title: A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare.
abstract: OBJECTIVE
  To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties.
  
  
  BACKGROUND
  The physical healthcare environment is regarded as a quality factor for health care. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment.
  
  
  METHODS
  Systematic psychometric review.
  
  
  METHODS
  A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016).
  
  
  METHODS
  Consensus based standards for selection of health measurement instruments guidelines were used to evaluate psychometric data reported.
  
  
  RESULTS
  Twenty-three instruments were included. Most of the instruments are intended for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated.
  
  
  CONCLUSIONS
  Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators are user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required.
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.|Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.|Department of Architecture, Chalmers University of Technology, Göteborg, Sweden.
authors.forename: Marie
authors.identifier: http://orcid.org/0000-0001-7044-8896
authors.initials: M
authors.lastname: Elf
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.|Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Susanna
authors.identifier: http://orcid.org/0000-0003-3356-7583
authors.initials: S
authors.lastname: Nordin
authors.affiliation: Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg University, Göteborg, Sweden.|Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Helle
authors.initials: H
authors.lastname: Wijk
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Mckee
mesh_terms: D055317:Evidence-Based Practice; D005160:Facility Design and Construction; D006272:Health Facility Environment / Q000592:standards*; D006801:Humans; D011594:Psychometrics
keywords: evidence-based design; healthcare facilities; measurement instruments; nursing; older adults; physical healthcare environment; systematic psychometric review