Investigating Space Use Patterns in a Malaysian Hospital Courtyard Garden: Lessons from real-time observation of patients, staff and visitors


  • Madihah Mat Idris University of Sheffield
  • Magda Sibley School of Architecture, Faculty of Social Science, University of Sheffield, Sheffield, United Kingdom
  • Karim Hadjri School of Architecture, Faculty of Social Science, University of Sheffield, Sheffield, United Kingdom



Observation, space use patterns, courtyard garden, hospital.


This paper examines the behaviour of users of a large central courtyard in a hospital with the aim to develop an understanding of the activities and the space use patterns of patients, staff and visitors. Video-based and direct observation, as well as behaviour mapping, were employed to investigate how different types of users interact with the courtyard garden. This study reveals that significant differences existed in the way different user groups utilised the courtyard garden on a daily basis and this was found to be highly influenced by the physical environment, the hospital opening hours and the courtyard micro-climate.

eISSN: 2398-4287 © 2018. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license ( Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.


Author Biography

Madihah Mat Idris, University of Sheffield

PhD student , School of Architecture


Almhafdy, A., Ibrahim, N., Ahmad, S.S. and Yahya, J. (2013a). Analysis of the Courtyard Functions and its Design Variants in the Malaysian Hospitals. Procedia-Social and Behavioral Sciences, 105, pp.171-182.

Almhafdy, A., Ibrahim, N., Ahmad, S.S. and Yahya, J. (2013b). Courtyard design variants and microclimate performance. Procedia-Social and Behavioral Sciences, 101, pp.170-180.

Aripin, S. (2007). November. Healing Architecture: Daylight in hospital design. In Conference on Sustainable Building South East Asia, Vol. 5, p.7.

Bechtel, R.B., Marans, R., Michelson, W. (1987). Methods in Environmental and Behavioural Research. Van Nostrand Reinhold, New York.

Cooper Marcus, C. (2007). Healing gardens in hospitals. Interdisciplinary Design and Research e-Journal, 1(1), pp.1-27.

Cooper Marcus, C., and Barnes, M. (1995). Gardens in healthcare facilities: Uses, therapeutic benefits, and design recommendations. Concord, CA: Center for Health Design.

Cooper Marcus, C., Francis, C. (1998). People Places: Design Guidelines for Urban Open Space, 2nd ed. John Wiley & Sons, Inc., Toronto.

Gehl, J. (1987). Life Between Buildings: Using Public Space. Van Nostrand Reinhold, New York.

Ghazali, R. and Abbas, M. Y. (2012) ‘Natural Environment in Paediatric Wards: Status and Implications’, Procedia - Social and Behavioral Sciences, 68(December 2010), pp. 173–182

Goličnik, B., & Thompson, C. W. (2010). Emerging relationships between design and use of urban park spaces. Landscape and Urban Planning, 94(1), 38-53.

Ittelson, W.H., Rivlin, L.G., Prohansky, H.M. (1970). The use of behavioural maps in environmental psychology. In: Prohansky, H.M., Ittelson, W.H., Rivlin, L.G. (Eds.), Environmental Psychology: Man and his Physical Setting. Holt, Rinehart &Winston, New York, pp. 658–668.

Jamaludin, A. A., Hussein, H., & Tahir, K. M. (2016). Resident’s acceptance of internal courtyard buildings. In MATEC Web of Conferences (Vol. 66, p. 00098). EDP Sciences.

Jewitt, C., (2012). ‘An introduction to using video for research’, National Centre Research Method (NCRM).

Kubota, T., Zakaria, M. A., Abe, S., & Toe, D. H. C. (2017). Thermal functions of internal courtyards in traditional Chinese shophouses in the hot-humid climate of Malaysia. Building and Environment, 112, 115-131.

Naderi, J.R. and Shin, W.H. (2008). Humane design for hospital landscapes: a case study in landscape architecture of a healing garden for nurses. Herd, 2(1), pp.82–119.

Paine, R. (1984). Design Guidelines for Hospital Outdoor Spaces: Case Studies of Three Hospitals (Doctoral dissertation in Landscape Architecture, University of California, Berkeley).

Sadafi, N., Salleh, E., Haw, L. C., and Jaafar, Z. (2011). Evaluating thermal effects of the internal courtyard in a tropical terrace house by computational simulation. Energy and Buildings, 43(4), 887-893.

Said, I. (2003) ‘Garden as an Environmental Intervention in Healing Process of Hospitalised Children’, Proceedings KUSTEM 2nd Annual Seminar on Sustainability Science and Management, Environment Détente: Quo Vadis Ecological Economics and Sciences, 6-7 May 2003, Awana Kijal Golf and Country Resort, Kemaman, Terengganu., pp. 1–11.

Sh. Ahmad, S., Mat Som, N., Ong, S.H., Harith, Z.Y., and Othman, A.R. (2007). ‘Daylighting in Courtyard hospital wards in Malaysia’, in PAM Academic Journal, Kuala Lumpur, Yamagata, Vol 1, 1/2007, pp 97-117.

Sherman, S. A., Varni, J. W., Ulrich, R. S. and Malcarne, V. L. (2005). ‘Post-occupancy evaluation of healing gardens in a paediatric cancer centre’, Landscape and Urban Planning, 73(2–3), pp. 167–183.

Shukor, S.F.A. (2007). Design Characteristics of Healing Garden for Down’s Syndrome Children in Malaysia (Master dissertation, Universiti Putra Malaysia).

Shukor, S.F.A. (2012). Restorative Green Outdoor Environment at Acute Care Hospitals. Case Studies in Denmark. Forest & Landscape Research, (57-2012). (Doctoral dissertation, University of Copenhagen).

Toone, T. L. (2008). Effects of Healing Garden Use on Stress Experienced by Parents of Patients in a Pediatric Hospital (Master dissertation, Texas A & M University).

Ulrich, R.S. (1984). View through a Window May Influence Recovery from Surgery. Source: Science, New Series, 224(4647), pp.420–421.

Verderber, S. and Reuman, D. (1987). Windows, Views, And Health Status In Hospital Therapeutic Environments. Journal of Architectural and Planning Research, 4(2), pp.120–133.

Whitehouse, S., Varni, J. W., Seid, M., Cooper-MArcus, C., Ensberg, M. J., Jacobs, J. R. and Mehlenbeck, R. S. (2001). ‘Evaluating a Children’S Hospital Garden Environment: Utilization and Consumer Satisfaction’, Journal of Environmental Psychology, 21(3), pp. 301–314.

Whyte, W.H. (1980). The Social Life of Small Urban Spaces. Conservation Foundation, Washington, DC.

Whyte, W.F. and Whyte, K.K. (1984). Learning from the Field: A guide from Experience. Beverly Hills, CA: Sage Publications.

Wiles, R., Prosser, J., Bagnoli, A., Clark, A., Davies, K., Holland, S. and Renold, E., 2008. Visual ethics: Ethical issues in visual research.



How to Cite

Mat Idris, M., Sibley, M., & Hadjri, K. (2018). Investigating Space Use Patterns in a Malaysian Hospital Courtyard Garden: Lessons from real-time observation of patients, staff and visitors. Environment-Behaviour Proceedings Journal, 3(8), 32-45.

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