An Exploratory Study of the Therapeutic Value of Outdoor Environments in Psychiatric Hospitals in Southeast Nigeria

Abstract

This exploratory study investigated the relationship between outdoor environmental features and patient satisfaction in psychiatric hospitals in Southeast Nigeria, a region experiencing rapid urbanisation, where cultural perceptions of nature's therapeutic role may differ from Western contexts. A quantitative, cross-sectional survey was conducted across four psychiatric facilities, sampling 121 inpatients to assess their experiences and satisfaction with the outdoor environment. The findings revealed that the most common outdoor environment consisted of buildings and walls, with a generally neutral to slightly negative perception of the outdoor views among patients. Contrary to expectations based on theories like the Stress Reduction Theory, Theory of Supportive Design, and Biophilic Design Theory, no statistically significant association was found between the dominant outdoor views and patient satisfaction. The study, therefore, highlights the importance of socio-cultural influences which define patients' preferences and perceptions of therapeutic environments. It suggests that social support and opportunities for family visits may be more critical to patient well-being in this context than the aesthetic qualities of outdoor views. The research also acknowledges the potential impact of varying levels of urbanisation and familiarity with natural settings on patients' environmental perceptions. The study concludes that designing therapeutic outdoor spaces in Southeast Nigeria requires a nuanced approach that considers cultural, social, and individual factors, emphasising the need for accessible outdoor environments that foster social interaction and patient autonomy.