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Designing healing environments: A literature review on the benefits of healing gardens for children in healthcare facilities and the urgent need for policy implementation

Originally Published:
Key Point Summary
Key Point Summary Author(s):
Piatkowski, M.
Key Concepts/Context

Numerous studies have shown benefits of nature in healthcare environments. Healing gardens have been of particular interest in healthcare design, but research on these settings tends to focus on outcomes for older adults. Healing gardens may support positive outcomes for children as well, including physical, mental, and emotional health. Findings in this review include examples of how gardens support play, development, and restoration for pediatric patients. Further, the review argues for increased incorporation of gardens in pediatric healthcare design.


The aim of this literature review was to explore and document the potential positive impacts of hospital healing gardens for pediatric patients.


Researchers used a thematic approach to identify literature for this review of articles, books, reports, and policy documents. They began by focusing on four themes: (1) the definition of a healing garden, (2) theories, (3) the value of play and its impact on children’s development, and (4) policies. Keywords and terms in the search included “healing gardens,” “children,” “healthcare facilities,” “policy,” “biophilic,” “hospital setting,” “design,” “therapeutic gardens,” “pediatric healthcare,” “exemplars of healing gardens in hospitals,” “therapeutic effects,” and “restorative environment.” The researchers used Google Scholar, Google, ScienceDirect, Scopus, and the Search Library Discovery at the University of Gloucestershire to conduct this search.

Design Implications
The authors recommend the following design considerations for children’s healing gardens: open spaces that support a variety of options to play; signage to support wayfinding; accessible pathways to gardens; plants that support sensory experiences, natural forms, and colors; educational boards to explain the intent of the garden; moveable seating; spaces for both prospect and refuge; adequate shade; adequate and comfortable seating; and access to pedestrian routes.

The researchers found many different definitions of the term “healing garden.” The term “healing” may be misleading, as it denotes a direct curing effect, when the term is actually intended to denote the restorative effect during the healing process.

The findings in the literature from different parts of the world show differences in how these gardens are used, either for more passive use (e.g., sitting) compared to more active use (e.g., horticulture therapy activities), as well as differences in how these gardens are perceived in western and eastern cultures.

The research includes many theories around the human-nature connection, especially related to biophilia. Another theory discussed in this review is the “attention restoration theory,” which says that humans experience mental restoration when looking at nature or spending time in nature. The authors argue that these theories support the need for healing gardens in hospitals to create happier experiences for children and help to alleviate stress.  

Findings include research on the opportunity for play as an important and unique aspect of healing gardens designed for children. The authors outline general research on the importance of play in all children’s development and then share specific research on the benefits of outdoor play in nature. The authors discuss the benefit of gardens as a place for children to escape from the wards where they may feel isolated and have a chance to play with other children.

Further, the review includes some additional benefits of gardens, including noise reduction, improving air quality, opportunities to grow healthy food, and the potential for better recovery rates and lower need for medication.


This methodology in this review is not systematic or rigorous, but more of a summary of ideas from various sources, including some research findings with the aim to support a case for healing gardens for children. Recommendations in this review should be considered with caution, as the authors have drawn conclusions based on singular studies.

The authors identify the need for more research on this topic and specifically call for more quantitative research. However, there may be some confusion about quantitative research, as they provide examples of studies as not being “quantifiable” (e.g., Roger Urlrich’s 1984 study findings), which do in fact include quantitative methods (e.g., number of days in the hospital and dosing of pain-reducing medication).

Key Point Summary Author(s):
Piatkowski, M.
Primary Author
Din, S. K.-J.
Paper Type