The Influence of Healthcare Environment Architecture on the Psycho-Neuro-Endocrine-Immunological System

Titolo Rivista PNEI REVIEW
Autori/Curatori Silvia Moneti
Pubblicazione Online First 21/05/2026 Fascicolo 2026/Online First
Lingua Inglese Numero pagine 14 P. 1-14 Dimensione file 0 KB
DOI 10.3280/pnei2025oa22560
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This article is a re-elaboration based on the book Archi-Therapeia. The Influ-ence of Architecture on the PNEI Mind-Body System authored by Silvia Moneti, Architect and Teacher with a Master’s degree in PNEI and Integrated Care Science. In particular, reference is made to the chapter concerning design guidelines for healthcare facilities, with the aim of presenting a set of strategies that can be implemented within care envi-ronments to promote patients’ psychophysical wellbeing. The initial sections address issues related to orientation, accessibility, social interaction, spatial organization and personalization of the patient room. The discussion then proceeds with the presentation of guidelines concerning lighting, acoustics and clinical aromatherapy. The final sections focus on the design of labor and breastfeeding rooms, intensive care units and spaces for home-based care. The article concludes with the hope that the collected evidence may be translated into future architectural projects for healthcare facilities and care environments, while continuing to promote Architecture as a discipline within the PNEI framework and as a form of integrated therapy in its own right.

  1. Alt P.L. (2017). Sacred Space and the healing journey. Annals of Palliative Medicine, 6(3), 284-296.
  2. Andersson M. (2017). Normative and Relational Aspects of Architectural Space. In Nord C. and Ho¨gstro¨m E., eds., Caring Architecture: Institutional and Relational Practice (pp. 127-142), Cambridge Scholars Publishing, Newcastle upon Tyne.
  3. Andersson M., Fridh I. and Lindahl B. (2019). Is it possible to feel at home in a patient room in an in-tensive care unit? Reflections on environmental aspects in technology-dense environments. Nursing Inquiry, 26.
  4. Antonelli M., Donelli D., Barbieri G., Valussi M., Maggini V. and Firenzuoli F. (2020). Forest Volatile Organic Compounds and Their Effects on Human Health: A State-of-the-Art Review. Environmental Research and Public Health, 17(6506).
  5. Bailey E. and Timmons S. (2005). Noise Levels in PICU: an Evaluative Study. Paediatr. Nurs., 17, 10: 22-26.
  6. Bass J. and Takahashi J.S. (2010). Circadian Integration of Metabolism and Energetics. Science, 330, 6009: 1349-1354.
  7. Baumgarten M. and Poulsen I. (2015). Patients’ Experiences of Being Mechanically Ventilated in an ICU: a Qualitative Metasynthesis. Scandinavian Journal of Caring Sciences, 29, 2: 205-214.
  8. Berglund B., Lindvall T. and Schwela D.H. (1999). WHO Guidelines for Community Noise. Testo disponibile al sito: http://whqlibdoc.who.int. (20.07.2025).
  9. Bottalico L., Charitos I.A., Kolveris N., D’Agostino D., Topi S., Ballini A. and Santacroce L. (2019). Philosophy and Hippocratic Ethic in Ancient Greek Society: Evolution of Hospital-Sanctuaries. Open Access Macedonian Journal of Medical Sciences, 7(19).
  10. Busch-Vishniac I.J., West J.E., Barnhill C., Hunter T., Orellana D. and Chivukula R. (2005). Noise Levels in Johns Hopkins Hospital. J. Acoust. Soc. Am., 118, 6: 3629-3645. DOI: 10.1121/1.211832
  11. Calbert H. and Mary R. (2004). Patient-Friendly Hospital Environments: Exploring the Patients’ Per-spective. Health Expectations, 7: 61-73.
  12. Calbert H. and Mary R. (2005). Patient-centred improvements in health-care built environments: perspectives and design indicators. Health Expectations, 8: 264-276.
  13. Chaput-McGovern J. and Silverman M.J. (2012). Effects of Music Therapy with Patients on a Post-Surgical Oncology Unit: a Pilot Study Determining Maintenance of Immediate Gains. Arts Psychother., 39, 5: 417-422.
  14. Codoñer-Franch P. and Gombert M. (2018). Circadian Rhythms in the Pathogenesis of Gastrointestinal Diseases. World Journal of Gastroenterology, 24, 38: 4297-4303.
  15. D’Cunha N.M., McKune A.J., Isbel S., Kellett J., Georgousopoulou E.N. and Naumovski N. (2019). Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study. Journal of Alzheimer’s Disease, 72: 549–562.
  16. Fabbri C. and Montalti M. (2011). L’infermiere. Manuale teorico-pratico di infermieristica. Maggioli Editore, Rimini.
  17. Farrar A.J. and Farrar F.C. (2020). Clinical Aromatherapy. Nurs. Clin., 55: 489-504.
  18. Gesler, W. (1992). Therapeutic landscapes: Medical issues in the light of the new cultural geography. Social Science & Medicine, 34: 735-746. DOI: 10.1016/0277-9536(92)90360-
  19. Giménez M.C., Geerdinck L.M., Versteylen M., Leffers, P. Meekes G.J.B.M., Herremans H., De Ruyter B., Bikker J.W., Kuijpers P.M.J.C. and Schlangen L.J.M. (2017). Patient Room Lighting Influences on Sleep, Appraisal and Mood in Hospitalized People. Journal of Sleep Research, 26: 236-246.
  20. Glaser R. and Kiecolt-Glaser J.K. (2005). Stress-Induced Immune Dysfunction: Implications for Health. Nature Reviews Immunology, 5, 3: 243-251.
  21. Graven S.N. (2000). The Full-Term and Premature Newborn. Sound and the Developing Infant in the NICU: Conclusions and Recommendations for Care. Journal of Perinatology, 20: 88-93.
  22. Graven S.N. and Browne J. (2008). Auditory Development in the Fetus and Infant. Newborn and Infant Nursing Reviews, 8, 4.
  23. Hauck Y., Rivers C. and Doherty K. (2008a). Women’s experiences of using a Snoezelen room during labour in Western Australia. Midwifery, 24: 460-470.
  24. Hauck Y., Summers L., White E. and Jones C. (2008b). A Qualitative Study of Western Australian Women’s Perceptions of Using a Snoezelen Room for Breastfeeding During their Postpartum Hospital Stay. International Breastfeeding Journal, 3: 20. DOI: 10.1186/1746-4358-3-2
  25. Haus E. and Smolensky M. (2006). Biological Clocks and Shift Work: Circadian Dysregulation and Potential Long-term Effects. Cancer Causes and Control, 17, 4: 489-500.
  26. Iyendo T.O. (2016). Exploring the Effect of Sound and Music on Health in Hospital Settings: a Narrative Review. International Journal of Nursing Studies, 63: 82-100.
  27. Johansson L., Bergbom I. and Lindahl B. (2012). Meanings of Being Critically Ill in a Sound-Intensive ICU Patient Room: A Phenomenological Hermeneutical Study. The Open Nursing Journal, 6: 108-116. DOI: 10.2174/187443460120601010
  28. Kreier F., Kalsbeek A., Sauerwein H. P, Fliers E., Romijn J.A. and Buijs R.M. (2007). Diabetes of the Elderly and Type 2 Diabetes in Younger Patients: Possible Role of the Biological Clock. Experimental Gerontology, 42, 1: 22-27.
  29. MacAllister L., Zimring C. and Ryherd E. (2019). Exploring the Relationships Between Patient Room Layout and Patient Satisfaction. Health Environments Research & Design Journal, 12(1): 91-107. DOI: 10.1177/193758671878216
  30. Mahoney M.M. (2010). Shift Work, Jet Lag, and Female Reproduction. International Journal of Endocrinology, 813764. DOI: 10.1155/2010/81376
  31. Melamed S. and Bruhis S. (1996). The Effects of Chronic Industrial Noise Exposure on Urinary Cortisol, Fatigue, and Irritability: A Controlled Field Experiment. J. Occup. Environ. Med., 38, 3: 252-256. DOI: 10.1097/00043764-199603000-0000
  32. Monsuez J.J., Franc¸ois V., Ratiney R., Trinchet I., Polomeni P., Sebbane G., Muller S., Litout M., Castagno C. and Frandji D. (2019). Museum Moving to Inpatients: Le Louvre à l’Hôpital. International Journal of Environmental Research and Public Health, 16, 206.
  33. Nasser K., Cahana C., Kandel I., Kessel S. and Merrick J. (2004). Snoezelen: Children with Intellectual Disability and Working with the whole family. The Scientific World Journal, 4: 500-506.
  34. Niessen F. (2006). Neurosensory Visual Development of the Foetus and Newborn and Neonatal Intensive Care Units. Archives de Pédiatrie, 13: 1178-1184.
  35. Olausson S., Lindahl B. and Ekebergh M. (2013). A Phenomenological Study of Experiences of Being Cared for in a Critical Care Setting: The Meanings of the Patient Room as a Place of Care. Intensive and Critical Care Nursing, 29, 4: 234-243.
  36. Plack C.J. (2013). The Sense of Hearing. Psychology Press, New York.
  37. Pohl P., Dizdar N. and Hallert E. (2013). The Ronnie Gardiner Rhythm and Music Method – a Feasibility Study in Parkinson’s Disease. Disabil. Rehabil., 35, 26: 2197-2204. DOI: 10.3109/09638288.2013.77406
  38. Robinson S. and Pallasmaa J. (2017). Mind in Architecture. Neuroscience, Embodiment and the future of design. The MIT Press, Cambridge.
  39. Segerstrom S.C. and Miller G.E. (2004). Psychological Stress and the Human Immune System: a Meta-Analytic Study of 30 Years of Inquiry. Psychol. Bull., 130, 4: 601-630. DOI: 10.1037/0033-2909.130.4.60
  40. Short A.E., Short K.T., Holdgate A., Ahern N. and Morris J. (2011). Noise Levels in an Australian Emergency Department. Australas Emerg. Nurs. J., 14, 1: 26-31.
  41. Sternberg E.M. (2006). Neural Regulation of Innate Immunity: a Coordinated Non-specific Host Response to Pathogens. Nature Reviews Immunology, 6, 4: 318- 328.
  42. Sternberg E. and Wilson M. (2006). Neuroscience and Architecture: Seeking Common Ground. Cell, 127: 239-242.
  43. Stevens R.G., Blask D.E., Brainard G.C., Hansen J., Lockley S.W., Provencio I., Rea M.S. and Reinlib L. (2007). Meeting Report: the Role of Environmental Lighting and Circadian Disruption in Cancer and Other Diseases. Environmental Health Perspectives, 115, 9: 1357-1362.
  44. Tronstad O., Flaws D., Patterson S., Holdsworth R. and Fraser J.F. (2023). Creating the ICU of the Future: Patient-Centred Design to Optimise Recovery. Critical Care, 27, 1: 402.
  45. Ueda T., Suzukamo Y., Sato M. and Izumi S. (2013). Effects of Music Therapy on Behavioral and Psychological Symptoms of Dementia: a Systematic Review and Meta-Analysis. Ageing Res. Rev., 628-641.
  46. Ulrich R.S., Zimring C., Zhu X., DuBose J., Seo H.B., Choi Y.S. and Joseph A. (2008). A review of the research literature on evidence-based health-care design. Health Environment Research and Design Journal, 1 (3): 61–125. DOI: 10.1177/2F19375867080010030
  47. Vedhara K., Cox N.K., Wilcock G.K., Perks P., Hunt M., Anderson S., Lightman S.L. and Shanks N.M. (1999). Chronic Stress in Elderly Carers of Dementia Patients and Antibody Response to Influenza Vaccination. Lancet, 353, 9153: 627-631.
  48. Vora L.K., Gholap A.D., Hatvate N.T., Naren P., Khan S., Chavda V.P., Balar P.C., Gandhi J. and Khatri D.K. (2024). Essential Oils for Clinical Aromatherapy: A Comprehensive Review. Journal of Ethnopharmacology, 330, 118180.
  49. Wahl S., Engelhardt M., Schaupp P., Lappe C. and Ivanov I.V. (2019). The inner clock - Blue light sets the human rhythm. Journal of Biophotonics.
  50. Wilms L. and Oberfeld D. (2018). Color and emotion: effects of hue, saturation, and brightness. Psychological Research, 82: 896–914.
  51. Wright N.E., Thislethwaite D., Elton R.A., Wilkinson E.M. and Forfar J.O. (1983). The Speech and Language Development of Low-Birth-Weight Infants. British Journal of Disorders of Communication, 18, 3: 187-196. DOI: 10.3109/1368282830901224
  52. Zauner J., Plischke H., Stijnen H., Schwarz U.T. and Strasburger H. (2020). Influence of Common Lighting Conditions and Time-of-Day on the Effort-Related Cardiac Response. Plos One, 15, 10.
  53. Zeki S. (2013). Clive Bell’s “Significant Foam” and the neurobiology of aesthetics. Frontiers in Human Neuroscience, 7 (730): 1-14.

Silvia Moneti, The Influence of Healthcare Environment Architecture on the Psycho-Neuro-Endocrine-Immunological System in "PNEI REVIEW" Online First/2026, pp 1-14, DOI: 10.3280/pnei2025oa22560