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Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions.

Do the hospital rooms make a difference for patients' stress? A multilevel analysis of the role of perceived control, positive distraction, and social support

a b s t r a c tThis study analyses the processes through which the physical environment of health care settings impacts on patients' well-being. Specifically, we investigate the mediating role of perceptions of the physical and social environments, and if this process is moderated by patients' status, that is, if the objective physical environment impacts inpatients' and outpatients' satisfaction by different socialpsychological processes. Patients (N ¼ 206) evaluated the physical and social environments of the care unit where they were receiving treatment, and its objective physical conditions were independently evaluated by two architects. Results showed that the objective environmental quality affects satisfaction through perceptions of environmental quality, and that patients' status moderates this relationship. For inpatients, it is the perception of quality of the social environment that mediates the relationship between objective environmental quality and satisfaction, whereas for outpatients it is the perception of quality of the physical environment. This moderated mediation is discussed in terms of differences on patients' experiences of health care environments.

Hearing loss is frequent in old age and has been associated with fewer social activities and depression. However, hearing problems have also been associated with other comorbidities, which prevent more definitive conclusions about the unique role on older people's wellbeing. Moreover, little attention has been paid to the psychological processes through which this relationship occurs. This study aims to investigate the effect of hearing loss on older adults' wellbeing from a longitudinal perspective. Using data from three points in time, we investigated the mutual relationship between hearing loss, depression and social activities. Based on longitudinal data of the Survey of Health, Ageing and Retirement in Europe (SHARE) from ten European countries, we conducted the test of competing auto-regressive crosslagged theoretical models. Results show that hearing loss reduces social activity, which is mediated by depression. The adequacy of this model (versus a model proposing that social activity restriction mediates the relationship between hearing loss and depression) was supported in each of the countries of the sample. Findings showing that hearing loss can contribute to depression and, subsequently, to restriction in social activities have implications for early detection and clinical interventions on hearing loss.

Evidence points to the role of the physical environment on patient wellbeing, but its specific contribution is not clear. Two experimental studies were conducted. First, we investigated the inferences people make about the physical environment given information about the social environment, and vice versa. In six conditions, participants were exposed to information about an inadequate, neutral, or good hospital physical environment; or about a negative, neutral, or positive hospital social environment. Results showed that people associate the quality of hospitals' physical and social environments, and the corresponding expected well-being. Study 2 sought to disentangle the independent effect of the physical and social dimensions. Levels of quality of the physical and social environments were crossed in a 3 × 3 between-subjects design. Results showed that both dimensions have a specific significant effect. In particular, the physical environment seems

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