A major goal of this research was to investigate the process of emotional healing that occurs as patients, families, and staff used a healing garden in a children's hospital. The next goal was to identify any barriers or constraints that were preventing use of the healing garden, such as problems with accessibility or lack of knowledge about the garden. The final research goal involved the issue of consumer satisfaction with the hospital experience. To address these goals, a multimethod design was used, including a post-occupancy evaluation, surveys, and in-depth qualitative interviews. Results were interpreted using the environmental preference theories.;Behavioral observations, surveys, and interview data indicated a number of benefits of the garden. Participants reported they used the garden, or other outdoor natural spaces, as an escape from hospital stress, and use was accompanied by an increase in consumer satisfaction. Mood changes were attributed to specific, multisensory physical aspects of natural environments such as greenery and running water. Themes from interviews led to several preliminary hypotheses: (1) Natural environments that offer maximal opportunities for pleasurable multisensory stimulation are most relaxing to those in hospital because they counteract the cognitive processing demands of the hospital; (2) It is necessary to extend the environmental preference theories from the visual realm to consider how multisensory aspects of experiences influence responses to and preferences for various environments; (3) Gardens in hospitals may serve as symbols of more basic issues and needs; and (4) While healthy children may request more interactive "things for kids to do" in the garden, more chronically or critically ill children are particularly appreciative of the opportunity for refuge within gardens, and prefer familiar objects or plants that can be associated with home.;In terms of quality improvement, the results indicated that the garden was not utilized as much, or as effectively, as intended. Based on these findings, recommendations were developed to promote more effective design and use of hospital healing gardens. These research findings can be used to guide the future planning, design, building, and subsequent evaluation of healing gardens and environments in children's hospitals and pediatric settings.
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