Perception of signage and spatial orientation among users in a public pediatric referral hospital in Lima, Peru
DOI:
https://doi.org/10.59594/iicqp.2025.v3n2.147Keywords:
Hospitals, Orientation, Patient navigation, Signage, Pediatric Health FacilitiesAbstract
Objective: To evaluate users’ perception of signage and their spatial orientation ability in a national pediatric referral hospital in Lima, Peru.
Methods: An observational, analytical, cross-sectional study was conducted at the Instituto Nacional de Salud del Niño San Borja. A total of 354 parents, guardians, or caregivers of pediatric patients were surveyed. Signage perception and self-assessed spatial orientation were measured using Likert scales. Non-parametric tests and Spearman correlation analysis were performed.
Results: Most respondents (88.4%) preferred asking staff for directions, while only 11.6% relied on signage or maps. No significant differences in orientation were found according to visit frequency or educational level, except for overall self-assessment scores, where males scored higher than females (7.77 vs. 6.92; p < 0.05). A moderate correlation was observed between signage perception and self-assessed spatial orientation (rho = 0.39; p < 0.001).
Conclusions: Most users rely more on staff than on signage to navigate the facility. Optimizing signage and exploring more effective orientation strategies are necessary to enhance the visitor experience.
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References
Sahoo B, Pillai JSK, Md S, Sahoo MC. Implementation of Wayfinding Signage in Public Hospitals and Its Evaluation Towards Quality Improvement. Cureus. 2024;16(7):e65435. doi: 10.7759/cureus.65435
Jiang Z min, Zhang P hong, Shang R xue, Tian X liang. Investigation and Simulation on Human Evacuation Behaviour in Large Hospital Building in Shenyang. Procedia Eng. 2014;71:101–6. doi: 10.1016/j.proeng.2014.04.014
He Y, Bai W, Ye Y, Guo W, Wang X, Zou X. A lean approach to enhance the visual experience during wayfinding in the emergency department spaces: a case study of a large-scale general hospital in China. Archit Eng Des Manag. 2025;21(4):642–64. doi: 10.1080/17452007.2024.2382294
Rodrigues R, Coelho R, Tavares JMRS. Users' Perceptions of Signage Systems at Three Portuguese Hospitals. HERD. 2020;13(3):36-53. doi: 10.1177/1937586720924761
Rousek JB, Hallbeck MS. The use of simulated visual impairment to identify hospital design elements that contribute to wayfinding difficulties. Int J Ind Ergon. 2011;41(5):447–58. doi: 10.1016/j.ergon.2011.05.002
Iftikhar H, Luximon Y. Wayfinding Information Syntheses: A Study of Wayfinding Efficiency and Behavior in Complex Outdoor Institutional Environment. HERD. 2023;16(2):250–67. doi: 10.1016/j.ergon.2011.05.002
Adams A, Theodore D, Goldenberg E, McLaren C, McKeever P. Kids in the atrium: comparing architectural intentions and children's experiences in a pediatric hospital lobby. Soc Sci Med. 2010;70(5):658-67. doi: 10.1016/j.socscimed.2009.10.049
Morag I, Sonmez V, Van Puyvelde A, Pintelon L. Improving wayfinding in hospitals for people with diverse needs and abilities: An exploratory approach based on multi-criteria decision making. Appl Ergon. 2024;114:104149. doi: 10.1016/j.apergo.2023.104149
Lee E, Daugherty J, Selga J, Schmidt U. Enhancing Patients' Wayfinding and Visitation Experience Improves Quality of Care. J Perianesth Nurs. 2020;35(3):250-4. doi: 10.1016/j.jopan.2019.11.003
Çelebi C, Dündar M. Investigation of Circulation Areas Depending on Spatial Planning Criteria in Healthcare Facilities. En: Aslan FE, Kurtulan G, Yalın H, editores. Scientific Researches in Health Sciences II [Internet]. Berlín: Peter Lang; 2021 [citado el 18 de agosto de 2025]. p. 379–401. Disponible en: https://www.scienceopen.com/book?vid=8945beb7-c3e0-4420-bc0d-f3e7aa61adf5
Seguro Social de Salud. Guía rápida para implementar la señalética de los establecimientos de salud del Seguro Social de Salud - EsSalud [Internet]. Lima: EsSalud; 2016 [citado el 18 de agosto de 2025]. Disponible en: https://www.essalud.gob.pe/downloads/guia_rapida_implement_senaletica_en_establecim_de_saluda.pdf
Ministerio de Salud del Perú. Norma técnica de salud para señalización de seguridad de los establecimientos de salud y servicios de salud y servicios médicos de apoyo [Internet]. Lima: MINSA; 2006 [citado el 18 de agosto de 2025]. Disponible en: https://www.gob.pe/institucion/minsa/informes-publicaciones/353455-norma-tecnica-de-salud-para-senalizacion-de-seguridad-de-los-
Departament of Health. Wayfinding: Effective wayfinding and signing systems guidance for healthcare facilities [Internet]. 2021 [citado el 18 de agosto de 2025]. Disponible en: https://www.england.nhs.uk/publication/wayfinding-effective-wayfinding-and-signing-systems-guidance-for-healthcare-facilities/
Organización Panamericana de la Salud [Internet]. OPS; 2024 [citado el 18 de agosto de 2025]. Hospitales Seguros. Disponible en: https://www.paho.org/es/emergencias-salud/hospitales-seguros
Organización Panamericana de la Salud [Internet]. OPS; 2017 [citado el 18 de agosto de 2025]. Agenda de Salud Sostenible para las Américas 2018-2030. Disponible en: https://www.paho.org/es/agenda-salud-sostenible-para-americas-2018-2030
Naciones Unidas. Objetivos y metas de desarrollo sostenible [Internet]. [citado el 18 de agosto de 2025]. Desarrollo Sostenible.. Disponible en: https://www.un.org/sustainabledevelopment/es/objetivos-de-desarrollo-sostenible/
Rodrigues R, Coelho R, Tavares JMRS. Healthcare Signage Design: A Review on Recommendations for Effective Signing Systems. HERD. 2019;12(3):45-65. doi: 10.1177/1937586718814822
Instituto Nacional de Salud del Niño San Borja [Internet]. INSNSB; 2024 [citado el 18 de agosto de 2025]. Quiénes somos. Disponible en: https://portal.insnsb.gob.pe/quienes-somos/
Mora R, Oats A, Marziano P. Percepción de la señalización y orientación espacial de los usuarios de tres complejos hospitalarios de Santiago, Chile. Rev Medica Chile. 2014;142(10):1291–6. doi: 10.4067/S0034-98872014001000009
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. doi: 10.1016/j.jbi.2008.08.010
StataCorp. Stata Statistical Software. College Station: TX: StataCorp LLC; 2021.
Posit Software, PBC. Rstudio: Integrated Development for R [Internet]. Boston: Posit Software; 2025 [citado el 18 de agosto de 2025]. Disponible en: https://posit.co
Hu B. Wayfinding for modern healthcare: A participatory approach to designing a wayfinding system in a Chinese Hospital Setting. Des J. 2023;26(4):662–72. doi: 10.1080/14606925.2023.2216877
Morag I, Parush A. The effect of verbal instructions while using digital indoor wayfinding devices on gender, performance, and self-reported strategies. Appl Ergon. 2024;114:104160. doi: 10.1016/j.apergo.2023.104160
Nuvolari-Duodo I, Brambilla A, Ricciardi GE, Dolcini M, Capolongo S. New Requirements for post-COVID-19 Hospital Inpatient Wards: Evidence, Design Recommendations and Assessment Tools. Ann Ig. 2024;36(2):182-93. doi: 10.7416/ai.2024.2601
Qi F, Lu Z, Chen Y. Investigating the Influences of Healthcare Facility Features on Wayfinding Performance and Associated Stress Using Virtual Reality. HERD. 2022;15(4):131-51. doi: 10.1177/19375867221108505
Zhu B, Cruz-Garza JG, Yang Q, Shoaran M, Kalantari S. Identifying uncertainty states during wayfinding in indoor environments: An EEG classification study. Adv Eng Inform. 2022;54:101718. doi: 10.1016/j.aei.2022.101718
Daykin N, Byrne E, Soteriou T, O'Connor S. The impact of art, design and environment in mental healthcare: a systematic review of the literature. J R Soc Promot Health. 2008;128(2):85-94. doi: 10.1177/1466424007087806
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