Aims:
The built environment of rehabilitation centers plays a critical yet underexplored role in supporting patient recovery. While evidence-based design (EBD) has gained traction in healthcare architecture as a framework for translating empirical research into design decisions, its systematic application within healing garden contexts remains insufficiently theorized. Existing literature addresses EBD components and healing garden principles largely in isolation, leaving a notable gap in their integrated conceptualization for rehabilitation settings. This study therefore aims to: (1) identify the design components influencing rehabilitation center quality within both EBD and healing garden frameworks; (2) categorize and prioritize these components according to their frequency and emphasis in the existing literature; and (3) construct a three-tiered conceptual framework that synthesizes findings from both traditions and delineates directions for future empirical inquiry.
Methodology:
This study adopts an applied research design employing systematic literature review and qualitative content analysis as its primary methodological strategies. A total of 114 sources were retrieved from peer-reviewed databases including IranDoc, SID, Civilica, and Google Scholar: 41 sources pertaining to evidence-based design (13 domestic, 2007–2024; 28 international, 1389–1402 SH) and 73 sources pertaining to healing gardens (33 domestic; 40 international). Search terms included rehabilitation centers, healthcare facilities, evidence-based design, and healing garden. Retrieved sources were subjected to open coding, followed by iterative merging of overlapping codes and thematic classification into five conceptual categories: (i) sensory-perceptual, (ii) functional-behavioral, (iii) physical-spatial, (iv) control-oriented and psychological, and (v) therapeutic-operational components. In parallel, six internationally recognized rehabilitation centers — Søkso, Groot Klimmendaal, Ezra LeMarp, Spaulding, Başakşehir, and the Basel Spinal and Brain Injury Center — were purposively selected from the literature as illustrative documentary cases. Selection criteria were based on the degree to which each facility reflected the identified design components and its documented presence in peer-reviewed EBD and healing garden scholarship. A comparative descriptive analysis was subsequently applied to examine the distribution of components across these cases. It must be noted that this study does not include user interviews, behavioral observation, post-occupancy evaluation (POE), clinical outcome data, control groups, or statistical effect analysis; accordingly, component frequency should not be interpreted as evidence of causal efficacy.
Conclusion:
Findings reveal that 18 design components can be organized across the five conceptual categories identified above. Components present in 100% of the documentary cases — including tree and vegetation diversity, human–nature connection, natural light, and adequate views — represent the most consistently documented priorities in the literature. Components such as furniture, spatial flexibility, natural materials, and social support appeared in approximately two-thirds of cases, while elements such as horticultural therapy, positive distraction, and appropriate nursing station placement were absent from or minimally represented in the reviewed cases, indicating significant research gaps. At the macro-theoretical level, this study proposes a conceptual framework at the intersection of EBD and healing garden principles, structured around the five thematic categories, which provides a coherent organizational scaffold for future research. At the meso-policy level, the five categories offer a preliminary basis for developing design guidelines, checklists, and institutional standards for rehabilitation facility planning, contingent upon empirical validation. At the micro-practical level, the identified components serve as preliminary design guidance — not as proven prescriptions — for architects and planners, with recommendations framed in non-causal terms such as “it is suggested,” “may facilitate,” and “provides a preliminary basis for.” Future research should prioritize post-occupancy evaluations, clinical outcome studies, and user-centered methodologies to empirically validate the framework proposed here.