Children's perceptions about being hospitalized and the hospital environment

The current study seeks to understand how children interact with and interpret the therapeutic environment in hospitals, and the extent to which they perceive it as physically threatening and/or safe.  It has been well documented that hospital stays for children can lead to separation anxiety, post-traumatic stress disorder, and other psychological sequelae.  This study’s purpose is to identify aspects of the hospital’s physical environment that promote a sense of well-being as well as aspects that are frightening, threatening or stressful.

Fifty children (ages 5-17) were asked to participate in a photography project that documented their perceptions of the physical environment of the hospital.  Children were provided cameras and a checklist of items to photograph (the checklist included items such as: “Something that makes you happy,” or “Something that makes you scared”) as a part of three photo activities.  The first activity involved taking pictures of their hospital room, the second activity involved taking pictures in a common area (a medical-free play area for children located down the hall from the patient rooms), and the third activity focused on their bedtime routine.

The analysis will examine children’s understanding of their therapeutic environment.  Children’s concerns about the presence and sounds of medical equipment will be explored in the context of their perceptions of non-medical parts of their environment (the view out the window, art, personal items such as stuffed animals). We will compare the responses for children who are experiencing their first hospitalization, and for whom hospitalization is very traumatic, to those who have experienced many hospitalizations, for whom hospitalization is typically a less traumatic experience.  The purpose is to explore ways in which the physical environment can be modified to promote an improved sense of safety and wellbeing and to reduce the likelihood of psychological trauma resulting from hospitalization.