Thermal comfort differences among patients with different orthopedic diseases: A case study of Shaanxi Provincial People's Hospital, China

As a public building with high human traffic, the thermal environment of hospitals is crucial to the health and comfort of visitors. Existing research has primarily focused on thermal comfort differences between patients and healthy individuals, while studies on the impact of specific diseases on human thermal comfort remain limited. Among orthopedic patients, diseases caused by traumatic, metabolic, neurogenic, and other etiologies exhibit diverse pathological mechanisms. Therefore, this study investigates the influence of disease etiology on patients' thermal comfort by categorizing orthopedic diseases, using Shaanxi Provincial People's Hospital in China as a case study. Through questionnaires and field measurements in hospital waiting areas, the results reveal significant variations in the Neutral Standard Effective Temperature (NSET*) among four patient groups: mechanical trauma and strain-related diseases (23.5 °C), degenerative and biomechanical imbalance diseases (24.2 °C), metabolic disorders and vascular insufficiency diseases (25.4 °C), and inflammatory and hyperproliferative diseases (27.9 °C, influenced by immune responses). The thermal acceptability range (SET*) for inflammatory patients was the narrowest (22.6–28.2 °C), indicating heightened sensitivity to temperature fluctuations, while degenerative disease patients exhibited the strongest adaptability, with a SET* range spanning 10.6 °C (21.2–31.8 °C). Preference analysis further showed that inflammatory patients favored warmer environments (27.6 °C), whereas degenerative patients preferred neutral-to-cool conditions (23.5 °C). These findings provide empirical support for optimizing thermal comfort standards in orthopedic waiting areas and inform evidence-based revisions to hospital environmental guidelines.