Healing-Oriented Patient-Centered Care in the Healthcare Environment

Abstract

Contemporary medical practitioners increasingly recognize the critical impact of healing-environment design on patients’ recovery, positioning it as a pivotal consideration in healthcare facility planning. While existing research has predominantly focused on enhancing the functionality and efficiency of healthcare environments, it has often overlooked the significance of individual patient needs and their distinct experiences. This paper aims to utilize the principles of epidemiology and empirical analysis to explore the application and research trends of the patient-centered care (PCC) concept in healthcare facility design, to promote interdisciplinary collaboration and achieve customized healthcare environments. Based on bibliometric analysis and key literature review methods, this paper systematically examines and interprets the research development trends of PCC in healing environment design, integrating both macro and micro perspectives, and reveals how design factors in therapeutic environments support the realization of PCC principles, thereby improving patients’ rehabilitation experiences and health outcomes. The results indicate that current research on PCC is trending towards increasingly diversified integration via high-frequency keywords such as recovery, healing environment, and evidence-based design, highlighting the shift from functional optimization to emotional care, technological integration, and nature-based interactions in design. Notably, patient-centered care has become a consensus and core integrating concept in this field. This paper not only reveals the key role of healing environments in constructing PCC practice pathways but also provides theoretical support and strategic reference for the planning of healthcare spaces and the collaborative design of nursing processes, and demonstrates that healing environments have evolved from passive spaces into active rehabilitation mediums through interdisciplinary collaboration, thereby facilitating the implementation of the patient-centered healthcare philosophy.

1. Introduction

In modern medical practice, the influence of environmental factors on patient recovery has been increasingly emphasized, making the design of healing environments a key component of healthcare facility planning. However, although the design of healing environments has been widely explored in academic research, the focus of research has often remained on optimizing environmental functionality and efficiency, with less attention paid to the individual needs and feelings of patients. There is still a gap between the research focus and patients’ actual feelings. As a result, a gap persists between research priorities and patients’ lived experiences, and much remains unknown about how the implementation of specific healing environment designs affects patients’ recovery outcomes. This misalignment suggests a disconnect between current prevailing approaches and the principles of patient-centered care (PCC).

To bridge this gap, the proposed design principles of PCC provide a key entry point for improving healthcare architecture by creating functional and empathetic healing spaces that accommodate patients’ individual needs and emotional responses. The improvement of design has led to the creation of healthy therapeutic environments that effectively support and facilitate the healing process for patients [1]. Building on this foundation, through an in-depth analysis of empirical cases, this paper aims to propose specific design strategies and recommendations aimed at optimizing healthcare facility environments to better serve the needs of modern healthcare and support holistic patient recovery.

Evidence-based design (EBD) plays a crucial role in healthcare architecture. It is an approach that uses scientific research and rigorous data to guide design decisions with the goal of creating healthcare environments that positively impact patient health, work efficiency, and building energy consumption [2,3], with a particular emphasis on considering the needs and preferences of patients, healthcare professionals, and family caregivers, as well as the impact of environmental factors on health outcomes during the design process [4]. By grounding design solutions in empirical evidence, EBD supports the creation of safer, more efficient, and more patient-friendly healthcare environments, thereby advancing the implementation of PCC principles.

Current research trends in healing environment design indicate that researchers are increasingly focusing on how to enhance the patient’s healing experience through environmental design, which includes the study of elements such as natural light, landscaping, indoor plants, and art therapy [5], as well as how they affect patient mood, pain perception, and the healing process [6]. Through bibliometric analysis, the keywords in the field related to PCC currently include “health environment”, “patient experience”, “rehabilitation”, and “evidence-based design”. These keywords reflect researchers’ emphasis on healthcare treatment environments, as well as their focus on patient experience and rehabilitation outcomes. In addition, other keywords and themes of interest to scholars, such as “healthcare environment”, “comfort”, “nursing care,” “stress”, and “built environment” reveal strong connectivity and commonality among research on comfort-oriented healing environments, suggesting that researchers are actively exploring how design can enhance patient comfort and recovery.

Particularly, the prominence of keywords such as “open space” and “healing environment” reflects heightened attention to health environments in the post-pandemic era and illustrates a distinct trend within healing environment research. These research hotspots highlight key development trends in this field. Future research directions may further explore the impact of different environmental factors on specific patient groups (e.g., elderly, children, pregnant women) and how emerging technologies such as Augmented Reality (AR) can be integrated into the patient wellness process. Healing-oriented care environments play a crucial role in PCC by helping patients cope with the psychological stress of illness by providing spaces that support physical healing and creating a comfortable and reassuring environment [7,8]. In addition, such environments facilitate communication and interaction between patients and healthcare professionals, thereby improving the personalization and effectiveness of patient care [9]. This paper seeks to offer new perspectives and strategies for the healthcare facility design to ensure that such environments are both scientifically grounded and human-centered, thereby more effectively embodying the principles of PCC.

2. Materials and Methods

This study employs a methodological framework that integrates bibliometrics with critical literature review strategies, ensuring both a macro-level overview and micro-level analytical depth. Building upon extensive relevant literature, a knowledge-graph-based approach was first utilized to visually represent the current state of research. Knowledge graphs not only reveal co-occurrence relationships between keywords and the evolutionary trajectories of research themes but also intuitively display disciplinary intersections and hotspot clusters, thereby providing a clear structural framework for the field [10]. This approach helps reduce the subjectivity inherent in relying solely on textual reviews. Subsequently, through in-depth reading and structured analysis of selected key literature, the theoretical foundations and practical implications were examined, compensating for the knowledge graph’s limitations in depth of interpretation. By integrating macro-level trend identification with micro-level content analysis, this study constructs a comprehensive methodological framework aimed at providing a reliable knowledge foundation and insights for healing-oriented, patient-centered nursing research.

Within this overarching framework, specific research steps commence with the collection and organization of literature data, followed by detailed elaboration.

2.1. Literature Data Collection

In this paper, two software programs were used for knowledge mapping, namely CiteSpace (6.1.R6) [11] and VOSviewer (1.6.20) [12], which have their own characteristics and complement each other. VOSviewer (1.6.20) is based on a probabilistic data standardization method and generates visualizations of multiple keyword relationships, including density visualization with notable clarity and readability. On the other hand, CiteSpace software (6.1.R6), developed in Java language and grounded in citation analysis and information-visualization theory, offers advantages in mapping temporal evolution, identifying keyword bursts, and visualizing structural research trends. Compared with the VOSviewer software, it can more comprehensively display the time evolution of keyword development trajectories and keyword-emergence data with clear visualization outputs.

To ensure the quality of the collected data, the Web of Science Core Collection (WoSCC) was used as the primary data source. WoSCC is widely adopted in bibliometric research because of its curated coverage of high-impact journals and detailed citation information [13,14].

At the same time, previous scientometric studies have shown that WoSCC exhibits language and regional biases, for example, a dominance of English-language and Western journals [15,16]. These caveats, together with recent analyses of WoSCC’s changing coverage [17,18], were taken into account when interpreting our results.

A total of 96 records were retrieved from six high-impact WoS indexes, SSCI (1990–2024), SCI-E (1990–2024), CPCI-S (1990–2024), CPCI-SSH (1990–2024), CCR-E (1985–2024), and IC (1993–2024), and 89 records remained after excluding invalid data. These documents were subsequently processed using data-visualization software to map the research field. The purpose of the article scope review section was to examine the current state of research, collaborative networks and research trends, and to identify the scope of the study. As shown in

Table 1. Process and results of core ensemble data collection.

Source	Web of Science Core Collection
Citation	SCI-EXPANDED, SSCI, CPCI-S, CPCI-SSH, CCR-E, IC
	#1=TS=(“rehabilitation” OR “Art Rehabilitation” OR “Medical Rehabilitation” OR “Recovery”)
Search Steps	#2=TS=(“healing design” OR “therapeutic design” OR “Human-Centered Design” OR “Wellness Design” OR “Health-focused Design” OR “Patient-centered” OR “Embodied” OR “user experience”)
	#3=TS=(“Healthcare Environment”)
	#4 = #1 AND #2 AND #3
Timespan	1 January 2000–1 October 2024
Document Type Qualified records	Article and Review 89

, the search formula for the intersections of research on “rehabilitation”, “healing design” and “healthcare environments”.

In the retrieval formula, keywords categorised by subject are divided into three groups. This is reflected in the retrieval steps as follows: #1 Collect derivative terms related to ‘rehabilitation’, remove terms with low thematic relevance, and retrieve the union set of keywords; #2 Compile synonyms associated with ‘therapeutic’ and “design”, and retrieve their union set; #3 Extract literature related to ‘Healthcare Environment’; #4 Compute the intersection across all three thematic categories, resulting in 96 initial records for bibliometric analysis. After filtering out “articles” and ‘review articles’, 89 publications meeting the screening criteria were retained. Because this retrieval strategy identifies the complete intersection of the three themes within WoS, the final dataset represents the full corpus of literature meeting the study’s interdisciplinary scope. It should be noted that the ‘Topic’ search field (TS) in the WoSCC includes titles, abstracts, author keywords, and KeyWords Plus. While KeyWords Plus broadens the search scope by generating terms from cited references, it may introduce records that are only indirectly related to the author’s intent (noise). Therefore, a manual screening process was strictly applied to exclude invalid data and ensure the thematic precision of the final dataset.

For data processing, the advanced search functions within the WoS were first used to extract data volume, journal sources, and disciplinary classifications at the intersection of rehabilitation, healing design, and healthcare environment research. These were presented through charts and graphs. Subsequently, using CiteSpace and VOSviewer, keyword co-occurrence analysis (KCOA), overlay visualisation, time-zone diagram analysis, and burst-keyword detection were performed to generate scientific knowledge maps that identify current hotspots, developmental trends, and future directions. Notably, the retrieval timespan in this study was set from 2000 to 2024. The limited number of records retrieved prior to this period can be attributed to the inherent limitations of the ‘Topic’ search in historical bibliometric analysis and the dynamic nature of the database coverage. Previous authoritative studies published in the Journal of Informetrics and Scientometrics have documented that the indexing completeness of Web of Science—such as author address information and other metadata fields—exhibits significant temporal variations, with higher rates of missing data in earlier years [19]. Consequently, the ‘Topic’ search (covering titles, abstracts, and keywords) is less comprehensive for historical data compared to recent years [20]. Therefore, focusing on the post-2000 period ensures the reliability and consistency of the bibliometric analysis.

2.2. Research Methods

This study primarily employs bibliometric methodologies, utilising a combined macro- and micro-level research approach to comprehensively outline research trends within the field of healing-oriented, patient-centered care in therapeutic environments. It further explores the theoretical foundations and empirical research underpinning these trends, offering fresh insights and research directions for the discipline.

Bibliometric mapping was conducted using CiteSpace and VOSviewer. Specifically, Kleinberg’s burst detection algorithm was applied to identify emerging trends [21], while Freeman’s betweenness centrality was used to highlight pivotal nodes in the network [22].

The overall research design follows widely used procedures for bibliometric studies, including study design, data collection, data analysis, and visualization.

At the macro level, this study employs bibliometric statistical analysis to identify and outline overarching trends within the research domain. By analysing extensive literature data, it reveals co-occurrence relationships among keywords, the evolution of research hotspots, and the overall structure of the field. This method provides a visual and quantitative representation of disciplinary development and research priorities [23]. At the micro level, this study engages in a critical literature review to analyse theoretical foundations and empirical studies in depth. This enables close examination of methodological innovations and the significance of research findings [24]. Through this analysis, current research directions and gaps are identified. The key literature review also supports interdisciplinary knowledge integration, bringing together insights from architecture, psychology, medicine, and other disciplines to understand how they collectively shape advances in healing-oriented PCC [25].

By combining these methodological approaches, this study aims to validate the relevance and applicability of innovative research methodologies identified through a critical literature review. Bibliometric analysis provides a macro-level perspective, revealing the acceptance and influence of these methodologies within academia, while a critical literature review offers deeper insights into their implementation. This dual methodology enables a more comprehensive examination of the application potential for healing-oriented, patient-centered care practices within therapeutic environments.

2.3. Research Issue

This paper is organized around the following seven research questions, which aim to bridge the gap between current research in the field in terms of practical application. By addressing these questions, this study provides valuable insights into the field, emphasizes the importance of interdisciplinary collaboration in creating effective healing environments through the multifaceted impact of healing environment design on patient recovery, and suggests future research directions to advance the practice of healing-oriented PCC. The specific research questions are as follows:

Q1: What are the major keywords and themes in current research on healing-oriented patient-centered care?

Q2: What are the major challenges to the implementation of healing-oriented patient-centered care?

Q3: What trends and future research directions emerge from current research hotspots?

Q4: What role does the healing-oriented care environment play in patient-centered care?

Q5: How does the healing-oriented care environment affect the patient’s healing and recovery process?

Q6: What are the latest advances and innovative practices in healing-oriented patient-centered care?

Q7: What gaps in current research does this paper address?

2.4. Research Framework

As shown in Figure 1, the research framework provides a structured and systematic approach designed to explore the core topics of this study. The research begins with an in-depth analysis of the theoretical foundations, including the philosophy and practice of PCC, principles of evidence-based design (EBD), and the theoretical foundations of healing environment design. The research methodology was clarified through bibliometric analysis and critical literature review, organized around seven core research questions.

Relevant literature was retrieved from the WoSCC, providing a high-quality data set. During the data-analysis and hotspot-identification stage, keyword co-occurrence network analyses were conducted, and visualizations were generated using VOSviewer and CiteSpace to reveal the evolution of the research field and hotspot trends. Subsequently, data visualizations were used to interpret patterns and insights. The study then explores the impact of healing-oriented PCC practices, the role of multidisciplinary collaborative research in healthcare settings was analyzed, and the application and effectiveness of Augmented Reality (AR) technologies in rehabilitation for special patient groups. The overall research framework ensures that the study is systematic, rigorous, and methodologically coherent.

Therefore, this paper employs a multidimensional analytical strategy grounded in both macro and micro perspectives, revealing a limited amount of research explicitly focused on true ‘patient-centeredness’. The study centers on patient-centered design, healing environments, and the application of evidence-based design within the broader context of PCC. Macro-level analysis examines developmental trajectories and theoretical foundations across existing literature, while micro-level analysis investigates implementation outcomes through case studies, particularly their impact on patient recovery and treatment effectiveness.

3. Results

3.1. Background of Publications

3.1.1. Descriptive Statistics

According to bibliometric theory, the temporal distribution of literature volume within specific disciplines reflects their general developmental trajectory. Annual publication counts serve as crucial metrics for evaluating scientific research progress, with trends in output volume indicating shifts in domain knowledge. Consequently, literature volume functions as a critical metric for assessing the accumulation and evolution of scholarly knowledge. It is also important to acknowledge the dynamic nature of the WoSCC database, where citation counts and indexing are subject to continuous updates and retroactive changes. Consequently, the bibliometric data presented in this study represents a snapshot captured at the time of retrieval, which may result in minor variations in reproducibility for future searches. As illustrated in Figure 2, the overall trend in article publication demonstrates a clear upward trajectory, evidenced by the rising height of the light blue bars. This pattern highlights the expanding body of research situated at the intersection of rehabilitation, healing design, and healthcare environments. The interdisciplinary field under examination in this study constitutes an emerging research topic frontier. Prior to 2018, publication remained relatively unstable, with no relevant literature appearing in 2001, 2003, 2005, or between 2007 and 2010. Notably, the period preceding 2017 was characterised by pronounced annual fluctuations, indicating the field’s early developmental stage. A rapid escalation in publication volume occurred thereafter, with 2024 exhibiting a doubling of output compared with the preceding year. This reflects a marked intensification of research activity and growing scholarly attention. The pronounced increase in publications after 2020 corresponds closely with the onset of the COVID-19 pandemic, during which hospitals were compelled to reconsider ventilation, infection prevention, stress reduction, and patient isolation. This shift stimulated renewed scholarly interest in healing environments and PCC recovery-oriented spatial design.

However, interpreting this surge requires caution regarding the data source. As documented by authoritative studies in Scientometrics, the Web of Science Core Collection is characterized by its dynamic nature, involving continuous coverage expansion and retrospective indexing updates [17,18]. Consequently, the sharp increase in publication volume observed in recent years (particularly the peak in 2024) should be attributed not only to the flourishing academic interest in healing environments but also to the database’s broadened journal coverage and indexing depth over time. This dynamic feature implies that the observed growth trends reflect a composite of genuine scientific output increase and database evolution.

The deep blue trend line in Figure 2 represents citation counts for papers published in the field, demonstrating a sustained upward trend, which indicates increasing recognition and academic influence. Overall, both publication volume and citation patterns affirm that research in this domain continues to expand in scale and significance.

The sources of publications related to rehabilitation, healing design, and healthcare building integration are shown in Figure 3. It is worth noting that among the 89 articles in the WoSCC database, 66 research directions were categorized according to the “Web of Science Categories”, an analytical search tool in the WOS platform. By applying the criterion of “more than two articles per research direction”, nine research directions with a high number of articles were identified to map the disciplinary distribution of publications (see Figure 3). These nine frequently represented subject areas include public environmental occupational health (27 articles), rehabilitation (10), nursing (5), computer science cybernetics (4 articles), computer science information systems (4), building construction technology (4), civil engineering (4), engineering electrical and electronics (4), and healthcare science services (4). The substantial disparity in publication volume between the top two categories and the remaining disciplines suggests that the scope of research in this field is relatively limited, primarily addressing themes related to public environments and rehabilitation. While certain areas remain undeveloped or emerging, research in the public environment appears comparatively mature, whereas research in the fields of architecture, civil engineering, and engineering remains relatively limited. All remaining research directions with fewer than two publications were classified as “Other”. Although the latter accounts for 41 publications (47.2% of the total), it spans a wide range of fields, including chemistry, social sciences, neuroscience, imaging sciences, orthopedics, biomedical engineering, physics, applied medicine, medical ethics, and forestry geography. This wide disciplinary spectrum highlights the substantial potential for interdisciplinary collaboration in this field, as well as the inherent complexity of research at intersections between the study of rehabilitation, healing design, and healthcare environments, which emphasizes the need for systematic and comprehensive inquiry into these interrelated domains.

3.1.2. Keyword Co-Occurrence Network Analysis

Keyword co-occurrence temporal mapping can reveal evolution, structure, and thematic focus of research within a field by organizing keywords according to clustering patterns and chronological distribution. To clearly identify the developmental pathways, research hotspots, and emerging frontiers, the keyword co-occurrence is arranged in chronological order, allowing visual tracking of shifts in research focus across different time periods. The keyword co-occurrence results (Figure 4), generated using CiteSpace, illustrate keyword distributions across time intervals, enabling identification of both high-frequency terms and their temporal emergence. As shown in Figure 4, the chronological presentation of keyword clusters, spanning the years 2000 to 2024, clearly depicts the progression and transformation of research themes. Each vertical time band marks the first appearance of a keyword; larger node sizes indicate higher keyword occurrence frequency of the keyword, and the connecting lines between the circular nodes reflect stronger conceptual associations.

In Figure 4, the theme of research on rehabilitation, healing design, and healthcare environments can be divided into four phases:

Phase 1 (2000–2006): Early problem formulation. The earliest keywords, which originated from the appearance of “negativity”, “disease”, and “program”, frame the research in the field through a problem-driven lens, raising fundamental questions for future inquiry. These terms reflect early conceptual exploration, laying the groundwork for subsequent research.

Phase 2 (2006 onwards): Emergence of the core concept “recovery”. Around 2006, the keyword “recovery” appeared with high frequency, marking the field’s first explicit articulation of its core objective: supporting patient recovery through healing environmental design. This period also introduces key terms such as “empirical design”, “healing environment”, and “fulfillment”, representing initial attempts to address how environmental design contributes to patient healing. These studies catalysed further inquiry into healthcare environmental design and patient recovery.

Phase 3 (2011–2016): Decentralization and thematic expansion. Research becomes more diversified, with emerging themes including “mental health”, “protection”, “caregiving”, “healing gardens”, and notably “patient-centered care”. The term “patient-centered care”, first appearing in 2014, subsequently influenced 53 subsequent research articles, connecting with 11 high-frequency keywords, such as resistance, healing environments, rehabilitation, quality of architectural space, co-managed care, evidence-based design, and bionic design. This reflects the growing incorporation of PCC principles into healing environment research.

Phase 4 (2017–2024): Expansion, integration, and technological convergence. Although keyword frequencies are lower in this period, the number of research hotspots and emergent topics increases significantly, illustrating strengthened interdisciplinary collaboration across rehabilitation, healing design, and healthcare architecture. Prominent emerging themes include bionic design, somatic therapy, human-centeredness, and healing spaces, as well as technology-driven topics such as management, augmented reality, Internet of Things, and global health. These trends suggest a shift toward integrated, technology-enhanced, and user-centered healing environments.

The obtained data were imported into VOSviewer for keyword co-occurrence analysis, identifying a total of 383 keywords with ‘keywords’ as the unit of analysis. Since the overall number of articles in the dataset is not large, and the keyword count remains manageable, the minimum co-occurrence threshold was set to 1 to ensure that the full clustering structure could be visualized. After eliminating 11 irrelevant or non-informative keywords, a total of 372 valid keywords were retained for analysis.

In the VOSviewer network visualization, relationships between related keywords are displayed using text, nodes (circles), connecting lines, and color-coded clusters. Larger nodes represent higher frequency keywords; thicker connecting lines indicate stronger co-occurrence relationships; the shorter (closer) distances suggest greater conceptual relevance; and the colors indicate distinct thematic clusters. As shown in Figure 5, studies related to rehabilitation, healing design, and healthcare environments in the WoSCC database are divided into six major clusters: brown, blue, red, green, orange, and purple.

Cluster 1 (Brown): Rehabilitation, Congenital Conditions, and Psychosocial Adjustment. Cluster 1 (brown) centres on terms related to “amputation”, “congenital defects”, and “rehabilitation”. Associated keywords include “autonomy”, “psychosocial adjustment”, “congenital”, “qualitative method”, “prosthetics”, “expressive arts-based intervention”, “stroke rehabilitation”, and “children”. Together, these indicate a strong research focus on irreversible physical impairments including congenital limb deformities [26], accidental amputation [27], stroke [28], and elderly-related conditions [29]. In response, researchers have developed a holistic approach through qualitative methods, developing arts-based rehabilitation, VR pain modulation interventions [30,31], and interactive digital tools for paediatric patients [32,33,34]. Concurrently, the ‘paediatric’ patient cohort warrants particular attention, especially as ‘children’ frequently emerge as a key term. Given children’s visual preferences for colour perception, olfactory sensitivity to scents, and tactile responsiveness to objects, related healing design research focuses on ‘therapeutic gardens’ within paediatric or children’s hospitals. Garden plants provide multisensory comfort through visual and olfactory stimulation, while their medicinal properties also aid treatment [35]. It is widely recognized that nature’s therapeutic effects can alleviate patient suffering and depression. Therapeutic landscape design positively influences children’s mental well-being, whilst biophilic design principles demonstrate practical benefits for paediatric patient recovery [36]. Furthermore, the keyword ‘rehabilitation’ closely aligns with ‘care’; rehabilitation within this field manifests as compassionate nursing practices. Evolving from patient care research, this has yielded patient-centered nursing principles.

Cluster 2 (Blue): Recovery, Healing Environments, and Human-Centered Design. Cluster 2 (blue) shows that ‘recovery’ is one of the most significant keywords in the entire dataset, alongside terms such as ‘health’, ‘healing environment’, ‘framework’, ‘innovation’, “therapy”, and ‘behaviour’. These associations reaffirm that recovery is the primary objective of healing design in healthcare contexts. Research within this cluster emphasizes that patient-centered care and human-centered design (HCD) approaches help align built environments with patient needs, psychological well-being, and digital transformation in mental health services [37]. Healing design affects not only patients but also visitors and staff [38], and contributes meaningfully to both physical and psychological recovery. Beyond hospitals, clinics, community health centres, postnatal recovery centres, and similar facilities are vital venues for public health services. Possessing healing functions, they provide recuperative spaces and care services for users, collectively termed ‘healthcare environments’ hereafter. By endowing healthcare spaces with healing properties—even down to preventable injury measures within wards—patient experiences are enhanced [39]. Mental well-being, as a core patient outcome, remains a focal point in healing design, with psychological health serving as a benchmark for recovery quality. Evidence-based design (EPD) appears as a particularly important methodological tool, supporting post-admission assessments, rehabilitation environments, and critical care design [40]. Feedback and analysis from practical case studies demonstrate that design facilitates a deeper understanding of patient needs and preferences. This understanding enables the creation of healthcare environments and nursing services that meet patient requirements while simultaneously enhancing the effectiveness and safety assessment of healthcare environments.

Cluster 3 (Red): Stress, Anxiety, and Psychological Responses to the Built Environment. Cluster 3 (red) is dominated by the keywords “stress”, “satisfaction”, and “anxiety”, reflecting concentrated research on patient psychological states and methods for improving them [41,42]. Studies often use semi-structured interviews to capture patients’ immediate emotional reactions to healing environments. Findings suggest that environmental stressors—such as difficulty navigating a facility—lead to frustration, anxiety, and negative self-perception. This indicates that current research on healing design prioritizes function-oriented aspects while overlooking the actual experiences of users within the facility and its context. Interventions explored in this cluster include visual access to nature via window openings [40], incorporation of aromatic plants into healthcare settings [43], and other biophilic strategies aimed at improving psychological well-being during the healing process.

Cluster 4 (Green): Biomimicry, Built Environment Innovation, and Long-Term Care Sustainability. Cluster 4 (green) features keywords associated with biomimetic design and its functional applications within healthcare settings. While some overlaps with Cluster 3, the later emergence of Cluster 4 keywords indicates that it represents a newer developmental stage, building on earlier psychological research. Studies in Cluster 4 explore specific design applications of healing design in paediatric wards [36]. Furthermore, following the implementation of healing design, scholars have developed an interest in the sustainability of caregiving models and the long-term effectiveness of care delivery [44].

Cluster 5 (Orange): Immersive Technologies, Telemedicine, and Virtual Therapeutic Interventions. Cluster 5 (orange) relates to technologically mediated therapeutic environments, incorporating terms such as ‘metaverse’, ‘wearable devices’, ‘augmented reality’, ‘artificial intelligence’, ‘virtual reality’, and ‘telemedicine’. Research in this cluster includes AR-based therapy, where immersive or projected scenes support rehabilitation [33], and early VR-based programs such as the ‘Virtual Mindful Walking’ system developed in 2015 to help patients modulate pain through mindfulness in immersive virtual environments [45].

Cluster 6 (Purple): Co-Managed Care, Gait Rehabilitation, and Feasibility Studies. Cluster 6 (purple) revolves around terms such as ‘centered care’, ‘co-managed care’, ‘gait rehabilitation’, ‘feasibility’, and specialised medical terminology, including ‘material testing’. The emergence of the keyword ‘co-managed care’ reflects a shift toward systematic, team-based rehabilitation models [29], representing the synthesis of the multiple therapeutic methods, following feasibility analysis.

Overall, the cluster analysis reveals that this domain is anchored in patient-centered and human-centered principles, employing implementation approaches such as expressive arts therapy and architectural design. These interventions focus on creating calm, supportive, and comfortable environments to optimize psychological and physiological outcomes, ultimately achieving the primary objectives of facilitating recovery, rehabilitation, and enhanced well-being.

3.2. Research Data and Hotspots

3.2.1. Chart Centered on the Patient-Centered Care

Figure 6 further highlights the focal points from Figure 5 by presenting a co-occurrence network diagram with ‘patient-centered care’ as the central node keyword. As shown in Figure 6, ‘patient-centered care’ occupies a central and integrative position in healthcare environment research, serving as the primary point of convergence for multiple research trends.

As a core node, ‘patient-centered care’ is closely linked with important concepts such as ‘healing environment’, ‘recovery’, ‘evidence-based design’, and ‘biophilic design’, indicating their close relationship. These associations indicate that such domains represent foundational components of patient-centered care in healthcare environmental design. Patient-centered care prioritizes patients’ needs, preferences, and values, aligning design decisions with personalized requirements recovery requirements [46] and ensuring that care is delivered within a supportive and responsive environment [47]. Moreover, Figure 6 reveals notable connections between ‘patient-centered care’ and ‘architectural space quality’, indicating the interdisciplinary integration of patient-centered care between architectural design and spatial quality. This highlights the importance of considering how spatial layout, sensory comfort, material choices, and environmental quality affect patient experiences and recovery [6].

Patient-centered care thus extends far beyond clinical treatment. It encompasses healthcare environment design, technological systems, care pathways, and organizational management models [48]. The co-occurrence relationships illustrated in Figure 6 reveal the depth and breadth of PCC’s influence across multiple disciplines connected with healthcare architecture. These patterns not only reaffirm the role of patient-centered care in enhancing healthcare quality and patients’ satisfaction but also indicate potential directions for future research, such as integrating design innovation with personalized care; embedding digital and intelligent technologies into PCC frameworks; and exploring how PCC principles optimize environmental, operational, and psychosocial aspects of healthcare environments. Such developments mark an ongoing shift toward holistic, personalized, and evidence-informed healing environments.

3.2.2. Chart Centered on the Healing Environment

Figure 7 presents a keyword co-occurrence network diagram centered ‘healing environment’, revealing its strong interconnections with terms such as ‘patient-centered care’, ‘recovery’, ‘evidence-based design’, ‘biophilic design’, ‘behavior’, ‘satisfaction’, and ‘health’. As illustrated in Figure 7, the healing environment plays a core conceptual pillar within patient-centered care, highlighting its essential role in shaping patient experience, well-being, and recovery outcomes. The close association between ‘healing environment’ and ‘patient-centered care’ indicates that effective healing environments must prioritize individual patient needs, emotional states, and personal preferences, thereby reinforcing PCC principles. The strong linkage with ‘recovery’ further emphasizes that healing environments exert a direct and measurable influence on patients’ healing trajectories, contributing to reductions in stress, improvements in comfort, and acceleration of physical and psychological restoration. The linkage between ‘evidence-based design’ and ‘biophilic design’ underscores the integration of scientific research, empirical evaluation, and natural elements into healing environments. Evidence-based design supports the rational optimisation of healthcare spaces grounded in validated research findings, while biophilic design promotes connections to nature that enhance patient mood, cognitive function, and stress reduction. Healing environments comprise not only physical design interventions —such as optimized floor plans, enhanced ward aesthetics, improved natural lighting [49]—but also psychological and social dimensions. These include considerations for patient privacy, sense of control, social interaction opportunities, and culturally sensitive spatial configurations [39]. These elements collectively exert a significant influence on patient recovery and satisfaction. Concurrently, within physical design, healing environments emphasise spatial comfort and functionality [50,51]. Physical design variables—such as noise reduction, acoustic control, thermal comfort, natural sunlight exposure, and spatial legibility—play particularly significant roles in shaping patient experiences. Reducing environmental stressors (e.g., excessive noise or visual clutter) has been shown to significantly support patient recuperation and sleep quality [52]. Furthermore, the association of the healing environment with terms such as ‘behavior’, ‘satisfaction’, and ‘health’ highlights its multidimensional impact. Healing environments influence: patient behavior, by encouraging mobility, relaxation, and positive engagement; patient satisfaction, by enhancing comfort, safety, and perceived care quality; overall health outcomes, by reducing anxiety, improving emotional well-being, and fostering therapeutic engagement [53]. In summary, environmental design aims to holistically enhance patient stress wellbeing through informed spatial and environmental intervention [54]. By influencing patient behavior, psychological states, satisfaction, and health, the healing environment represents a foundational component in achieving high-quality, patient-centered care.

3.2.3. Chart Centered on the Rehabilitation

Figure 8 presents a keyword co-occurrence network diagram centered on ‘rehabilitation’, which appears as a dominant and structurally influential node within the network. Its strong connections with multiple key terms underscore the centrality of rehabilitation in healthcare design and therapeutic environment research. Rehabilitation is significant not only in helping patients recover from illness or injury [55], but also with achieving comprehensive restoration of physical, psychological, and social functioning [56]. Its central position highlights the growing recognition that holistic recovery is a critical objective within contemporary healthcare systems.

Figure 8 shows that ‘rehabilitation’ also exhibits strong connections with keywords such as ‘environment’, ‘evidence-based design’, ‘recovery’, and ‘healthcare’. These relationships emphasize the crucial role of the built environment in supporting the rehabilitation processes. In particular, the strong association between ‘rehabilitation’ and ‘evidence-based design’ reflects a research trend toward designing therapeutic spaces guided by empirical findings, enhancing both functional support and patient engagement. Such approaches respect patient needs while enabling the development of personalized rehabilitation plans that more effectively promote physical and psychological recovery [57,58]. The connection between ‘rehabilitation’ and ‘healthcare’ indicates that rehabilitation is not an isolated intervention but a core component of an integrated healthcare system encompassing coordinated medical care, patient education, and community-based support networks [59].

The presence of related terms such as ‘quality of life’, ‘social integration’, ‘rehabilitation’, ‘allied health professions’, and ‘assistive technology’ highlights the interdisciplinary nature of rehabilitation. Allied health professions, such as physiotherapy, occupational therapy, and speech therapy, are integral to rehabilitation delivery, demonstrating the importance of interprofessional teamwork throughout the recovery process [60]. Meanwhile, the association with ‘assistive technology’ reveals growing interest in leveraging digital tools, mobility devices, smart sensors, and adaptive technologies to enhance patients’ autonomy, improve treatment outcomes, and foster social integration [61].

Of particular significance is the emergence of augmented reality (AR) technology as a novel and rapidly expanding research direction within rehabilitation. AR overlays digital information onto real-world environments, enabling immersive therapeutic experiences that support motor training, cognitive rehabilitation, pain distraction, and functional skill development. Its increasing presence in the keyword network indicates that AR-assisted rehabilitation is becoming a major trend, offering new possibilities for personalized, engaging, and adaptive therapeutic interventions [62].

As such, the rehabilitation-centered keyword network reveals a field characterized by increasing technological integration, interdisciplinary collaboration, and environmentally informed therapeutic strategies, underscoring rehabilitation’s foundational role in the evolution of healing-oriented, patient-centered care.

3.2.4. Keyword Highlighting Chart

Figure 9 presents a keyword prominence map generated by CiteSpace, which reveals strong shifts in keyword emergence intensity from 2000 to 2024. By examining each keyword’s ‘Strength’ and ‘Begin-End’ periods, the map clearly illustrates the level of academic attention given to specific concepts during particular timeframes [63]. The strength value, which reflects how frequently a keyword is cited within a specific year, correlates positively with the intensity and significance of research activity in that field [64]. Accordingly, the prominence map enables a deeper understanding of the shifting research focus and the evolution of scholarly interest within the domain [21].

As evident from Figure 9, the prominence of the keyword ‘patient-centered care’—particularly with an intensity value of 0.87 in 2014, and its sustained surge from 2014 to 2018 indicates that patient-centered care received significant attention within the healthcare sector during this period. This care model emphasizes respecting patients’ wishes and preferences and ensuring that patient values guide all clinical decisions, thereby enhancing the quality and effectiveness of healthcare services. This term also reflects a growing recognition among healthcare providers that collaboration with patients facilitates a deeper understanding of their needs and expectations, resulting in more personalized and high-quality care.

The patient-centered care model is widely considered capable of improving patient satisfaction, reducing readmission rates and hospital stays, and, consequently, elevating the overall quality of healthcare services [65,66]. This approach encourages healthcare professionals to form partnerships with patients, ensuring that medical decisions respect their wishes, needs, and preferences, while providing necessary education and support to promote active participation in their care process [67]. As healthcare systems transition from traditional disease-centered models towards patient-centered care, the demand for enhanced patient experience and greater involvement in decision-making has intensified. This shift simultaneously emphasizes patients as active partners in the care process, rather than passive recipients of treatment [1].

Increasing collaboration among healthcare providers, designers, and researchers has further supported the development of patient-centered care models through the integration of diverse expertise [68]. An expanding body of research evidence demonstrating improved health outcomes and patient experiences has continued to drive the adoption and implementation of this model [69], contributing to the creation of a more humanized, efficient, and patient-centered healthcare system.

The keyword ‘evidence-based design’ recorded an intensity value of 1.66 in 2006. This high-intensity citation surge indicates that ‘evidence-based design’ attracted significant attention within therapeutic environment research that year. Its prominence stems from the approach’s emphasis on employing scientific research methods and empirical data throughout the design process to assess how the built environment affects patient health, staff productivity, and building energy performance. The introduction of this methodology provided healthcare architecture with a novel design decisions framework guided by evidence, enabling superior therapeutic outcomes and increased patient satisfaction [70]. Furthermore, 2006 marked a period in which healthcare architecture faced increasing pressure to re-evaluate traditional design practices and pursue innovation to respond to evolving medical demands and accommodate rising patient expectations. Evidence-based design addressed these needs by offering a systematic and scientifically grounded approach to improving clinical environments.

The growing demand for higher design standards in healthcare facilities, driven by advances in medical technology and the expansion of healthcare services, also contributed to the increased attention. In addition to functional requirements, designers increasingly recognized the need to evaluate the impact of physical environments on patient well-being. Evidence-based design supports this requirement by facilitating detailed analyses that help create more human-centered and efficient healthcare environments. This period further coincided with heightened interest in interdisciplinary collaboration, encouraging knowledge exchange and cooperation among healthcare professionals, designers, and researchers across fields such as medicine, architecture, and psychology. This collaborative momentum contributed to the significant citation surge for ‘evidence-based design’ observed in 2006.

In 2015, the keyword ‘healthcare facilities’ exhibited an intensity value of 1.26, with its prominence peaking from 2015 to 2016. This highlights the increasing focus on healthcare facility planning and design during these years. Global population growth and ageing trends have continuously amplified the demand for healthcare services, prompting greater research attention to the planning and design of healthcare facilities [71,72]. Additionally, rapid advancements in medical technologies have created a need for healthcare facilities capable of supporting new treatment modalities and specialized equipment, stimulating interest in future-oriented healthcare facility design [73]. Patients’ expectations have also risen, with growing emphasis on environments that provide not only safe and high-quality medical care but also comfort, accessibility, and psychological support. This shift has encouraged researchers to explore more human-centered and patient-friendly approaches to healthcare facility design. Concurrently, increasing global awareness of environmental concerns has led to greater consideration of sustainability, energy efficiency, and ecological impact in healthcare facility design [74]. Together, these factors contributed to the emergence of healthcare facility planning and design as a prominent research hotspot between 2015 and 2016.

These highlighted terms constitute key elements in the evolving discourse on healing-oriented, patient-centered care within therapeutic settings. They not only reflect current scholarly priorities but also offer critical insights for this study on designing and implementing more effective healing environments. By examining the timing and intensity of these keywords, we gain a clearer understanding of future directions for therapeutic environment design and patient-centered care.

Table 2. Keywords with more than three occurrences from the Web of Science core collection of research intersections on rehabilitation, healing design, and healthcare environments between 2000 and 2024.

Cluster	Keywords	Occurrence	Total Link Strength
2	recovery	18	214
1	rehabilitation	10	111
3	health	9	100
2	Evidence-based design	9	90
3	environment	6	73
2	impact	6	66
2	healing environment	6	64
4	biophilic design	5	59
3	design	5	58
5	virtual reality	4	55
4	prevalence	4	54
3	depression	4	53
2	care	4	52

presents the 13 keywords identified by applying the condition of an ‘occurrence frequency exceeding three times’ within the specified literature set from 2000 to 2024. Furthermore, the thematic patterns reflected in Table 2 are complemented by the detailed high-frequency keyword analysis depicted in Figure 9. Because Table 2 and Figure 9 were generated using VOSviewer and CiteSpace, respectively, their underlying statistical approaches differ. CiteSpace’s keyword statistics integrate temporal influence, whereas VOSviewer focuses primarily on quantitative occurrence frequency, providing a macro-level perspective on keyword frequency analysis.

Table 2 shows that high-frequency keywords predominantly belong to Cluster 2, including ‘recovery’, ‘empirical design’, ‘impact’, ‘healing environment’, and ‘care’. Among these, ‘recovery’ is the most frequently occurring keyword, and its influence correlates positively with both the strength and frequency of its network connections. Appearing 18 times across 25 years and linking to multiple related keywords, ‘recovery’ clearly constitutes a central research focus within this field. ‘Recovery’ denotes the medical process through which patients regain bodily functions [75], and researchers often employ low-intensity or indirect interventions, such as therapeutic gardens, to enhance patient experiences [76]. In contrast, ‘rehabilitation’—the second most frequent keyword in Table 2, refers to the medical process for patients who face greater difficulty in restoring normal or prior bodily functions. In such cases, studies more commonly utilise highly perceptible interventions, such as interactive art installations, to support therapeutic goals [77]. ‘Virtual reality’ is the sole keyword from Cluster 5 appearing in Table 2, primarily representing research involving specialized therapeutic technologies for patients with limited prospects of full functional recovery [78,79]. Because the keywords within Cluster 6 emerged later and have attracted comparatively less attention, no high-frequency keywords from this cluster appear in Table 2.

Among these high-frequency terms, ‘evidence-based design’, ‘healing environment’, ‘health’, ‘biophilic design’, and ‘recovery’ are closely associated with the concept of ‘patient-centered care’. Analysis of evidence-based design within healing environments demonstrates that patient-centered care prioritizes patients’ needs, values, and preferences, hereby guiding the optimization of the rehabilitation process while simultaneously advancing more innovative healthcare design and care delivery models [80,81,82]. Thus, patient-centered care functions as a broad and influential guiding principle within this research domain.

4. Discussion

4.1. Multidisciplinary Collaboration: A Growing Trend in Studying Patient Experience

This study employs bibliometric analysis to examine developmental trajectories and research focal points within the field of healing-oriented therapeutic environments. From early foundational theoretical discussions to contemporary empirical design practices, the focus has shifted significantly, progressively evolving toward a patient-centered and holistic model of healing environment design. The evolution of this research field indicates that healing-oriented, patient-centered care within therapeutic settings has advanced through four distinct phases, transitioning from initial theoretical conceptual models to deeper practical application and integration:

(1)

Early Stage: Foundational Environment Design and Basic Patient Requirements. Research initially centered on the basic physical characteristics of healthcare spaces, such as spatial layout, lighting conditions, and ventilation, which were regarded as environmental determinants directly influencing patient recovery. Early studies focused on reducing patients’ pain perception and improving sleep quality by adjusting lighting and acoustic conditions in hospital wards.

(2)

Developmental Stage: Integration of Psychological and Sociological Factors. Over time, researchers recognized that altering a single physical environmental variable is insufficient to address patients’ complex and evolving needs [72]. Consequently, research began to incorporate psychological and sociological theories, exploring how environmental design influences patients’ emotional states and social interactions. This stage introduced design strategies such as introducing natural elements and artwork to enhance psychological well-being.

(3)

Advanced Stage: Integration of Technology and Patient-Centered Design. By 2014, following substantial theoretical and empirical research, patient-centered care philosophy gained widespread adoption. Research priorities shifted toward understanding patients’ experiences and personalized needs. Studies began tailoring therapeutic spaces to distinct patient groups, including children, the elderly, and individuals with chronic conditions, while employing interdisciplinary methodologies such as behavioral experiments and user-experience surveys.

(4)

Latest Trends: Digitalisation Advancing Medicine and Evidence-Based Design (EBD). Recent years witnessed rapid technological development, propelling healing environment research into advanced domains involving digital and immersive technologies [78]. Augmented reality (AR) and virtual reality (VR) are increasingly used to create virtual healing spaces that support both physical rehabilitation and psychological treatments, such as ‘Post-traumatic stress disorder (PTSD)’ therapy. Moreover, ‘evidence-based design (EBD)’ has gained widespread application, emphasizing the use of empirical data and measurable outcomes to guide design decisions and validate their effects on patient recovery [83].

The PCC places the patient’s needs, preferences, and individual values at the heart of the care process [84]. It emphasizes the importance of addressing patients’ psychological, social, and cultural dimensions, aiming to enhance their overall healing experiences and create more inclusive and supportive therapeutic environments. Achieving these goals requires integrating healthcare environment design with PCC principles.

In addition, interdisciplinary collaboration has become foundational, as knowledge and technology from multiple disciplines, including architectural design, psychology, and healthcare, converge to support PCC implementation. Technologies such as AR and VR now offer personalized and interactive rehabilitation experiences, reinforcing the need for cross-disciplinary engagement.

Within healing environment design, PCC continues to deepen. Studies demonstrate that targeted design improves patient satisfaction and rehabilitation efficiency, prompting designers and healthcare professionals to prioritize patients’ feelings and preferences. Future research should investigate emerging strategies and technologies to further enhance the effectiveness of healing environments and advance the realization of PCC.

Despite clear progress, practical challenges persist. Accurately assessing the impact of environmental modifications on patient recovery and designing optimal healing environments under resource constraints remain critical areas requiring future research attention.

4.2. Healthcare Environment Design Guided by the Principle of Patient-Centered Care (PCC), an Emerging Trend

By strengthening patient agency, PCC fosters a more humane and responsive care model. Translating theoretical insights into actionable design strategies requires connecting macro-level trends with empirical evidence. Based on this study’s synthesis, five design dimensions are proposed to support PCC-oriented hospital architecture:

(1)

Spatial Programming

Layouts must balance clinical efficiency with human dignity. Privacy differentiation is paramount; designs should prioritize single-occupancy rooms or flexible zoning to protect dignity. At the same time, visibility must be optimized to ensure nursing staff maintain clear lines of sight to support safe clinical oversight without compromising privacy. Circulation paths should be optimized to separate public, patient, and logistical flows, thereby minimizing noise, confusion, and cross-contamination.

(2)

Environmental Comfort

Healing environments require rigorous sensory conditioning. Lighting design should maximize daylight exposure and implement circadian-responsive artificial lighting to improve sleep and mood. Acoustic comfort requires sound-absorbing materials and spatial zoning to mitigate noise, one of the most common stressors in healthcare settings. Equally, thermal and air quality should be managed effectively through advanced ventilation and personal climate controls.

(3)

Biophilic Integration

Exposure to nature contributes to psychological restoration. Strategies include healing gardens, accessible greenery, and natural light penetration using courtyards. Natural materials, such as wood and stone, help create an emotionally supportive environment that alleviates patient anxiety.

(4)

Digital Augmentation

Technology expands therapeutic capacity. AR and VR can support pain distraction, virtual rehabilitation physiotherapy, and cognitive rehabilitation. IoT-based intelligent monitoring systems should be subtle to enhance safety without increasing patients’ cognitive burden or compromising privacy. Additionally, digital wayfinding tools can reduce cognitive stress in complex hospital environments.

(5)

PCC-based Engagement

Healing environments should foster patients’ autonomy and active participation. Family-inclusive room layouts, transparent communication through digital displays, and patient control over environmental settings (e.g., lighting, shading, temperature) strengthen patients’ empowerment and reduce stress.

The synthesis of bibliometric patterns and empirical cases allows the study to propose a set of PCC-based design guidelines. These guidelines offer a transferable framework that bridges empirical evidence and architectural practice, facilitating more effective PCC-based healthcare facility design.

4.3. The Positive Impact of PCC-Oriented Service Systems and Healing Environments on Patients

Healing environments are central to PCC, influencing patients across psychological, physiological, social, and cultural needs dimensions. Effective therapeutic environments should be designed using service design thinking, ensuring a holistic system that supports patients throughout their healthcare journey. Design strategies, such as the use of natural light, indoor greenery, employing soothing color palettes, and selecting comfortable furnishings, have been shown to reduce anxiety and stress, supporting overall psychological recovery [85].

To strengthen the empirical basis of this study, several representative healing-environment projects, which are summarized in

Table 3. Empirical case analysis in this study.

Region	Hospital	Healing Strategies	Evidence/Outcomes
Asia	KTPH (Singapore)	Biophilic design, natural ventilation	↑ Patient satisfaction/↓ stress
Europe	Maggie’s Centre (UK)	Psychological care, warm materiality	↓ Anxiety/↑ coping ability
North America	Cleveland Clinic	Light/noise optimization	↑ Sleep quality

, were examined. For example, the Khoo Teck Puat Hospital in Singapore demonstrated measurable improvements in patient satisfaction and well-being due to extensive biophilic features, while Maggie’s Centre in the UK showed reduced stress levels through post-occupancy evaluations. These empirical cases operationalize the bibliometric findings and demonstrate design PCC in practice.

Service touchpoints, which refer to every interaction patients have with the healthcare environment, facilities, and hospital staff during treatment, significantly influence patients’ experience [86]. Optimizing these interpersonal touchpoints considerably affects psychological well-being and treatment outcomes [87]. Therapeutic environments support these interactions by providing spaces conducive to comfort, dialogue, and mutual understanding. This positive interaction helps alleviate patient stress, promotes positive emotional shifts, and ultimately accelerates the recovery process.

A healing environment extends beyond physical spaces; it encompasses a fully integrated service system. Incorporating service design principles helps create holistic patient care through well-structured touchpoints, supportive interpersonal interactions, and optimized clinical processes.

Moreover, healing environments foster social interactions, support personalized care, and enhance overall care quality [88].

The sustainability considerations, such as the use of eco-friendly materials, energy-efficient technologies, and green spaces, contribute to patients’ long-term well-being while promoting healthy lifestyles. Safety, artistic expression, and environmental odor management are also indispensable elements in healing environment design, collectively contributing to secure and restorative care settings.

As the field develops, healing environments are expected to play an even more significant role in optimizing clinical outcomes. Achieving this requires collaboration among architects, designers, healthcare professionals, psychologists, and patients to ensure the environments truly meet patients’ needs and support recovery and long-term health.

4.4. The Critical Role of Evidence-Based Design in Patient-Centered Care

EBD exerts a profound influence on patient care outcomes by ensuring that healthcare environments are grounded in scientific evidence rather than intuition. EBD uses rigorous research to guide design decisions, ensuring alignment with patient needs and preferences while improving clinical outcomes [83].

By incorporating empirical data, EBD enables healthcare spaces to better meet patients’ expectations, increasing their satisfaction and strengthening the therapeutic capacity of the environment. EBD is a continuous process—designs evolve as new evidence and patient feedback emerge, ensuring that care environments remain responsive and effective. As healthcare increasingly emphasizes patient experience and outcomes, the adoption of EBD is expected to expand. EBD has the potential not only to accelerate the recovery but also to support patients’ sustained healthy behaviors post-discharge.

The implementation of EBD requires a nuanced understanding of patients’ behaviors, preferences, and environmental responses. It ensures environments are not merely aesthetically pleasing but also functionally aligned with patients’ recovery and their quality of life. The widespread adoption of EBD will enhance the overall quality of healthcare delivery, enabling more personalized, effective, and sustainable patient-centered care.

5. Conclusions

This study employs bibliometric methods and a critical literature review, integrating both macro and micro perspectives to systematically examine the application and developmental trends of PCC within health environment design. Current PCC-related research exhibits a clear trend towards multidisciplinary integration, particularly within healing environment design, where increasing emphasis is placed on patients’ psychological and social needs. Keyword analysis reveals high-frequency terms such as ‘recovery,’ ‘healing environment,’ and ‘evidence-based design,’ reflecting a shift in research focus from functional optimization toward emotional care, technological augmentation, and nature-interacted design.

Research in healing environment design is progressively shifting from traditional physical space optimization toward comprehensive frameworks that prioritize patients’ subjective experiences, emotional well-being, and participatory engagement. This paradigm shift not only enhances patients’ involvement in the healing process but also improves their overall rehabilitation experience. Continued implementation of the PCC philosophy across related studies highlights the critical importance of interdisciplinary collaboration in healing environment design, with contributions from architecture, psychology, and nursing collectively advancing innovation in patients’ rehabilitation-focused environmental design.

This study also presents several limitations. First, it relies exclusively on the WoSCC for literature retrieval. While this represents high-quality academic sources, it excludes other significant databases such as Scopus and CNKI. Second, the final dataset consists of 89 valid publications, a relatively small sample size that may affect the stability of the keyword co-occurrence networks and the generalizability of clustering outcomes. Moreover, certain emerging technologies, such as the application of AR and the metaverse healing environments, remain underrepresented. Third, the present study does not sufficiently address the differentiated and personalized needs of distinct patient groups (e.g., children, the elderly, patients with chronic conditions). Consequently, tailored therapeutic design and care strategies that address diverse physiological, psychological, and sensory needs remain underdeveloped, hindering precise rehabilitation interventions for specific patient populations.

Future research may progress in three directions. First, strengthening research on personalized therapeutic strategies tailored to distinct patient groups. Second, expanding the evaluation of intelligent technologies, such as AR and IoT, within sustainable healthcare environments. Third, establishing a comprehensive evidence-based mechanism that spans the entire design-use-feedback cycle, enabling quantifiable assessment and continuous optimization of patients’ health benefits provided by therapeutic environments. In summary, healing-oriented PCC environments represent more than spatial improvements; they constitute a crucial pathway toward realizing a genuinely ‘human-centered’ model of healthcare.

By offering actionable insights for designing and evaluating evidence-based therapeutic environments, this study stands to benefit multiple stakeholder groups, including patients, families, healthcare professionals, designers, hospital administrators, and policymakers, by supporting more effective interdisciplinary collaboration and fostering environments that enhance care quality, rehabilitation outcomes, and the overall human-centered nature of healthcare delivery.