Art Inspired by Nature - When you are ill, can viewing a piece of artwork make you feel better, and if so, what type of art is most conducive to healing? Most of the research exploring the impact of art on the healing process has focused on measuring patient preferences. Patients consistently respond positively to representational nature art. Even studies with children reveal a strong preference for nature art over abstract or cartoon-like images. (1) Furthermore, researchers have identified particular characteristics of nature art most conducive to healing: calm or slowly moving water, verdant foliage, foreground spatial openness, park-like or Savannah-like properties, and birds or other unthreatening wildlife. (2)
This penchant for views of nature, especially long views with meandering bodies of water, is partly a result of our genetic wiring. E.O. Wilson describes this innate attraction to nature as Biophilia, and exploiting this tendency even through art can speed the healing process. (3) Instinctively, we have known this for a long time. In Ancient Greece, the chronically and terminally ill sought medical care at temples located on hilltops with sweeping views of the Mediterranean Sea. Throughout history there are many examples of cultures harnessing the restorative properties of nature, and yet, it was not until 1984, that scientific data finally confirmed that nature promotes healing.
The landmark study, “View through a Window May Influence Recovery from Surgery” published in Science magazine in 1984 was the first study to prove that patients heal more rapidly when exposed to views of nature. Environmental psychologist, Roger Ulrich, reviewed the medical records of patients recovering from gallbladder surgery at a suburban Pennsylvania hospital. Patient rooms either overlooked a grove of trees or a brick wall. Those patients with tree views recovered almost a full day faster and required fewer doses of pain medication than those patients who viewed the brick wall. (4)
In subsequent research, Ulrich and colleagues measured the impact of different visual stimuli including nature art, abstract art, and a control condition with no art on patients recovering from heart surgery. Those patients exposed to a sunny, spatially open view of trees and water experienced the least anxiety and pain as compared to the other conditions. (5) This study demonstrates the importance of locating art such as nature photography in patient rooms, especially when an actual view of nature is unavailable.
Image Credits. Top Row: From a Hill to a Field by Paul Balmer, Afternoon Walk by Kevin Conklin, Carp Shanghai by Phyllis Crowley. Bottom Row: Red Orchid by Henry Domke, Late Afternoon, Duck River by Sandy Garvin, Summer Field III (Sleeping Giant) by Arlayne Peterson.
Perception of Quality - The recent surge in hospital art programs coincides with a shift in the marketplace as providers acknowledge that positive clinical outcomes alone are not enough to satisfy patients. Patients expect high quality clinical care, but their overall impressions of the experience have more to do with the tangible aspects of the environment such as parking, nursing service, housekeeping, food service, and even art. A recent article in the New England Journal of Medicine found that
“…another style of competition appears to be emerging, in which hospitals compete for patients directly, on the basis of amenities. Though amenities have long been relevant to hospitals' competition, they seem to have increased in importance – perhaps because patients now have more say in selecting hospitals." (6)
Amazingly, patients rate nonclinical experiences as twice as important than a hospital’s clinical reputation, and they are willing to bypass the closest hospital and travel for care at an alternative facility that offers a better overall experience (7).
Why do amenities matter so much? As anxious patients try and gauge quality, they often focus on aspects of the experience that they can easily understand such as a compassionate nurse, a clean bathroom, or a beautiful painting. In the article “Clueing in Customers” service expert, Leonard Berry, advises health organizations to more carefully consider all the environmental clues that factor into a customer experience, especially since the “product” is so difficult to judge. He explains “...when we’re considering a doctor or a medical facility, most of us unconsciously turn detective, looking for evidence of competence, caring, and integrity – processing what we can see and understand to decipher what we cannot.” (7)
Environmental clues that convey concern for a person’s wellbeing become especially important in places where patients and families wait. Often patients and families scrutinize these environments in search of anything to divert their attention away from troubling thoughts and feelings. The Press Ganey Pulse Report found that “patients who spent more time in the waiting area reported higher levels of satisfaction if they perceived the waiting room was comfortable and pleasant.” (8) Furthermore, in a study for Weill Cornell Medical Center, researchers found “positive correlations between more attractive environments and higher levels of perceived quality, satisfaction, staff interaction, and reduction of patient anxiety.” (9)
The selection and placement of art in waiting and examination rooms can have a profound impact on the patient and family experience, especially when the art is thoughtfully integrated into the overall interior design scheme. At CAMA, we carefully consider how design elements such as the size of the artwork, wall composition, color, and lighting interact in order to create art installations that serve as focal points within a space. Art programs executed with such attention to detail create highly impactful art features that deliver memorable experiences. Art programs of this caliber surprise and delight the senses, often resonating deeply with patients and families coping with the stress of illness and injury.
One family member felt so moved by the artwork installed in a waiting room at the Smilow Cancer Hospital at Yale-New Haven that she felt compelled to contact the artist and express her gratitude. She writes,
“I am sitting at the Cancer Hospital waiting for my husband to be admitted…Your paintings are in the waiting room…and I must tell you they are beautiful. I particularly love one of a marsh at high tide with a sunny sparkle on the water. A very serene touch in a place that seems well designed to cater to patients and families that might be feeling anxious.”
The watercolor painting referenced above is by the artist Deborah Quinn-Munson of South Dartmouth, Massachusetts. This is just one of 700 pieces of original art that make up the Smilow Cancer Hospital art collection. Abe Lopeman, Vice President and Executive Director of Smilow, describes how art was carefully selected to address both the emotional and physical needs of patients and families. He explains,
“The artwork is deliberately non-institutional and unique to this building...We wanted to create spaces that would divert attention and provide inspiration and comfort.” (10)
This collection showcases the work of local artists—many of whom were patients or had family members who were patients at Smilow. By working with these artists, CAMA was able to orchestrate and galvanize the creation of a healing arts program that generated a powerful and deeply emotional sense of pride that continues to promote the arts as a critical component of healing spaces.
- Eisen, S. (2006). Effects of art in pediatric healthcare. Unpublished doctoral dissertation. Texas A&M University, College Station, TX: Department of Architecture.
- Ulrich, R., & Gilpin, L. (2003). Healing arts. In S. B. Frampton, L. Gilpin and P. Charmel (Eds.), Putting patients first: Designing and practicing patient-centered care. San Francisco: Jossey-Bass, 117-146.
- Wilson, E. O. (1984). Biophilia. Cambridge, MA: Harvard University Press.
- Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224, 42–421.
- Ulrich, R., Lunden, O., & Eltinge, J. (1993). Effects of exposure to nature and abstract pictures on patients recovering from open heart surgery. Psycholophysiology: Journal of the Society for Psychophysiological Research, 30, suppl 1, S7.
- Goldman, D.P., Romley, J.A. & Vaiana, M. (2010). The Emerging Importance of Patient Amenities in Hospital Care, The New England Journal of Medicine, 363:2185-2187. doi: 10.1056/NEJMp1009501
- Berry, L., & Bendapudi, N. (2003). Clueing in customers. Harvard Business Review, 81(2), 100-106.
- Press Ganey Associates, Inc. (2010). Medical practice pulse report: Patient perspectives on American health care. South Bend, IN. Retrieved November 17, 2010, from http://www.pressganey.com/researchResources/medicalPractices/pulseReports.aspx, 13.
- F. Becker, F. & Douglass, S.J. (2008). The ecology of the patient visit: Physical attractiveness, waiting times, and perceived quality of care. Journal of Ambulatory Care Management, 31(2), 140.
- Smilow Cancer Hospital at Yale-New Haven. (2010). The Art of Healing. Retrieved from https://www.youtube.com/watch?v=pi0x8Se_LX4
Life Indoors is an ongoing series of papers exploring how the built environment impacts health and wellbeing. Contact firstname.lastname@example.org for more information.