physiological health. Thematic analysis revealed 5 key themes forming 15 domains that articulate a set of evidence-based design recommendations, reflecting user-centered health needs and experiential outcomes. Building on this synthesis, this study proposes a multidimensional conceptual framework that elucidates how SOEs shape health outcomes through interactions between user engagement, design conditions, and experiential processes. The framework provides an integrative synthesis of evidence to architects, landscape designers, and healthcare policymakers to support outdoor design and evaluation in healthcare settings. The findings emphasize the importance of integrating spatial design with operational and policy-level strategies and highlight the need for further empirical research to strengthen evidence-based practices and address existing knowledge gaps.