Outline

  1. Media and social impact valuation of a living wall: The case study of the Sagrado Corazon hospital in Seville (Spain)
  2. Introduction
  3. Methods
  4. The hospital and the living wall
  5. Media impact assessment
  6. Survey methods and questionnaire design
  7. Statistical analysis
  8. Results
  9. Media impact assessment
  10. Users’ perception and WTP
  11. Discussion
  12. Conclusions
  13. Acknowledgments
  14. Supplementary data
  15. References
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Contents
lists
available
at
ScienceDirect
Urban
Forestry
&
Urban
Greening
journal
homepage:
www.elsevier.com/locate/ufug
Original
article
Media
and
social
impact
valuation
of
a
living
wall:
The
case
study
of
the
Sagrado
Corazon
hospital
in
Seville
(Spain)
Luis
Pérez-Urrestarazu
a,
⁎
,
Ana
Blasco-Romero
a
,
Rafael
Fernández-Cañero
b
a
Urban
Greening
&
Biosystems
Engineering
Research
Group,
Area
of
Agro-Forestry
Engineering,
Universidad
de
Sevilla,
ETSIA
Ctra,
Utrera
km.
1,
41013,
Seville,
Spain
b
Urban
Greening
&
Biosystems
Engineering
Research
Group,
Department
of
Agro-Forestry
Sciences,
Universidad
de
Sevilla,
ETSIA
Ctra,
Utrera
km.
1,
41013,
Seville,
Spain
ARTICLE
I
NFO
Keywords:
Marketing
Soft
benefits
Users’
perception
Vertical
garden
Vertical
greening
systems
ABSTRACT
Vertical
greening
systems
have
increased
in
popularity
during
the
last
years
due
to
their
experienced
added
ecological
and
aesthetic
value
for
current
clients.
The
use
of
living
walls
is
in
line
with
a
service
sector
focusing
on
environmental
consciousness.
Still,
scientific
evidence
is
lacking
regarding
the
multiple
benefits
of
LW.
There
is
also
a
lingering
fear
of
high
installation
and
maintenance
costs.
Therefore,
it
is
important
to
assess
the
intangible
benefits
that
increase
the
value
of
living
walls
and,
hence,
of
the
place
in
which
they
are
installed.
The
main
objective
of
this
work
is
the
valuation
of
the
returns
obtained
because
of
the
publicity
related
to
a
living
wall
installed
in
the
‘Quirónsalud
Sagrado
Corazón’
Hospital
in
Seville
(Spain)
and
the
assessment
of
the
public’s
perception
towards
it.
The
investment
that
the
hospital
would
have
made
in
order
to
obtain
a
similar
media
impact
has
been
estimated.
The
living
wall
proved
to
be
very
profitable
in
terms
of
publicity
as
the
installation
costs
were
recovered
six
times
over.
Also,
the
attitude
towards
the
presence
of
such
a
greening
system
in
the
premises
was
assessed.
To
do
so,
555
questionnaires
were
handed
out
face-to-face
to
patients,
visitors
and
workers
present
at
the
hospital.
Most
participants
concurred
that
the
living
wall
induced
positive
reactions
and
improved
their
psychological
well-being.
Therefore,
they
completely
agreed
with
the
investment
made
by
the
hospital
on
such
a
vertical
greening
system.
1.
Introduction
Many
cities
are
currently
facing
several
problems
related
to
a
high
construction
density
and
lack
of
green
spaces.
For
this
reason,
unconventional
urban
greening
methods
such
as
green
roofs
and
vertical
greening
systems
are
being
implemented.
The
use
of
living
walls
(LW)
is
becoming
popular,
even
indoors,
as
a
way
of
introducing
plants
into
the
built
environment.
However,
in
many
cases,
an
LW
is
not
installed
because
of
the
expenditure
it
involves,
especially
regarding
installation
and
maintenance
costs.
For
this
reason,
it
is
important
to
take
into
account
the
advantages
of
these
technologies,
several
of
which
involve
an
economic
gain
that
contributes
to
recovering
the
investment.
In
some
cases,
non-economic
characteristics
such
as
aesthetics
and
environmental
protection
are
key
motivators
(Balram
and
Dragićević,
2005)
which
incentivise
LW
installations.
In
the
service
sector,
users
or
clients
are
more
environmentally
conscious,
so
these
systems
can
provide
an
added
ecological
value
that
is
highly
appreciated.
Also,
some
authors
point
to
an
increase
of
the
property
value
when
there
are
green
areas
around
(Bengochea
Morancho,
2003;
Czembrowski
and
Kronenberg,
2016;
Netusil
et
al.,
2014).
In
the
case
of
an
LW,
these
increments
have
been
estimated
at
between
2
and
5%
(Perini
and
Rosasco,
2013).
Of
course,
these
figures
are
inconclusive
as
they
depend
on
multiple
variables
(characteristics
of
the
building,
location,
type
and
dimensions
of
the
LW,
etc.).
Over
the
last
years,
the
scientific
community
has
been
researching
about
the
multiple
ecological
and
environmental
benefits
associated
with
LWs,
such
as
enriching
urban
biodiversity,
improving
air
quality
or
enhancing
building
thermal
performance
(Pérez-Urrestarazu
et
al.,
2015).
Sometimes,
the
effect
of
an
LW
can
be
measured
directly
or
determined
using
models.
For
example,
noise
attenuation
or
indoor
temperature
modulation
due
to
an
LW
can
be
empirically
tested.
Therefore,
there
are
some
studies
that
quantify
those
benefits
in
terms
of
economic
impact
(e.g.,
energy
savings).
But
in
other
cases,
people
benefit
from
an
environmental
amenity
without
consciously
using
it
(Tomalty
and
Komorowski,
2010).
This
indirect
use
value
is
considered
as
a
soft
or
intangible
benefit,
not
directly
tradable
and
quite
difficult
to
quantify
(e.g.,
users’
positive
feelings
towards
a
‘greener’
space
or
marketing
benefits
related
with
the
public
’s
interest
in
environmentally
friendly
products
and
sustainability).
As
an
example,
Tomalty
and
Komorowski
(2010)
quantified
the
economic
value
of
different
green
http://dx.doi.org/10.1016/j.ufug.2017.04.002
Received
21
November
2016;
Received
in
revised
form
6
March
2017;
Accepted
4
April
2017
⁎
Corresponding
author.
E-mail
addresses:
lperez@us.es
(L.
Pérez-Urrestarazu),
anablascoromero@gmail.com
(A.
Blasco-Romero),
rafafc@us.es
(R.
Fernández-Cañero).
Urban Forestry & Urban Greening 24 (2017) 141–148
Available online 13 April 2017
1618-8667/ © 2017 Elsevier GmbH. All rights reserved.
MARK
Previous PDF in this issueNext PDF in this issue
roof
case
studies.
For
each
benefit
considered
they
used
a
different
method
to
make
the
estimations.
For
instance,
the
value
of
the
publicity
gained
as
a
direct
consequence
of
green
roof
investments
was
assessed
as
a
marketing
benefit.
The
Noise
Sensitivity
Depreciation
Index
(NSDI)
(Andersson
et
al.,
2013)
was
used
to
estimate
the
financial
gain
due
to
sound
attenuation.
Stormwater
retention
was
valued
considering
the
cost
of
regular
stormwater
retention
infrastructure
required
to
have
the
same
effect
as
the
green
roofs
studied.
Yang
et
al.
(2008)
calculated
the
economic
benefit
linked
with
the
pollutant
removal
capacity
of
a
green
roof.
Economic
science
has
developed
specific
methods
to
estimate
the
value
of
environmental
assets
in
monetary
units
(Bengochea
Morancho,
2003;
Tomalty
and
Komorowski,
2010).
In
‘Stated
preference’
techni-
ques,
such
as
contingent
valuation,
the
economic
value
is
attributed
by
asking
people
their
Willingness
To
Pay
(WTP)
for
certain
services
or
benefits
provided
by
green
infrastructure
(Bengochea
Morancho,
2003;
de
Groot
et
al.,
2002;
Jim
and
Chen,
2006;
Tomalty
and
Komorowski,
2010).
This
WTP
can
be
related
to
how
people
perceive
and
interact
with
the
green
infrastructure,
and
their
self-reported
well-being
and
preferences
(Dallimer
et
al.,
2014;
Mell
et
al.,
2013).
There
are
several
studies
using
contingent
valuation
to
establish
the
economic
value
of
green
infrastructure
(Breffle
et
al.,
1998;
Dallimer
et
al.,
2014;
Jim
and
Chen,
2006;
Mell
et
al.,
2016,
2013).
Most
of
them
are
related
to
conventional
green
infrastructures,
mainly
parks
and
open
areas.
There
are
some
experiences
with
green
roofs
(Bianchini
and
Hewage,
2012;
Clark
et
al.,
2008;
Claus
and
Rousseau,
2012;
Tomalty
and
Komorowski,
2010),
but
an
absence
of
them
in
LWs.
Part
of
the
value
attributed
to
vegetated
environments
lies
in
their
positive
effect
on
health
and
well-being,
providing
relief
from
the
pressures
of
high-density
living.
Even
a
passive
involvement
with
nature,
relying
on
the
visual
amenity,
can
bring
about
considerable
psychological
benefit(
Özgüner
and
Kendle,
2006;
Ulrich,
1984).
Buildings
with
certain
types
of
integrated
vegetation
seem
to
be
more
liked,
aesthetically
pleasing,
and
restorative
than
those
without
vegeta-
tion
(White
and
Gatersleben,
2011).
As
viewing
nature
has
been
reported
to
relieve
stress
and
pain,
it
makes
it
an
ideal
medium
for
use
in
healthcare
settings
( Vincent
et
al.,
2010
).
Particularly,
in
the
case
of
hospital
confinement,
some
patients
see
their
access
to
outdoor
environments
almost
entirely
limited
to
views
through
windows.
Patients
in
hospital
rooms
with
plants
and
flowers
or
even
with
access
to
a
vegetated
sight
had
significantly
shorter
hospitalisations,
fewer
intakes
of
analgesics,
lower
ratings
of
pain,
anxiety
and
fatigue,
more
positive
feelings
and
higher
satisfaction
(Bringslimark
et
al.,
2009;
Park
et
al.,
2004;
Park
and
Mattson,
2009,
2008;
Ulrich,
1984).
These
findings
emphasise
the
therapeutic
value
of
plants
in
the
hospital
environment.
Citizens
generally
have
a
positive
attitude
towards
green
infra-
structure
elements
and
these
reactions
are
related
with
their
support
for
them
(Jungels
et
al.,
2013).
Environmental
satisfaction
is
affected
by
many
factors,
such
as
gender
or
age,
but
also
depends
on
the
characteristics
of
the
green
spaces
(type
of
vegetation,
colours,
smells)
(Qin
et
al.,
2013),
so
it
is
important
to
assess
people
’s
response
to
their
interaction
with
nature.
Measuring
individual
stances
towards
urban
green
spaces
has
received
sparse
coverage
in
the
environment
and
planning
literature
(Balram
and
Dragićević,
2005).
Some
studies
are
available
involving
positions
regarding
urban
green
spaces
( Balram
and
Dragićević,
2005;
Carrus
et
al.,
2015;
Jim
and
Chen,
2006;
Mell
et
al.,
2013),
but
few
of
them
involve
green
roofs
or
green
façades
(Fernandez-Cañero
et
al.,
2013;
Jungels
et
al.,
2013;
Rahman
et
al.,
2015;
White
and
Gatersleben,
2011
Yuen
and
Nyuk
Hien,
2005)
and
only
Wong
et
al.
(2010)
referred
to
vertical
greening
systems
in
general.
The
main
objective
of
this
work
is
the
valuation
of
the
effect
of
an
LW
installed
in
a
hospital
in
Seville
(Spain)
in
terms
of
its
impact
in
the
media
and
on
people.
The
media
repercussion
due
to
the
LW
was
evaluated
considering
it
as
a
marketing
investment.
On
the
other
hand,
the
influence
of
the
LW
on
the
hospital
personnel
and
users
and
their
point
of
view
concerning
the
presence
of
vegetation
(specially
the
LW)
were
assessed
by
means
of
a
survey
in
order
to
estimate
the
benefit
obtained
from
it.
The
first
working
hypothesis
is
that
the
LW
in
the
hospital
had
a
monetary
return
in
marketing
making
its
installation
worthwhile.
The
second
involves
the
belief
that
the
LW
positively
influenced
the
hospital
personnel,
visitors
and
patients,
who
agreed
with
the
investment
made
by
the
medical
centre.
2.
Methods
2.1.
The
hospital
and
the
living
wall
Quirónsalud
Sagrado
Corazón
Hospital
(QSCH)
is
part
of
Quirónsalud,
a
Spanish
hospital
group
made
up
of
several
private
hospitals.
In
2015,
QSCH
received
around
138,000
patients
and
had
575
workers.
Apart
from
the
main
hospital
building,
QSCH
has
three
medical
centres
in
diff
erent
locations
in
Seville
(Spain).
In
2012,
the
main
building
was
remodelled
and
an
LW
was
installed
outdoors
in
August
2012
on
an
external
façade
facing
the
main
hall
of
the
hospital.
The
LW
has
an
approximate
area
of
40
m
2
(17
m
long
by
2.2
m
high).
In
its
design,
inspired
by
Burle
Marx’“
Suspended
Garden”,
around
1400
plants
of
40
different
species
were
used.
For
the
LW
installation,
a
felt
system,
composed
of
1
×
1
modules
with
pockets
in
which
the
plant
rootballs
are
inserted,
was
used.
The
LW
can
be
viewed
from
the
main
hall
through
a
large
window
(Fig.
1)
and
from
some
of
the
rooms
for
patients.
2.2.
Media
impact
assessment
All
the
QSCH
media
appearances
due
to
the
LW
were
identified
from
its
installation
until
the
end
of
2015
in
order
to
calculate
the
return
on
investment
of
the
LW
in
terms
of
media
impact.
The
comparable
cost
methodology
(Tomalty
and
Komorowski,
2010)
was
used
as
a
way
of
estimating
the
marketing
benefits
of
green
infrastructure
by
assessing
the
value
of
the
free
publicity
received
as
a
direct
consequence
of
the
LW’s
presence.
To
do
so,
the
real
cost
these
media
appearances
would
have
entailed
has
been
calculated.
Those
costs
are
broken
down
into
the
ad
production
charge
(not
taken
into
account
in
this
study),
plus
the
cost
of
running
the
advertisement.
A
slightly
different
process
was
adopted
for
each
medium
considering
several
factors.
For
radio
and
television,
the
aspects
influencing
the
cost
were
the
channel/radio
station,
duration
of
the
interview/report
(including
only
the
minutes
talking
about
the
hospital’s
LW),
air
time
and
audience.
In
the
case
of
the
written
press,
the
process
was
more
complex
and
the
information
on
the
estimated
cost
of
each
published
article
was
provided
by
a
specialised
company
(Acceso
Group
S.L.)
which
made
an
internal
report
for
the
hospital.
Only
the
articles
about
the
LW
were
taken
into
account.
The
variables
involved
to
make
the
estimation
were
the
newspaper
in
which
the
article
was
published,
the
total
of
copies
distributed,
section,
number
of
pages,
area
covered
by
the
article
and%
of
the
page
occupied
by
it
(page
coverage),
position
on
the
page,
the
average
number
of
readers
and
the
author
of
the
article.
Finally,
the
advertising
rates
in
each
channel,
station
or
newspaper
were
considered
according
to
the
factors
previously
described.
For
the
digital
press,
the
parameters
usually
employed
are
the
number
of
visits
and
the
CPM
or
cost
per
thousand
impressions
(Kumar
and
Sethi,
2009
),
where
an
impression
can
be
defined
as
the
display
of
an
ad
while
a
user
is
viewing
a
web
page.
However,
the
number
of
visits
refers
to
the
digital
newspaper
and
not
to
a
certain
article,
so
the
estimation
using
this
number
is
not
accurate.
Therefore,
the
impact
on
the
digital
press
was
finally
excluded
from
the
study.
Also,
appearances
in
internet
social
networks,
as
well
as
in
blogs,
were
not
taken
into
account
due
to
the
difficulty
of
estimating
the
number
of
viewings
or
the
value
of
a
‘like’
or
a
‘share’.
L.
Pérez-Urrestarazu
et
al.
Urban Forestry & Urban Greening 24 (2017) 141–148
142
2.3.
Survey
methods
and
questionnaire
design
In
studies
about
postures
towards
green
infrastructure,
the
use
of
questionnaires
is
the
most
frequent
resource
to
assess
the
population’s
opinion
about
green
infrastructure.
The
usual
questionnaire
approach
to
measure
urban
green
spaces
views
is
to
include
a
range
of
semantic-
differential
(with
good/bad
options
for
example)
and
Likert
items
(with
agree/disagree
options)
to
operationalise
the
attitude
construct
(Balram
and
Dragićević,
2005).
In
this
work,
a
questionnaire
was
delivered
in
situ
and
face-to-face
to
555
individuals
present
at
the
hospital
(i.e.,
patients,
visitors,
workers)
by
a
trained
interviewer
who
gave
explana-
tions
to
respondents
when
necessary.
Most
of
the
surveys
(453)
were
conducted
from
April
to
October
2015
at
the
QSCH
main
building
where
the
respondents
could
view
the
LW.
The
rest
of
them
(101)
were
performed
from
November
2015
to
February
2016
at
the
Sagrado
Corazón
Quirónsalud
Medical
Centre
Sevilla
Este
(QSCH-SE)
in
order
to
have
responses
from
people
visiting
a
medical
centre
of
the
same
characteristics
but
with
no
LW.
Prior
to
starting,
each
participant
was
given
a
brief
description
of
the
study,
some
instructions
to
complete
the
questionnaire
and
an
assurance
of
anonymity.
An
informed
consent
was
obtained
verbally
and
participation
was
voluntary
with
no
compensa-
tion.
Table
1
shows
the
26
pre-coded
questions
and
the
options
for
responses
to
each
question
can
be
seen
in
Annex
B.
The
form
had
four
different
types
of
queries.
The
first
one
focused
on
the
respondents’
personal
data
and
descriptors,
such
as
age,
gender,
occupation
or
the
reason
for
being
in
the
hospital.
Then,
general
questions
about
attitude
towards
plants
and
green
spaces
were
introduced
in
order
to
evaluate
the
respondents’
preference
for
plants,
interest
in
gardening
and
previous
knowledge
about
LWs.
In
the
third
type
of
questions,
the
survey’s
respondents
were
asked
about
Self-Reported
Psychological
Well-Being
Gain
(Dallimer
et
al.,
2014)
and
stances
with
respect
to
the
LW.
Lastly,
‘Contingent
valuation
’
questions
were
posed
to
identify
the
respondent’s
WTP
or
how
much
they
think
the
hospital
should
invest
in
the
LW.
Gathering
WTP
and
self-reported
well-being
measures
from
the
same
individuals
at
the
same
time
and
place
enables
a
direct
compar-
ison
to
be
made
between
two
radically
different
measures
of
value
(Dallimer
et
al.,
2014).
In
most
questions,
Likert
scale
options
were
used,
though
multiple-choice
options
were
also
employed.
Question
18
used
a
Semantic
Differential
scale
and
required
being
in
front
of
the
LW
to
be
answered.
Therefore,
it
was
not
included
in
the
form
utilised
at
the
QSCH-SE.
A
pilot
test
was
conducted
before
implementing
the
full-
scale
survey.
Prior
to
the
statistical
analysis,
a
data
quality
control
was
performed.
2.4.
Statistical
analysis
Survey
responses
were
recorded
and
organised
using
Excel
2007
(Microsoft).
Data
were
analysed
applying
SPSS
17
for
Windows
(IBM
SPSS).
Variables
were
assessed
using
the
nonparametric
Kruskal–Wallis
one-way
ANOVA
test,
as
the
data
were
not
normally
distributed.
Dunnett’s
C
test
was
employed
for
multiple
comparisons.
Spearman’s
rho
correlation
coefficient
was
also
employed
to
investigate
the
association
between
categorical
variables,
since
the
data
were
not
showing
a
normal
distribution.
The
significance
level
was
de
fined
at
p
=
0.05.
Fig.
1.
View
of
the
LW
from
the
hall
and
participant
filling
out
the
questionnaire.
L.
Pérez-Urrestarazu
et
al.
Urban Forestry & Urban Greening 24 (2017) 141–148
143
3.
Results
3.1.
Media
impact
assessment
The
media
coverage
due
to
QSCH’ s
LW
included
30
appearances
in
23
different
newspapers,
2
radio
interviews
and
3
reports
in
a
regional
channel
and
1
in
national
TV
(accumulating
more
than
10
min
talking
about
the
LW).
The
total
investment
the
hospital
would
have
made
to
obtain
the
same
repercussion
is
198,945
€,
as
shown
in
Annex
A
for
the
different
media
considered.
The
printed
press
represented
the
highest
amount:
107,705
€.
Television
appearances
were
valued
at
87,149
€,
while
radio
would
only
have
cost
173
€.
These
figures
have
been
compared
with
the
investment
made
(26,162
€).
To
do
so,
only
the
installation
cost
has
been
taken
into
account
as
operation
and
maintenance
costs
are
too
variable.
Therefore,
the
Return
on
Investment
(ROI),
defined
as
the
difference
between
the
gain
and
the
cost
of
investment
divided
by
the
cost,
is
660%.
This
means
that
more
than
6
times
the
investment
was
recovered.
Of
course,
when
including
operation
(water
and
energy)
and
maintenance
costs,
ROI
would
decrease.
As
an
example,
considering
maintenance
costs
in
2015
(approximately
4200
€,
including
pruning,
disease
control,
cleaning
of
filters
and
tanks,
adjusting
irrigation
times,
plants
replace-
ments
and
SCADA
system
maintenance)
being
the
same
over
a
period
of
15
years,
ROI
will
still
represent
122.4%.
3.2.
Users’
perception
and
WTP
A
total
of
555
people
–
60.4%
women
and
39.6%
men-
were
surveyed
in
both
hospital
locations.
The
age
ranged
between
18
and
86
years
old,
distributed
as
shown
in
Fig.
2.
69.3%
of
the
respondents
were
employed
and
9.3%
unemployed,
while
11.3%
were
students
and
10.1%
retired.
It
is
interesting
to
note
that
less
than
10%
usually
work
outdoors.
Around
19%
were
hospital
workers
who
daily
spend
several
hours
inside
the
building.
26%
were
patients
and
37.6%
were
visiting.
62.5%
of
those
surveyed
only
visited
the
hospital
sometimes.
In
order
to
take
into
account
the
possible
influence
of
the
respondents’
interest
in
gardening
and
plants
on
their
answers,
some
questions
in
that
line
were
posed.
39%
were
quite
or
very
fond
of
gardening
(where
61%
were
women,
being
56.7%
over
45
years
old)
while
26%
had
little
or
no
interest
at
all.
Nonetheless,
nearly
80%
claimed
to
have
plants
at
home.
Whereas
88%
have
green
areas
close
to
their
residence,
only
29%
visit
parks
frequently
(daily
or
several
times
a
week).
On
the
other
hand,
34%
rarely
use
green
areas.
Most
partici-
pants
(87.4%)
value
the
presence
of
vegetation
in
their
working
environment,
this
being
very
important
for
22%
of
them.
On
the
other
hand,
22%
declare
not
having
any
plants
in
their
workplace.
When
the
participants
were
asked
if
they
knew
about
LWs
prior
to
this
study,
nearly
40%
responded
negatively.
Previous
knowledge
about
LWs
signifi
cantly
in
fluenced
(F
=
30.715;
p
=
0.000)
a
higher
desire
of
enjoying
an
LW
where
they
live
or
work
and
the
positive
belief
that
LWs
help
to
improve
health
(F
=
17.802;
p
=
0.000)
and
psychological
welfare
(F
=
26.121;
p
=
0.000).
They
also
agreed
more
with
the
hospital
investment
in
vegetation
and
had
higher
WTP
quantities
(F
=
26.710;
p
=
0.001).
Anyway,
people
generally
think
that
these
systems
have
a
positive
effect
on
those
close
to
them.
For
instance,
81.5%
of
the
respondents
agreed
that
LWs
may
favour
a
closer
contact
with
nature,
improving
their
psychological
well-being.
A
smaller
number
(51.4%)
believed
that
an
LW
may
have
a
therapeutic
effect
contributing
to
improving
the
health
of
those
who
perceive
it.
However,
this
seems
not
to
be
only
related
to
LWs
but
with
the
presence
of
vegetation
in
general,
as
50.6%
of
respondents
think
that
LWs
have
the
same
effects
as
conventional
gardens
on
those
who
perceive
them.
Only
6.5%
of
the
participants
would
not
like
to
have
an
LW
at
home
or
at
their
workplace,
and
70%
were
quite
or
very
attracted
to
that
idea.
76.2%
of
the
hospital
workers
surveyed
thought
that
the
LW
helps
to
improve
psychological
well-
being.
In
fact,
82%
of
them
declared
to
feel
happy
and
calm
when
viewing
the
LW.
Notwithstanding,
40%
of
the
hospital
personnel
respondents
had
little
or
no
interest
in
it
(taking
into
account
the
whole
sample,
the
value
was
26%).
Yet,
only
17%
of
workers
did
not
value
having
plants
at
work.
In
order
to
determine
if
having
the
LW
had
a
positive
impact
on
people,
the
participants
were
asked
how
they
felt
about
being
close
to
vegetation.
Di
fferent
options
were
provided
(several
of
which
could
be
Table
1
Questions
asked
in
the
questionnaire.
Question
number
Question
A
Gender
B
Age
C
Occupation
D
Type
of
job
1
Why
are
you
in
the
hospital?
2
How
often
do
you
visit
the
hospital?
3
Are
you
interested
in
gardening?
4
Do
you
have
plants
at
home?
5
How
many
green
areas
are
there
close
to
your
residence?
6
How
often
do
you
visit
parks
or
public
gardens?
7
How
much
would
you
be
eager
to
pay
monthly
to
increase/improve
green
areas
close
to
your
residence?
8
Which
of
these
emotions
or
reactions
does
being
near
plants
inspire
in
you?
9
How
much
do
you
value
the
presence
of
vegetation
in
your
working
environment?
10
Are
there
any
plants
in
your
working
environment?
11
Did
you
ever
hear
about
LWs
before?
12
LWs
may
favour
a
closer
and
more
frequent
contact
between
urban
dwellers
and
green
areas,
improving
their
psychological
well-being
13
LWs
have
the
same
effects
on
those
who
perceive
them
as
conventional
gardens
14
An
LW
may
have
a
therapeutic
effect
contributing
to
improving
the
health
of
those
who
perceive
it
15
Would
you
like
to
view
LWs
in
the
building
where
you
live
or
work?
16
If
you
are
in
the
hospital
hall
and
look
through
the
window,
what
would
you
like
to
see?
17
In
an
LW,
what
most
attracts
your
attention?
(State
your
order
of
preference)
18
When
you
look
at
the
LW
through
the
hall
window,
what
reactions
does
it
inspire
in
you?
19
The
investment
made
by
the
hospital
for
installing
the
LW
in
order
to
improve
comfort
and
aesthetics
through
the
presence
of
plants
is
appropriate
20
How
much
should
the
hospital
annually
spend
on
LW
and
plants?
21
Value
from
0
to
5
the
following
alternatives
to
make
the
hospital
more
inviting
22
If
you
had
a
choice
between
two
hospitals
with
the
same
quality
of
care
and
services
at
the
same
price,
would
you
choose
the
one
with
a
greater
presence
of
vegetation?
L.
Pérez-Urrestarazu
et
al.
Urban Forestry & Urban Greening 24 (2017) 141–148
144
selected
at
the
same
time),
some
of
them
considered
positive
(i.e.,
welfare,
serenity,
happiness),
others
negative
(i.e.,
allergy,
disgust)
or
no
reaction
at
all.
Most
of
them
(87.7%)
expressed
feeling
one
or
more
positive
emotions
or
reactions
when
being
near
plants.
Around
60%
experience
serenity
or
welfare
and
31%
happiness.
Though
30%
of
the
respondents
showed
negative
(mainly
allergies)
or
no
reactions,
most
of
them
felt
positive
ones
at
the
same
time.
Therefore,
only
12.3%
of
the
respondents
did
not
indicate
any
positive
response
at
all.
Further
in
the
questionnaire,
the
participants
(only
the
ones
actually
looking
at
the
LW)
were
asked
about
the
reactions
the
LW
inspired
in
them.
In
this
case,
this
aspect
was
approached
associating
these
reactions
with
antagonist
words
using
a
Semantic
Di
fferential
scale.
‘Calm’
and
‘happiness’
were
the
answers
preferred
(Fig.
3),
followed
by
‘pleasant’
and
‘stimulating’.
Curiously,
6.2%
of
the
respondents
considered
the
LW
more
‘Artificial’
than
‘Natural’.
In
any
case,
only
3.8%
expressed
indifference
or
negative
feelings
in
all
the
items
at
that
particular
moment.
With
the
purpose
of
evaluating
people’s
preferences
concerning
LWs,
the
participants
were
asked
to
rank
different
characteristics
according
to
which
one
drew
their
attention
more
(1
being
the
first
choice
and
5
the
last).
The
respondents
prefer
the
mix
of
colours
(M
=
2.11,
SD
=
1.17)
and
a
natural
and
wild
aspect
(M
=
2.18,
SD
=
1.25)
over
order
(M
=
3.53,
SD
=
1.27)
and
uniformity
in
an
LW
(M
=
4.05,
SD
=
1.16).
Different
textures
are
also
appreciated
(M
=
2.92,
SD
=
1.21).
When
the
hospital
users
were
asked
about
what
they
would
like
to
see
through
the
windows
of
the
hall,
93.4%
of
the
answers
involved
some
kind
of
vegetated
landscape,
though
an
LW
was
the
favourite
response
(53%).
Also,
they
were
asked
to
rate
from
0
to
5
(5
being
the
most
preferred)
three
different
options
to
make
the
hospital
more
inviting.
In
this
case,
the
most
valued
option
was
again
introducing
vegetation
by
means
of
planters
and
LWs
(M
=
4.06,
SD
=
1.17),
compared
to
putting
up
a
collection
of
paintings
(M
=
2.75,
SD
=
1.47)
or
installing
TV
monitors
(M
=
2.1,
SD
=
1.5).
In
order
to
estimate
the
economic
value
attributed
to
green
infrastructure,
the
participants
were
asked
how
much
they
were
WTP
monthly
to
increase/improve
green
areas
close
to
their
residence.
They
were
also
asked
about
how
much
the
hospital
should
annually
spend
on
LW
and
plants.
Table
2
shows
the
number
of
respondents
answering
certain
amounts
of
money
for
each
question.
22.4%
declared
to
be
WTP
‘nothing’
while
most
of
them
(59%)
responded
between
1
and
5
€
and
only
18.6%
were
WTP
10
€
or
more.
On
the
other
hand,
40.1%
answered
that
the
hospital
should
invest
between
100
and
1000
€,
35.7%
between
1000
and
10,000
€
and
5.7%
more
than
10,000
€.
Only
4.4%
thought
that
the
hospital
ought
not
to
spend
any
money
on
vegetation.
A
moderate
positive
correlation
is
observed
between
the
responses
to
both
questions
(Spearman’
s
rho
=
0.272;
p
<
0.02).
Among
those
thinking
that
the
hospital
should
not
invest
on
plants,
87%
were
not
WTP
for
green
areas
close
to
their
residence.
Those
WTP
more
than
10
€
represented
47%
of
the
ones
believing
the
hospital
should
spend
more
than
10,000
€.
Conversely,
38%
of
respondents
not
WTP
any
money
on
green
areas
considered
that
the
hospital
should
devote
more
than
1000
€
to
LWs
and
vegetation.
In
any
case,
85.3%
agree
that
the
investment
made
by
the
hospital
for
installing
the
LW
in
order
to
improve
comfort
and
aesthetics
through
the
presence
of
plants
is
appropriate
and
only
2.8%
disagree.
Lastly,
they
were
asked
if
they
Fig.
2.
Distribution
of
male
and
female
respondents:
age
group
and
type
(1:
worker;
2:
patient;
3:
visitor;
4:
others).
Fig.
3.
Semantic
Differential
scale
chart
showing
respondents
reactions
when
facing
the
LW.
L.
Pérez-Urrestarazu
et
al.
Urban Forestry & Urban Greening 24 (2017) 141–148
145
would
choose
a
hospital
with
more
presence
of
vegetation
over
another
with
the
same
quality
of
care
and
services
and
at
the
same
price.
In
this
case,
76.2%
would
choose
the
one
with
vegetation,
while
19.3%
do
not
really
care.
Lastly,
the
responses
obtained
were
analysed
according
to
the
respondents’
characteristics
(age,
gender,
occupation).
The
only
sig-
nificant
difference
in
responses
was
found
among
the
groups
of
age
considered.
Table
3
shows
the
attitude
towards
vegetation
according
to
age
groups.
The
respondents
over
45
years
old
showed
more
interest
in
gardening
and
vegetation
was
more
appreciated.
Also,
older
respon-
dents
gave
higher
values
in
response
to
questions
13
(F
=
4.947;
p
=
0.002),
14
(F
=
7.405;
p
=
0.000),
15
(F
=
5.552;
p
=
0.001),
19
(F
=
6.642;
p
=
0.000)
and
22
(F
=
2.795;
p
=
0.04),
the
last
one
being
less
significant.
4.
Discussion
The
results
show
that
the
investment
the
hospital
should
have
made
to
obtain
the
same
media
coverage
as
that
achieved
due
to
the
existence
of
the
LW
is
close
to
200,000
€
This
amount
might
be
even
higher,
as
only
written
press,
radio
and
television
appearances
were
considered,
but
the
presence
in
social
media
(Facebook,
YouTube,
etc.)
and
online
press
was
also
extensive.
A
similar
approach
was
used
by
Tomalty
and
Komorowski
(2010),
who
estimated
the
returns
in
free
publicity
since
the
construction
of
a
rooftop
garden
in
a
commercial
building
in
Toronto
(Canada)
at
$83,126.
Still,
it
is
difficult
to
assure
that
those
values
can
be
considered
as
an
economic
turnover
both
for
the
hospital
or
the
commercial
building
as
we
do
not
know
if
the
managers/owners
would
have
made
this
marketing
investment
had
the
green
infrastruc-
ture
studied
not
existed.
Moreover,
in
the
QSCH
the
media
coverage
has
been
unusually
broad
due
to
the
novelty
of
installing
such
a
green
infrastructure
in
a
hospital.
Therefore,
it
is
improbable
that
other
installations
would
have
a
similar
impact.
The
marketing
bene
fits
of
other
LWs
will
depend
on
a
number
of
factors
that
are
unknown
in
advance
or
difficult
to
quantify,
such
as
the
current
interest
of
local
media
in
green
infrastructure
and
green
buildings
(Tomalty
and
Komorowski,
2010),
the
significance
of
the
project
or
its
singularity.
Nevertheless,
noteworthy
greening
systems,
such
as
LWs,
undoubtedly
have
a
positive
marketing
impact,
especially
when
installed
in
locations
where
the
environmental
friendly
aspect
is
valued.
In
fact,
most
of
the
respondents
in
Wong
et
al.’s
(2010)
study
agreed
that
vertical
greenery
systems
can
increase
a
building ’s
property
value,
visual
interest
and
marketability.
However,
having
proper
maintenance
is
essential,
as
a
poor
state
of
the
LW
will
cause
exactly
the
opposite,
undesired
effect.
Additionally,
publicity
or
media
dissemination
can
be
favoured
or
incentivised.
For
example,
launching
a
marketing
campaign
when
an
LW
is
installed
can
be
a
way
of
increasing
its
visibility
and
potentiating
its
positive
effects.
If
done
in
a
controlled
manner,
a
small
investment
in
marketing
can
produce
a
higher
return.
By
employing
this
sort
of
initiatives,
vertical
greening
systems
will
become
more
popular
and
be
known
by
the
population
at
large.
Indeed,
one
of
the
reasons
that
may
cause
these
systems
not
to
be
more
widely
used
is
the
lack
of
knowledge
about
them.
Many
people
are
still
unfamiliar
with
LWs
(40%
of
the
participants
in
this
study
did
not
know
about
them),
which
can
even
lead
to
prejudices
and
misconceptions.
Yet,
other
non-ordinary
urban
greening
technologies
are
becoming
more
known.
For
example,
Jungels
et
al.
(2013)
found
that
most
respondents
(73%)
in
their
study
were
aware
of
green
roofs
as
a
concept.
This
fact
affected
their
perceptions
or
views
in
comparison
to
those
people
not
familiar
with
green
roofs.
It
appears
that
people
in
urbanised
societies
commonly
believe
that
contact
with
nature
provides
them
with
recuperation
from
stress
and
fatigue
and
improves
their
health
and
well-being
(van
den
Berg
et
al.,
2007
).
In
general,
they
think
that
vertical
greenery
systems
will
result
in
closer
and
more
frequent
contact
with
nature,
therefore
enhancing
the
psychological
well-being
of
city
dwellers,
and
that
vertical
greenery
systems
do
have
therapeutic
e
ffects
by
improving
the
health
of
their
users
(Wong
et
al.,
2010).
This
is
consistent
with
the
findings
of
our
study
in
which
most
people
agreed
with
these
assertions.
Only
a
few
expressed
negative
feelings,
such
as
distress
or
disgust,
when
looking
at
the
LW.
There
is
also
evidence
in
other
studies
of
people
recognising
natural
areas
to
be
scary,
disgusting
and
uncomfortable
(Bixler
and
Floyd,
1997).
But
the
most
frequent
reaction
experienced
was
serenity
or
calmness,
followed
by
welfare.
This
relaxing
eff
ect
of
vegetation
has
been
also
observed
in
experiences
with
green
roofs
(Rahman
et
al.,
2015).
Knowing
what
characteristic
of
the
green
infrastructure
con-
tributes
the
most
to
these
feelings
can
be
valuable.
It
seems
that
the
mix
of
colours
is
one
of
the
most
important
factors
affecting
the
overall
satisfaction
of
people
with
their
vegetation
environment,
which
is
consistent
with
Qin
et
al.’s
(2013)
findings.
Also
the
textures
and
wild
aspect
favour
positive
responses.
This
may
be
of
importance
for
LW
designers.
Table
2
Number
of
respondents
WTP
certain
amount
of
money
for
green
areas
vs.
quantities
they
think
the
hospital
should
annually
spend
on
LWs
and
plants.
How
much
should
the
hospital
annually
spend
on
LWs
and
plants
Nothing
1–100
€
100–1000
€
1000–10,000
€
>
10,000
€
Total
a
WTP
monthly
for
green
areas
Nothing
20
20
33
41
4
118
(22.4%)
1
€
1
27
60
33
3
124
(23.6%)
5
€
2
25
81
74
4
186
(35.4%)
10
€
0
1
27
27
5
60
(11.4%)
>1
0
€
0
1
10
13
14
38
(7.2%)
Total
a
23
(4.4%)
74
(14.1%)
211
(40.1%)
188
(35.7%)
30
(5.7%)
a
Values
in
parentheses
correspond
to
percentages
referring
to
the
526
respondents
who
answered
both
questions.
Table
3
Interest
in
vegetation
according
to
age
groups.
Age
group
>
60
46–60
36–45
<
35
ANOVA
Interest
in
gardening
3.91
±
0.133
a
3.56
±
0.083
a
2.97
±
0.081
b
2.87
±
0.074
b
F
=
25.144;
p
=
0.000
Value
vegetation
at
workplace
4.20
±
0.123
a
3.90
±
0.082
a
3.56
±
0.084
b
3.28
±
0.078
b
F
=
16.668;
p
=
0.000
Plants
at
home
4.09
±
0.135
a
3.66
±
0.097
a
3.06
±
0.111
b
3.19
±
0.096
b
F
=
13.064;
p
=
0.000
Would
pay
for
green
areas
2.36
±
0.161
ab
2.77
±
0.096
a
2.61
±
0.099
ab
2.43
±
0.080
b
F
=
3.018;
p
=
0.029
Mean
and
SD
values
according
to
a
Likert
scale
were
1:
Highly
disagree/None/Nothing;
5:
Highly
agree/Many/
>
10.
Different
letters
within
the
same
row
denote
significant
differences
following
Dunnett’s
C
test.
L.
Pérez-Urrestarazu
et
al.
Urban Forestry & Urban Greening 24 (2017) 141–148
146
Positive
reactions
towards
the
LW
observed
in
the
respondents
are
correlated
with
the
perception
of
benefits
and
the
support
of
those
systems.
A
low-moderate
positive
correlation
is
observed
among
the
emotions
felt
(i.e.,
happiness,
pleasantness,
serenity)
and
the
belief
that
LWs
may
improve
psychological
well-being
and
have
a
therapeutic
effect
(Spearman’s
rho
=
0.348–0.446;
p
=
0.000).
A
similar
relation-
ship
was
found
for
green
roofs
(Jungels
et
al.,
2013
).
This
fact
also
affects
the
value
given
to
the
existence
of
vegetation
and,
hence,
the
willingness
to
pay
for
it.
For
instance,
in
Dallimer
et
al.
(2014),
individuals
reporting
higher
well-being
when
visiting
natural
parks
were
WTP
more
than
those
with
lower
scores.
Our
results
show
a
positive
correlation
(Spearman’s
rho
=
0.26;
p
=
0.000)
between
the
economic
and
environmental
psychological
values
of
green
infrastruc-
ture
such
as
LWs.
The
tendency
to
pay
more
for
urban
environments
that
are
perceived
to
be
greener
(Mell
et
al.,
2016)
is
also
related.
Many
variables
affect
opinions
about
green
spaces,
but
several
authors
have
suggested
that
age
and
education
are
significant
factors
(Aytulkasapoglu
and
Ecevit,
2002;
Jungels
et
al.,
2013;
Lakhan
and
Lavalle,
2002).
For
example,
younger
people
tend
to
show
more
negative
reactions
to
green
roofs
(Jungels
et
al.,
2013),
this
improving
with
age.
Qin
et
al.
(2013)
described
a
higher
overall
satisfaction
with
green
spaces
for
elderly
people
compared
with
young
and
middle-aged
participants.
In
our
study,
older
participants
also
showed
more
positive
reactions
towards
the
LW.
This
can
be
explained
by
their
having
more
interest
in
gardening
and
plants
than
younger
respondents.
Also
the
age
groups
of
36–45
and
46–60
are
WTP
slightly
more
than
other
groups,
which
can
be
related
to
their
income
levels.
Some
authors
have
reported
gender
differences
in
the
perceptions
and
use
of
green
spaces
(Kaczynski
et
al.,
2009;
Ode
Sang
et
al.,
2016
).
Ode
et
al.
(2009)
determined
that
gender— but
not
age—had
an
effect
on
people’s
preferences
for
different
degrees
of
naturalness.
Women,
for
example,
saw
greater
aesthetic
value
in
green
spaces
than
men
did,
and
had
higher
self-reported
well-being
associated
with
urban
green
spaces.
All
the
same,
in
our
study
significant
gender-based
differences
were
not
found
in
the
responses.
Curiously,
only
when
asked
about
how
much
the
hospital
should
invest
on
vegetation
did
women
generally
respond
with
lower
quantities
than
men
(F
=
11.361;
p
=
0.01).
The
positive
influence
of
the
LW
observed
on
the
hospital
personnel
is
particularly
important
as
they
are
present
in
the
hospital
on
a
daily
basis
and
it
may
affect
their
performance
at
work.
Some
authors
have
detected
an
improvement
of
workplace
attitude
when
there
is
visual
access
to
greenery
(Lottrup
et
al.,
2013).
Leather
et
al.
(1998)
found
that
having
a
view
of
a
green
outdoor
environment
from
the
workplace
window
resulted
in
the
employees
feeling
less
uptight.
Pati
et
al.
(2008)
established
that
nurses
exposed
to
a
nature
view
showed
improved
alertness
level
and
reduced
stress.
This
supports
the
fact
that
more
than
75%
of
the
hospital
workers
interviewed
agreed
with
the
investment
made
on
the
LW.
However,
it
is
interesting
to
note
that,
among
the
participants
thinking
that
the
hospital
should
not
spend
more
than
100
€
per
year
on
vegetation,
24.5%
are
workers.
In
the
case
of
patients
or
visitors,
the
percentage
was
only
around
15%.
This
could
be
explained
because
hospital
workers
believe
that
investments
should
be
made
in
other,
more
important
items.
Also,
there
was
a
significance
difference
in
the
interest
in
gardening
and
plants
between
workers
and
the
rest
of
the
sample
(F
=
4.907;
p
=
0.002).
Taking
all
of
this
into
account,
the
main
question
that
remains
is:
can
an
LW
actually
be
considered
a
cost-effective
investment?
Even
according
to
the
results
shown
in
this
study,
the
answer
to
this
question
is
still
inconclusive.
It
will
depend
on
the
factors
considered,
as
many
indirect
intangible
benefits
are
in
play.
For
example,
Perini
and
Rosasco
(2013)
concluded
that
an
LW
of
the
same
type
as
the
one
installed
in
the
hospital
was
not
economically
sustainable.
In
their
study,
they
quanti-
fied
the
energy
use
reduction,
the
expenses
reduction
in
the
façade
management,
the
air
quality
improvement
and
the
increase
in
property
value.
Nonetheless,
other
soft
benefits,
such
as
the
ones
considered
in
this
study,
were
not
included.
The
main
reason
for
the
unsustainability
was
found
to
be
the
high
maintenance
costs
incurred
due
to
the
size
of
the
LW
used
in
the
model
(over
200
m
2
)
which
also
led
to
an
elevated
installation
cost.
This
is
an
important
point
as
maintenance
costs
are
often
computed
per
area
unit,
though
they
depend
on
other
variables
such
as
the
type
and
complexity
of
the
LW
or
its
height.
This
means
that
bigger
LWs
usually
have
higher
maintenance
costs
but
do
not
necessa-
rily
entail
a
higher
media
repercussion
or
more
psychological
benefits.
Perini
and
Rosasco
(2016)
point
again
to
the
installation
and
main-
tenance
costs
as
the
key
factors
for
the
economic
sustainability
of
greening
systems,
which
might
be
improved
by
means
of
incentives
such
as
tax
reductions.
Notwithstanding,
actually
improving
the
economic
sustainability
of
these
systems
relies
on
being
capable
of
quantifying
the
wide
range
of
benefits
procured
by
them.
5.
Conclusions
Urban
greening
systems,
and
in
particular
LWs,
have
many
benefits,
some
of
which
are
difficult
to
measure.
Exposing
and
quantifying
those
benefits
can
play
an
important
role
in
order
to
incentivise
their
use.
In
this
work,
we
have
aimed
to
assess
the
value
that
the
LW
added
to
the
hospital
in
terms
of
(i)
publicity
and
media
impact,
and
(ii)
its
eff
ect
on
the
hospital
personnel
and
users.
In
this
study
case,
the
media
impact
was
significant
due
to
the
novelty
of
the
news
and
the
wide
diffusion
obtained.
This
led
to
a
high
cost
recovery
ratio
(investment
vs.
returns
in
publicity).
Nevertheless,
no
such
impact
is
expected
for
every
LW
installation.
Although
not
much
importance
is
given
to
gardening
by
some
of
the
participants
in
the
study,
most
of
them
describe
having
positive
feelings
and
reactions
when
they
are
in
the
presence
of
vegetation.
Many
of
them
have
not
heard
about
LWs
before,
but
when
they
see
one,
most
think
that
these
elements
have
a
positive
effect,
improving
the
psychological
well-being
and
contributing
to
recovering
the
health
of
those
who
perceive
them.
However,
50%
of
respondents
believe
that
those
effects
can
be
also
gained
with
conventional
gardens.
In
any
case,
when
there
is
not
much
space
available,
LWs
represent
a
good
choice
in
order
to
include
vegetation
in
a
building.
In
fact,
people
generally
think
that
there
should
be
investments
in
green
areas
though
they
are
not
always
willing
to
pay
for
them.
Therefore,
most
participants
in
this
study
totally
agree
with
the
investment
made
by
the
hospital
and
preferred
having
an
LW
over
other
options
(green
or
not).
They
would
even
choose
a
hospital
with
more
presence
of
vegetation
over
another
with
similar
characteristics
but
no
plants.
The
results
obtained
involving
people’s
perceptions
about
LWs
provide
an
insight
into
public
preferences
towards
these
systems.
This
can
be
useful
for
companies
and
professionals,
such
as
architects,
landscapers
or
LW
designers.
It
can
also
serve
as
a
reason
to
install
LWs,
given
that
they
seem
to
be
appreciated
and
induce
positive
emotions.
Acknowledgments
We
would
like
to
express
our
gratitude
to
Quirónsalud
Sagrado
Corazón
Hospital,
especially
to
Ms.
Berta
Pascual
for
her
help
and
willingness.
We
also
thank
the
spin-off
company
Terapia
Urbana
S.L.
for
providing
the
information
about
the
living
wall
and
its
impact
in
the
media.
Appendix
A.
Supplementary
data
Supplementary
data
associated
with
this
article
can
be
found,
in
the
online
version,
at
http://dx.doi.org/10.1016/j.ufug.2017.04.002.
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