Users' views of hospital environmental quality: Validation of the Perceived Hospital Environment Quality Indicators (PHEQIs)

Environmental Quality Perception (EQP) is an important construct used to help to understand the relationship between people and the hospital environment. From a patient-centered care perspective, it is important that hospital design take into account the patients' (and other users') point of view. This paper presents the adaptation and validation of a measure of hospital EQP, the Perceived Hospital Environment Quality Indicators (PHEQIs; Fornara, Bonaiuto, & Bonnes, 2006), and seeks to confirm the factor structure of this construct in a different cultural context. Three scales, two focusing on physical environments and one evaluating the social environment, were completed by 562 users of four orthopedic units in Portuguese hospitals, two older and two recently built or renovated. To assess criterion validity, hospital physical environments were also objectively evaluated by two architects. Using a confirmatory factor analysis the three validation procedures produced acceptable fit indices in the final measurement models. Overall reliability values were satisfactory, as was the evidence for criterion validity. PHEQIs scales and factors correlated with global evaluation of the environment, supporting concurrent criterion validity; and predictive criterion validity was demonstrated given that users of older and newer hospitals differed significantly on the perception of quality of hospital EQP, and that high congruence between users' and experts' evaluations was found. Discriminant construct validity was supported, and some difficulties in showing convergent validity are discussed in terms of item formulation adequacy. Implications for research and practice are described.     

Pro-environmental behaviours and park visitors: The effect of place attachment

The purpose of this study was to explore the ability of place attachment to predict place-specific and general pro-environment behavioural intentions. The study sample (n = 355) consisted of visitors to a Canadian national park, Point Pelee National Park. The place attachment scale utilized in this study was designed to measure three subdimensions: place identity, place dependence, and place affect. Exploratory factor analysis of data measured by these scales revealed two place attachment subdimensions. Place affect, an individual’s emotions and feelings for a place, acted as a more generalized or pervasive phenomenon. Place affect items loaded on both the place identity (an individual’s cognitive assessment of a place) and place dependence (an individual’s functional assessment of a place). Structural equation modeling confirmed the strength of place attachment’s ability to predict place-related pro-environment intentions. It also identified place attachment’s prediction of pro-environment behavioural intensions related to everyday life. Place identity mediated the effects of place dependence in predicting pro-environment intentions. Further research which utilizes in-depth and longitudinal case studies is suggested to explore the role of place-specific emotion and feelings, as well as place identity in fostering environmentally-responsible action as these factors are theorized to play an important role in promoting pro-environmental behaviour. Studies of place attachment to everyday settings rather than iconic national parks are also called for.     

Benefits-based analysis of visitor use of Sorak-san National Park in Korea

Benefits-based management seeks to provide recreation benefits for recreation participants by managing the physical environments in which recreation occurs. This study investigates the relationship between benefits desired by visitors and the physical, social, and managerial characteristics of settings that facilitate realization of recreation benefits. Data such as perceived benefits from recreation experiences, setting attributes that significantly influenced perceived benefits, and sociodemographic variables were collected from 376 visitors to Sorak-san National Park in the eastern part of the Korean peninsula. Cluster analysis was used to group visitors' desired benefits into 12 domains: relationship with nature/scenery, escaping pressure, learning about nature, family togetherness, introspection, exploration, autonomy/achievement, being with friends, leading others, skills/learning, risk taking, and meeting/observing new people. Multiple regression was used to link benefit domains with the characteristics of settings. The social attribute of recreation settings was linked to eight of the ten benefit domains. There were two statistically strong multiple regression correlations: (1) between domain of “relationship with nature /scenery” and the attributes “forest/water,”“attractive nature,” and “facility/maintenance” and (2) between the domain of “escaping pressure” and the attributes “attractive nature” and “social.” The results of this study are useful to managers in their efforts to provide recreation opportunities for visitors to achieve beneficial outcomes.     

Aesthetic and affective effects of vocal and traffic noise on natural landscape assessment

National parks have mandates both to preserve and protect natural settings and to assist visitors in viewing and interacting with those settings. Considerable scholarship has examined the trade-offs between preservation and recreation goals, such as protection of a natural setting when some visitors want to experience it from noisy aircraft or ground vehicles. The current project expands on previous noise research that showed the presence of aircraft noise to be detrimental to aesthetic and affective environmental assessments. Participants rated 25 scenes under quiet conditions or while hearing 45 dB(A) or 60 dB(A) of either natural sounds (bird calls, breeze through foliage), natural sounds with aircraft sounds, natural sounds with ground traffic sounds, or natural sounds with human voices. Results indicated that the presence of any anthropogenic noise–air traffic, ground traffic, or voices–negatively impacted environmental assessments, and more so at louder levels, while the natural soundscape had little to no effect on assessments. Additionally, the presence of air traffic, ground traffic, and human voices significantly decreased participant ratings of serenity while also increasing ratings of hostility. These effects were strongest for scenes that were high in scenic beauty. Results are discussed in the context of sound quality management in national parks and other settings.     

PERCEPTION OF WATER QUALITY BY SELECT RESPONDENT GROUPINGS IN INLAND WATER-BASED RECREATIONAL ENVIRONMENTS1

ABSTRACT: This paper examines four lake environments which are paired by lake size and by trophic state, where trophic state is employed as an identifier of water quality. Two large lakes and two intermediate-sized lakes, with each pair having one oligotrophic lake and one eutrophic lake are selected for cross-sectional survey-oriented questionnaire research. This paper focuses upon one aspect of the research, namely, the perception of water quality by three user groups. The user groups examined are recreationists, cottage and homeowners, and fishermen. The groups are compared utilizing percentage response profiles and cluster level groupings. It appears from a preliminary analysis of the data that the lakes selected are viable trophic state endpoints for questionnaire analysis of respondents. Each user group surveyed does appear sensitive to select water quality parameters; where shifts in sensitivity appear within and between user groups with changes in ecological settings, as well as with factors independent of ecological settings.     

Hospital waste management in El-Beheira Governorate,Egypt

This study investigated the hospital waste management practices used by eight randomly selected hospitals located in Damanhour City of El-Beheira Governorate and determined the total daily generation rate of their wastes. Physico-chemical characteristics of hospital wastes were determined according to standard methods. A survey was conducted using a questionnaire to collect information about the practices related to waste segregation, collection procedures, the type of temporary storage containers, on-site transport and central storage area, treatment of wastes, off-site transport, and final disposal options. This study indicated that the quantity of medical waste generated by these hospitals was 1.249 tons/day. Almost two-thirds was waste similar to domestic waste. The remainder (38.9%) was considered to be hazardous waste. The survey results showed that segregation of all wastes was not conducted according to consistent rules and standards where some quantity of medical waste was disposed of with domestic wastes. The most frequently used treatment method for solid medical waste was incineration which is not accepted at the current time due to the risks associated with it. Only one of the hospitals was equipped with an incinerator which is devoid of any air pollution control system. Autoclaving was also used in only one of the selected hospitals. As for the liquid medical waste, the survey results indicated that nearly all of the surveyed hospitals were discharging it in the municipal sewerage system without any treatment. It was concluded that the inadequacies in the current hospital waste management practices in Damanhour City were mainly related to ineffective segregation at the source, inappropriate collection methods, unsafe storage of waste, insufficient financial and human resources for proper management, and poor control of waste disposal. The other issues that need to be considered are a lack of appropriate protective equipment and lack of training and clear lines of responsibilities between the departments involved in hospital waste management. Effective medical waste management programs are multisectoral and require cooperation between all levels of implementation, from national and local governments to hospital staff and private businesses.     

Perceived environmental quality of neighborhoods: Development of assessment scales and their relation to age and gender

The relation of age to perceived quality of neighborhoods is examined. For a large sample of persons age 18 and older (N: 1520), 15 factor scales of perceived quality of neighborhoods were developed and confirmed on a second sample (N: 1021). The scales are reliable (internally consistent and cross-validated) and ‘age fair’ in the sense that the internal structure of the set of scales is constant across age groups. The hypothesis of a positive, linear relationship between age and perceived quality of the neighborhood is supported in both exploratory and confirmatory samples. Some gender differences in scale level are also observed and cross-validated. No evidence of age-gender interaction is found for the age range: 21–69.     

Toward the Improvement of Trail Classification in National Parks Using the Recreation Opportunity Spectrum Approach

Trail settings in national parks are essential management tools for improving both ecological conservation efforts and the quality of visitor experiences. This study proposes a plan for the appropriate maintenance of trails in Chubusangaku National Park, Japan, based on the recreation opportunity spectrum (ROS) approach. First, we distributed 452 questionnaires to determine park visitors’ preferences for setting a trail (response rate = 68 %). Respondents’ preferences were then evaluated according to the following seven parameters: access, remoteness, naturalness, facilities and site management, social encounters, visitor impact, and visitor management. Using nonmetric multidimensional scaling and cluster analysis, the visitors were classified into seven groups. Last, we classified the actual trails according to the visitor questionnaire criteria to examine the discrepancy between visitors’ preferences and actual trail settings. The actual trail classification indicated that while most developed trails were located in accessible places, primitive trails were located in remote areas. However, interestingly, two visitor groups seemed to prefer a well-conserved natural environment and, simultaneously, easily accessible trails. This finding does not correspond to a premise of the ROS approach, which supposes that primitive trails should be located in remote areas without ready access. Based on this study’s results, we propose that creating trails, which afford visitors the opportunity to experience a well-conserved natural environment in accessible areas is a useful means to provide visitors with diverse recreation opportunities. The process of data collection and analysis in this study can be one approach to produce ROS maps for providing visitors with recreational opportunities of greater diversity and higher quality.     

Choosing restorative environments across the lifespan: A matter of place experience

Past research on restorativeness has emphasized mainly the potential of natural environments. In our hypothesis, built environments are also likely to be recognized as restorative places. In this study, focusing on restorative experiences more than on environments alone, attention is drawn on the relative importance of the four restorative components proposed by “attention restoration theory”—being-away, extent, fascination, compatibility—in leisure experiences of people at different stages of the lifespan, and on the characterization of these experiences in terms of relaxation and excitement. We also take account of the time available for restoration and the context in which the need for restoration may emerge, according to three models of the relationships between work and leisure: spill-over, compensation and segmentation. Results show that natural and built environments can have different restorative potentials in relation to the stage of the lifespan and to the time available for restoration; moreover, in people's perception, the four restorative components differ from each other in their relative importance. The social and affective dimensions came out as important features of restorative experiences. Finally, relaxation and excitement in leisure patterns were shown to be differentially related to work characteristics. Briefly, restorativeness emerged as the result of a global “place experience”.     

Effects of Impervious Cover at Multiple Spatial Scales on Coastal Watershed Streams1

Abstract: The spatial scale and location of land whose development has the strongest influence on aquatic ecosystems must be known to support land use decisions that protect water resources in urbanizing watersheds. We explored impacts of urbanization on streams in the West River watershed, New Haven, Connecticut, to identify the spatial scale of watershed imperviousness that was most strongly related to water chemistry, macroinvertebrates, and physical habitat. A multiparameter water quality index was used to characterize regional urban nonpoint source pollution levels. We identified a critical level of 5% impervious cover, above which stream health declined. Conditions declined with increasing imperviousness and leveled off in a constant state of impairment at 10%. Instream variables were most correlated (0.77 ≤ |r| ≤ 0.92, p < 0.0125) to total impervious area (TIA) in the 100‐m buffer of local contributing areas (～5‐km² drainage area immediately upstream of each study site). Water and habitat quality had a relatively consistent strong relationship with TIA across each of the spatial scales of investigation, whereas macroinvertebrate metrics produced noticeably weaker relationships at the larger scales. Our findings illustrate the need for multiscale watershed management of aquatic ecosystems in small streams flowing through the spatial hierarchies that comprise watersheds with forest‐urban land use gradients.     

Policy Utopias for Nutrient Credit Trading Programs with Nonpoint Sources

A promising program to address water contamination from nutrients is water quality trading (WQT), whereby entities with high abatement costs purchase credits from entities with lower abatement costs. The concept has found some success with point source water pollution, but very few trades have occurred in over 50 programs in the United States (U.S.) that have focused on nonpoint sources (NPSs). To understand why success has been slow, we identified three environments needed for programs to succeed: physical, economic, and institutional. We estimate that only 5% of watersheds in the U.S. currently listed as nutrient impaired provide a viable physical environment for trading nitrogen; 13% are suitable for phosphorus. Economic and institutional challenges would shrink that domain even further. Therefore, we find places with the ideal physical, economic, and institutional environments necessary for feasible WQT programs are virtual policy utopias — rare places with ideal environments. Fortunately, a growing literature provides the tools necessary to identify where these policy utopias are and to expand that domain through a better understanding about how to manage WQT programs more effectively.     

Enhancing the benefits of outdoor walking with cognitive engagement strategies

Being physically active in natural environments has been associated with improvements to physical health and mental well-being. Unfortunately, gaining access to outdoor settings that are supportive of both psychological well-being and year-round physical activity poses major challenges. Might altering how one engages in and interacts with the outdoor environment encouraging greater physical activity and enhance well-being? In order to investigate this approach, 117 adults were randomly assigned to one of two treatments - Standard Care (schedule setting, commitment) or Engagement (awareness plans) - and asked to take at least three, 30 minutes outdoor walks each week for two weeks. Participants in both treatment conditions reported significant increases in total time spent walking (p ≤ .05). Only those in the Engagement condition, however, experienced significant improvements in multiple dimensions of psychological well-being, including attentional functioning and feelings of frustration. In addition, participants in the engagement-based condition who walked at low to moderate levels were more likely to obtain psychological benefits. The results of this study suggest that promoting cognitive engagement with the environment may make it easier for individuals to achieve the psychological benefits typically associated with outdoor physical activity, even in settings that are less than ideal.     

Stability of self-reported favourite places and place attachment over a 10-month period

We investigated the reliability and stability of favourite place selections and evaluations of place attachment over a 10-month period. A simple random sample of 1273 respondents representative of the population of the two largest cities in Finland completed a mailed questionnaire. Reliability data was obtained in a second questionnaire (N = 427). We obtained five main favourite place types which were extensively managed natural settings (mainly urban woodlands), urban green spaces (mostly parks), waterside environments, exercise and activity/hobby areas, and indoor and outdoor urban areas. Sixty-four percent of the respondents in the second survey selected the same main favourite place type as 10 months earlier, which is more than what might be expected by chance. Extensively managed natural settings (mainly urban woodlands) and waterside environments were reselected most often. Indoor and outdoor urban favourite places had the lowest stability. We found evidence of people being more consistent in their attachment to natural favourite places than to urban favourite places. The findings lend further credence and credibility to earlier results concerning self-regulation and restorative experiences in favourite places.     

Neighborhood attachment and its correlates: Exploring neighborhood conditions, collective efficacy, and gardening

Neighborhood attachment relates to one’s emotional connection to physical and social environments. Such bonds are critical for shaping how people interact with their local environments, connect with others and may be vital for fostering sustainable health behavior change related to nutrition and physical activity. Using data from a population-based survey of neighborhood environments and health in Denver, Colorado (n = 410 respondents; n = 45 block-groups) and hierarchical linear modeling techniques, we examined the relationship between objective and perceived neighborhood conditions (e.g., crime, physical incivilities, sense of safety), social processes (e.g., collective efficacy) and recreational gardening and neighborhood attachment. Results indicate length of residency, collective efficacy, and home and community garden participation are associated with neighborhood attachment. Further research is warranted to consider neighborhood attachment as an intervening mechanism through which gardens and other outdoor everyday places may influence health behavior change.     

The Relationship Between Environmental Concern and Acceptability of Environmental Impacts among Visitors to Two U.S. National Park Settings

This study examined the relationship between environmental concern and ratings of acceptability of environmental impacts among visitors at two national park settings. Based on the concept of a social ecological paradigm shift, it was hypothesized that individuals with greater levels of environmental concern are less accepting of environmental impacts in national parks than individuals with lesser degrees of concern. Sample data came from Cape Lookout National Seashore (N=392) and Moores Creek National Battlefield (N=236), two national park units in the south-eastern U.S.A. Environmental concern was measured by the New Ecological Paradigm scale. Acceptability was measured by visitor responses to 25 items covering different types of environmental park impacts. Analysis of variance and Tukey's means comparison procedure were used to test for differences between groups defined by levels of environmental concern on impact acceptability. Significant relationships were found between environmental concern and 15 of the 25 specific impacts in the Cape Lookout sample and 13 significant relationships were found in the Moores Creek sample. However, the relationships between environmental concern and acceptability varied somewhat across the two samples. These findings suggested that individuals with greater environmental concern were less accepting (or tolerant) of certain types of park impacts, while individuals with lesser degrees of environmental concern were more accepting of certain park impacts. Differences across the study settings were attributed to the different orientations of park visitors between the two national park units and recency effects. While the data reported are preliminary, they should be informative for park management purposes, particularly in the determination of standards for park impacts.     

Satisfying shoppers’ psychological needs: From public market to cyber-mall

In many cities in North America and Europe, shopping centres are replacing the traditional high street shops. At the same time, electronic shopping is growing rapidly. In this paper, the results of a literature review of environment–behaviour research on shopping and shopping environments (e.g., farmer's markets, shopping centres, and electronic shopping) are presented. The focus of analysis is on how the physical features (e.g., layout and background music) influence shoppers’ experiences, and on how well these environments satisfy the psychological needs of their shoppers (e.g., social interaction, sensory stimulation, and security and comfort). Any implications for environmental design, and the future of shopping environments are discussed. A conceptual framework and suggestions for future research are proposed.     

Perceptions of the security and attractiveness of urban parking lots

This study concerns design features of urban parking lots which can increase the perception of such areas as both safe and attractive. College students evaluated the attractiveness and perceived security associated with 180 scenes of parking lots adjacent to commercial and multi-family residential structures in Atlanta and Athens, Georgia, U.S.A. High intergroup correlations (r > 0·90) indicated the reliability of evaluations of both perceived features. Regressions of physical features on perceived security ratings and attractiveness ratings yielded highly predictive models (R² = 0·76 and 0·80, respectively). For both sets of ratings a Maintenance and Design factor accounted for the most variance. Although attractiveness ratings were higher as the total amount of vegetation increased in a scene, security was in general rated higher only when vegetation was well maintained and appeared to be installed as part of a landscape design. Attractiveness was generally higher for multi-family residential scenes than for commercial scenes. Perceived security was higher for frontal views of structures, especially when entrances were proximate to the viewer. Research implications are discussed in terms of the impact of natural features in urban areas for increasing attractiveness and reducing fear of crime.     

MEANING AND FORM IN COMMUNITY PERCEPTION OF TOWN CHARACTER

This study explored the notion of ‘town character’ within the context of one Australian coastal town from the perspective of the community. Responses from a sample of residents to a set of local environmental features were collected using adjective rating scales. Data concerning the perceived character compatibility of features was also collected. Several multivariate statistical procedures, including multi-dimensional scaling, were used to explore the underlying structure in the response pattern and to determine the salience of meanings related to the community's conception of town character, as conveyed through local landscape features. Town character in the context of this study was found to be related to a variety of environmental features and associated meanings. Specifically, a positive character image was strongly supported by natural landscape features associated with their naturalness, beauty, pleasantness, distinctiveness, and interest, by certain built features, (specifically landmark features), associated with their distinctiveness, pleasantness, charm, familiarity, and interest, and by popular social settings associated with connotations of familiarity, friendliness, openness, liveliness, and safety. Features identified as incompatible with local character were associated with negative meanings that included boredom, ugliness, lack of charm, lack of stimulation, monotony, unpleasantness, and being ordinary.