Purpose: The aim of this article is to provide a narrative overview of theories that are available in the published literature on wayfinding in interior environments. Background: Wayfinding is an issue in healthcare facilities, and it has been documented that wayfinding problems have negative impacts on patients, visitors, caregivers’ time, and the organization’s bottom line. This issue can be more challenging for people with illness, low vision, cognitive disorders, and limited physical mobility. Wayfinding is a complex phenomenon depending on a variety of cognitive processes and behaviors. Methods: This article is a part of a broader literature review that searched for empirical studies on interior wayfinding. Four databases were systematically searched—PsychINFO, JSTOR, ProQuest, and EBSCO. A total of 81 articles satisfied all inclusion criteria for the broader study. Each article included in the broader study was reviewed to identify theory or theories, if any, that a study was founded on. Results: After an in-depth review of the theories, the authors proposed four categories of theories relating to human wayfinding. The four classes and the specific theories in those are articulated in this article, including major changes during their evolution. The four classes of theories explain four facets of wayfinding: (1) theories of perception, (2) theories of spatial knowledge development, (3) theories of mental representation of spatial knowledge, and (4) theories of spatial cognition. Conclusion: Since wayfinding is essentially a cognitive/problem-solving phenomenon, understanding the theoretical underpinnings of wayfinding may result in more meaningful and impactful design decisions.

Objectives: The aims of this study were to identify and evaluate scientific evidence examining the impact of the built environment on patient falls in hospital rooms. Methods: An integrative review (IR) with a systematic literature search was performed using the patient, intervention, comparison, outcome framework. We searched CINAHL, PsychINFO, PubMED, and Web of Science databases. The search included peer-reviewed studies from 1990 to 2017 written in English. An additional hand search was also conducted. Selected articles were reviewed and rated based on a hierarchical categorization, comprising six evidence levels, developed by the American Association of Critical-Care Nurses and adapted for evidence-based design systematic literature reviews. Results: After a multitiered process, 30 articles met the selection criteria. Thematic areas were created based on the examined elements of the physical environment including patient room configuration and available space, bathroom configuration, bathtub and shower, door, bed height and bed rail, flooring, floor mats, patient chair, lighting, toilet, handrail, grab bars, intravenous pole, sink, ceiling lift, and wheelchair and walking aids. Findings of studies on each element are discussed in detail. Conclusions: Some environmental elements have not been examined in past relational or causal studies, and the level of evidence for the examined attributes is not high enough to gain robust confidence in healthcare design decision-making. Because of the low level of evidence for several environmental elements, conclusions must be taken with caution. More studies using quantitative, relational, or causal designs are recommended to develop actionable interventions on patient falls in hospital rooms.

Purpose: This article assesses the magnitude and impact of wayfinding problems in US hospitals as perceived by staff. Background: Problematic wayfinding in healthcare facilities is a persistent issue, leading to frustration, stress, fatigue, physical aggression, wasted time, and a negative organizational image. Despite anecdotal evidence, few studies have quantified the impacts of wayfinding problems. Methods: This descriptive cross-sectional study used an online questionnaire to gather data from hospital staff in the United States. The questionnaire targeted (1) wayfinding for hospital staff, (2) wayfinding for hospital visitors, (3) the impact of wayfinding problems on staff, and (4) the importance of addressing wayfinding problems. Data from 301 questionnaires were analyzed using descriptive and nonparametric statistics. Results: Staff found it easy to navigate their own departments but more difficult to navigate other departments. Staff's responses indicated that wayfinding was relatively difficult for visitors. Each staff member spent about 30 min per week on helping others with wayfinding. The five locations in which users needed the most assistance were the cafeteria, restrooms, elevators, exits, and main lobby. Staff commonly escorted people to a point from which they could independently reach their destination. Wayfinding difficulties could distract staff from their main duties and cause frustration. Nearly 44% of the participants experienced incivility from users who had become frustrated by wayfinding problems. Participants rated addressing wayfinding problems as very important. Conclusions: Despite the extensive literature on the environmental factors that influence wayfinding, this study finds that hospital visitors in the United States still struggle with wayfinding, which indicates a potential gap between design research and practice.

The purpose of this study was to identify the elements of the interior environment and their attributes that contribute to interior wayfinding. While the majority of the literature on wayfinding has examined specific causal relationships, few studies have systematically investigated the wayfinding process of users to uncover several environmental elements and attributes that may influence wayfinding, particularly from a qualitative approach. Thus, an exploratory research design comprising qualitative methods and quantitative descriptive techniques was adopted. Eleven participants (female, n = 6; male, n = 5) were asked to locate 12 destinations in two university buildings. The primary data types were a think-aloud protocol and digital video recording. Findings showed that the environmental elements that contributed to wayfinding were landmarks, corridors, nodes, regions, stairs, central spaces, courtyards, entrances, connecting halls, voids, doors, interior windows, and outdoor views. The attributes of identified environmental elements that influence wayfinding are reported. The outcomes of the present study are expected to further our theoretical understanding of the phenomena and provide a foundation for additional investigations to develop guidelines and recommendations for design decision-making in practice.

The world’s population is aging and, as populations age, they exhibit an increased prevalence of chronic diseases, which can reduce the independence of elderly individuals. The set of initiatives known as aging in place, a common policy response to the aging population, is preferred by both the elderly population and policymakers. Aging in place is a broad and multifaceted topic that involves multiple stakeholders and academic disciplines. A science map of the literature on aging in place can help researchers pinpoint their efforts and help policymakers make informed decisions. Thus, this study maps the scientific landscape of the aging-in-place literature. This review used bibliometric analysis to examine 3240 publications on aging in place indexed in the Web of Science. Using VOSviewer 1.6.20, it conducted various analyses, including a citation analysis and an analysis of the co-occurrence of author-provided keywords. The study identified key research areas, leading countries, institutions, and journals, central publications, and the temporal evolution of themes in the literature. Based on its keyword co-occurrence analysis, the study identified five major research-area clusters: (1) aging-in-place facilitators, (2) age-friendly communities, (3) housing, (4) assistive technologies, and (5) mental health. This study improves the understanding of the various interdisciplinary factors that have influenced the research on aging in place. By making this research more accessible, the study can help researchers and policymakers navigate the extensive information on aging in place and complex relationships more effectively.