Background: Stress reduction is considered one of the fundamental strategies for health promotion. The physical environment plays a significant role in individuals' psychological well-being and stress reduction. This study was conducted to identify the physical components influencing the design of salutogenic hospitals and to examine the relationships between these components in the context of reducing patient stress.
Methods: This study employed a mixed-method research design. Following a comprehensive literature review and the identification of influential environmental factors, a 45-item questionnaire was developed based on an objective–content matrix and architectural design indicators. The questionnaire was administered to 210 patients admitted to Rajaie Cardiovascular Medical and Research Center. The collected data were analyzed using SPSS version 27. Subsequently, structural modeling was performed using path analysis in AMOS. Direct and indirect relationships among the identified factors, path coefficients, and model fit indices were evaluated.
Results: The findings identified six key physical design factors: legibility and functionality, safety and hygiene, environmental comfort, naturalness, aesthetics, and psychosocial comfort. Path analysis demonstrated that these factors interact through direct and indirect relationships, with psychosocial comfort emerging as the final outcome of the proposed model and playing a significant role in reducing users' stress.
Conclusion: Stress reduction in healthcare environments requires an integrated approach to hospital design. In the proposed model, legibility and functionality enhance psychosocial comfort both directly and indirectly through naturalness, aesthetics, safety and hygiene, and environmental comfort. This framework can improve users' experiences and contribute to achieving the goals of health-promoting hospitals by enhancing the quality of healthcare environments and services.