In recent decades, the architectural design of healthcare environments has experienced a fundamental shift toward human-centered and experience-oriented paradigms. Hospitals are no longer perceived merely as technical infrastructures for delivering medical services; rather, they are increasingly recognized as complex socio-spatial systems that profoundly influence the physical, psychological, and emotional well-being of their users. While patient-centered design has been widely emphasized in healthcare architecture, growing evidence demonstrates that the quality of hospital environments also plays a critical role in shaping the job satisfaction, performance, and mental health of healthcare professionals, particularly nurses. As the largest professional group within healthcare systems, nurses are continuously exposed to high workloads, emotional demands, time pressure, and physically challenging working conditions. Consequently, the interaction between nurses and the built environment becomes a decisive factor in their professional experience, well-being, and long-term retention.

From an architectural perspective, hospital environments influence nurses through multiple interrelated dimensions, including spatial organization, environmental comfort, accessibility to equipment and resources, circulation patterns, visual connections, social interaction, and organizational structures embedded within space. Poorly designed environments may exacerbate physical fatigue, psychological stress, dissatisfaction, and occupational burnout, whereas well-designed environments can enhance efficiency, safety, emotional well-being, and pleasure at work. Therefore, improving the quality of hospital environments for nurses represents a critical challenge in contemporary healthcare architecture and design research.

In this context, the concepts of ergonomics and hedonomics provide complementary theoretical frameworks for improving human–environment interaction in healthcare settings. Ergonomics aims to optimize the compatibility between humans and their working environments by addressing physical, cognitive, and organizational dimensions, thereby improving safety, efficiency, comfort, and performance while reducing occupational risks. Hedonomics extends beyond functional optimization and focuses on pleasure, enjoyment, and emotional satisfaction derived from interaction with environments, systems, and products. Hedonomic design seeks to transform work environments from merely tolerable or neutral spaces into pleasant, meaningful, and emotionally supportive places. Despite the conceptual synergy between ergonomics and hedonomics, existing research on hospital design has often addressed these approaches in isolation, leaving architectural and environmental dimensions underexplored.

A critical review of the literature reveals a lack of comprehensive and integrative frameworks that simultaneously consider ergonomic and hedonomic principles in hospital design with a specific focus on nurses’ satisfaction and pleasure. Although previous studies have examined isolated aspects such as workload, teamwork, organizational support, or environmental comfort, the absence of a unified structural model limits the applicability of these findings to architectural design and healthcare planning. This gap highlights the need for a systematic synthesis of existing knowledge to identify, categorize, and conceptualize the key components influencing ergonomic- and hedonomic-based hospital design.

The present study addresses this gap by conducting a systematic review and developing a unified structural model of effective components in ergonomic- and hedonomic-based hospital design aimed at enhancing nurses’ satisfaction. The objectives of this research are threefold: first, to identify the key components influencing nurses’ satisfaction and pleasure in hospital environments; second, to categorize these components into coherent dimensions relevant to architectural and environmental design; and third, to propose an integrated conceptual framework capable of informing evidence-based hospital design strategies.

To achieve these objectives, a systematic review was conducted using a seven-step meta-synthesis methodology. This approach enables the integration of qualitative findings from diverse studies and facilitates the development of higher-order concepts and theoretical models. International academic databases, including Web of Science, Scopus, PubMed, and Reaxys, were searched for studies published between 1999 and 2024. The search strategy employed keywords such as hospital, ergonomics, hedonomics, pleasure, and their related terms. The initial search yielded 1,924 articles. Following the PRISMA screening protocol, duplicate records were removed and inclusion and exclusion criteria were applied. Studies were excluded if they lacked sufficient relevance to the research question or if full texts were not accessible. Ultimately, 22 articles were selected for in-depth qualitative analysis.

To ensure methodological rigor and reliability, the processes of screening, coding, and data extraction were conducted independently by two researchers. Inter-rater reliability was assessed using Cohen’s Kappa coefficient, which yielded a value of 0.75, indicating substantial agreement. The selected studies were then analyzed through qualitative synthesis, during which extracted components were compared, refined, and merged to eliminate conceptual overlap and enhance analytical clarity.

The results of the meta-synthesis revealed four major categories of components influencing ergonomic- and hedonomic-based hospital design: organizational, social, individual, and environmental components. Organizational components emerged as the most prominent category, accounting for approximately 45% of the extracted factors. These components include teamwork, workload management, staffing levels, organizational support, recognition, work–life balance, and job rotation patterns. Many of these factors are closely associated with macro-ergonomics and underscore the central role of hospital management and organizational culture in shaping nurses’ work experiences, motivation, and satisfaction.

Social components constituted approximately 24% of the identified factors and primarily relate to interpersonal relationships and social interactions within hospital environments. These components include nurse–colleague relationships, nurse–patient interactions, patient appreciation, collaboration, trust, and social identity. Given the collaborative and emotionally demanding nature of nursing practice, supportive social environments and positive interpersonal interactions significantly contribute to nurses’ emotional well-being, sense of professional value, and pleasure at work.

Individual components accounted for approximately 19% of the extracted factors and were mainly associated with internal psychological and professional attributes rather than demographic characteristics. These components include motivation, professional identity, autonomy, self-confidence, stress management, and the perceived meaning of work. The findings indicate that nurses’ satisfaction is strongly influenced by the extent to which their personal values, professional goals, and sense of competence are supported by the working environment. However, individual components interact dynamically with organizational and social contexts and cannot independently ensure satisfaction.

Environmental components represented approximately 12% of the extracted factors and were the least frequently addressed category in the literature. Nevertheless, their limited representation does not reflect their actual importance. Environmental components encompass physical, perceptual, and cognitive aspects of hospital design, including micro-ergonomics (design of workstations, equipment, and spatial dimensions), environmental ergonomics (lighting quality, acoustics, thermal comfort, and noise control), cognitive ergonomics (wayfinding systems, signage, and spatial legibility), and cultural ergonomics (alignment of design with social, cultural, and contextual values). Access to resources, appropriate spatial organization, and restorative elements such as green spaces and quiet rooms emerged as recurrent environmental factors influencing nurses’ satisfaction and emotional responses.

Based on these findings, a unified structural model was developed to illustrate the dynamic interrelationships among the four categories of components. The model demonstrates that nurses’ satisfaction and pleasure are not the result of isolated factors but emerge from the interaction of organizational, social, individual, and environmental dimensions. Although organizational and social components appear more frequently in existing studies, environmental and architectural factors play a critical yet underexplored role in shaping nurses’ experiences and emotional well-being in hospital settings.

In conclusion, this study proposes an integrated ergonomic–hedonomic framework for hospital design that contributes to advancing knowledge at the intersection of architecture, ergonomics, and healthcare studies. The findings emphasize the necessity of adopting a holistic and multidisciplinary approach that simultaneously considers organizational structures, social interactions, individual experiences, and environmental design. By highlighting the architectural implications of ergonomic and hedonomic principles, this research provides a theoretical foundation for designing hospital environments that are not only efficient and safe but also pleasant, meaningful, and supportive for nurses. Future research should further investigate environmental and architectural dimensions, particularly from engineering and design perspectives, to develop evidence-based guidelines for creating healthcare environments that enhance nurses’ satisfaction, improve workplace quality, and ultimately support better healthcare outcomes.

Keywords: Ergonomics; Hedonomics; Hospital Design; Nurses’ Satisfaction ; Pleasure