Exploration of hospital room design on emotions, activity, and social connections after stroke: a qualitative study of patient experiences using virtual reality

Michelle M Shannon; Ruby Lipson-Smith; Marie Elf; Marcus White; John Olver; Tianyi Yang; Julie Bernhardt

doi:10.1080/09638288.2025.2451771

Exploration of hospital room design on emotions, activity, and social connections after stroke: a qualitative study of patient experiences using virtual reality

Disabil Rehabil. 2025 Jan 22:1-10. doi: 10.1080/09638288.2025.2451771. Online ahead of print.

Authors

Michelle M Shannon^{1

2

3}, Ruby Lipson-Smith^{1

2}, Marie Elf⁴, Marcus White⁵, John Olver⁶, Tianyi Yang⁵, Julie Bernhardt^{1

2}

Affiliations

¹ Stroke Theme, Level 1, The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.
² NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia.
³ Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Peninsula Campus, Monash University, Frankston, VIC, Australia.
⁴ Centre for Design Innovation, Department of Interior Architecture and Industrial Design, Swinburne University, Melbourne, VIC, Australia.
⁵ Environment, Technology and Participation, School of Health and Welfare, Dalarna University, Falun, Sweden.
⁶ Rehabilitation Medicine (School of Clinical Sciences), Monash University, Melbourne, VIC, Australia.

PMID: 39840937
DOI: 10.1080/09638288.2025.2451771

Abstract

Stroke patients are rarely asked about their responses to specific design attributes. Virtual reality (VR) offers a promising tool to explore how hospital environments are experienced after stroke.

Purpose: To gather perspectives and emotional responses regarding physical design attributes of hospital patient rooms after stroke.

Material and methods: We developed a 'VR experience' for adult stroke patients in both single and multi-patient room designs, with four additional physical design attributes: spaciousness, greenery outlook, night-time noise, and design attributes for social connectivity e.g. furnishings. A qualitative study approach involved semi-structured interviewing, that followed immersion in the VR patient room designs. Qualitative descriptive and thematic analysis was done. (Australian New Zealand Clinical Trials Registry, Trial Id: ACTRN12620000375954).

Results: Thirty-five stroke patients participated (April 2019-March 2020). Interviews yielded three themes and ten sub-themes. Themes were: (1) action and care supported by design and layout, such as ease of movement; (2) connection to people, nature, and place, emphasising social interaction and greenery; and (3) control of the environment, involving attributes like space.

Conclusions: Findings showed how physical design attributes enhance movement accessibility, promote social interaction, or provide sensory comfort. Using VR allowed rich, detailed feedback from patients, offering valuable insights for designing hospital environments.

Keywords: Hospital design; emotions; patient room; perspectives; social connectivity; stroke; virtual reality.

Plain language summary

Placement of recognisable furnishings, configuration of spaces in patient rooms, and quiet private spaces are perceived as supporting social interactions and movement.Positive distractors of greenery exposure, outdoor views, and human-based sounds support restorative opportunities from clinical care tasks.Noise, intrusive presence of other people in own space, and difficult access to technology/personal effects contribute to discomfort.Addressing emotions and social connectivity through environment design might prime social and physical activity for optimal brain recovery and repair.