Spatial cognition in hospital buildings for different types of visual impairment: a framework based on Grounded Theory

This study aimed to construct a systematic framework of spatial cognition for visually impaired individuals, elucidating the mechanisms through which spatial information is transformed into navigational behavior. Using a Grounded Theory approach, fifty-six participants were interviewed, leading to the identification of five key domains: effective environmental information, multi-source perception, perceptual information processing, spatial cognition acquisition, and prompting behaviours. These domains collectively describe a hierarchical pathway from environmental perception to behavioral response. We traced how each impairment group engaged cognitive strategies across key stages of the pathway and compared patterns across groups. Congenitally blind participants construct predominantly linear cognitive maps based on tactile and auditory cues. Acquired blind participants draw on prior visual experience to infer nonperceived spatial relations and build more coherent internal layouts. Partial visual impairment participants combine residual vision with multisensory inputs and recalibrate strategies as environmental conditions vary. In addition, our proposed framework integrates and extends established accounts of spatial cognition by situating them within visually impaired individuals’ multisensory experiences in hospitals.