Main Session
Sep
27
PQA 02 - Pediatric Cancer, Sarcoma and Cutaneous Tumors, Medical Education & Professional Development, and Health Services Research
2315 - Biophilic Design In Oncology Care: A Systematic Review Identifying Evidence Gaps In Built-Environment Interventions
Presenter(s)
Paige Cote, BS, MS2 - Tufts University School of Medicine, Boston, MA
P. Cote1, C. J. Walsh2, and K. Lichter3; 1Tufts University School of Medicine, Boston, MA, United States, 2University of Colorado School of Medicine, Aurora, CO, 3Department of Radiation Oncology & Applied Sciences, The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Dartmouth Cancer Center, Lebanon, NH
Purpose/Objective(s):
Healing environments are increasingly emphasized in healthcare design; however, the role of intentionally incorporated biophilic elements in oncology care remains poorly characterized. Biophilic design refers to the integration of natural elements—such as daylight, window views, indoor plants, gardens, and nature-based artwork—into clinical environments. While prior studies in general hospital settings suggest potential benefits, oncology-specific evidence has not been systematically evaluated. We conducted a systematic review to assess the current evidence for built-environment biophilic interventions in oncology care settings and to identify gaps relevant to future clinical research.Materials/Methods:
A systematic search of PubMed, Embase, and Web of Science was conducted in accordance with PRISMA guidelines. Studies were included if they evaluated physical biophilic design elements within oncology care environments and reported patient-centered outcomes. Immersive virtual reality interventions were excluded to maintain focus on built-environment modifications. Titles and abstracts were screened, followed by full-text review. Extracted data included study design, sample size, intervention type, care setting, and reported outcomes.Results:
A total of 374 records were identified; eight oncology-specific studies met inclusion criteria. Study designs included four cross-sectional studies, two qualitative studies, one mixed-methods study, and one prior systematic review. No randomized controlled trials or radiation oncology–specific built-environment trials were identified. Evaluated interventions included daylight access, window views, garden access, indoor plants, and nature-related artwork across inpatient oncology units, infusion centers, and cancer clinic waiting areas. Daylight and window views were associated with lower self-reported stress, improved mood, greater environmental satisfaction, and increased confidence in care quality. However, evidence was predominantly observational, single-center, and reliant on self-reported outcomes, with limited standardized quantitative measures and no longitudinal assessments.Conclusion:
Existing oncology literature suggests that biophilic built-environment interventions may improve patient-reported experience; however, current evidence is limited to observational and qualitative designs. No randomized trials or radiation oncology–specific built-environment evaluations were identified. These findings highlight a substantial evidence gap and an opportunity for rigorous environmental design research within oncology care, including radiation oncology settings.