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The hospital as a social space: children’s perspectives

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					The hospital as a social space: children‟s perspectives
Dr Jo Birch, Dr. Penny Curtis, Professor Allison James Centre for the Study of Childhood and Youth University of Sheffield

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The significance of social interaction

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Social interaction – opportunities and limitations

afforded by the space

desired by children

afforded by other people

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What would children and young people like?

(1) The significance of social interactions – the literature
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1959 Platt Report - children are sociable 1970 Hospitals, Children and their Families - children‟s interaction with other children on the ward varies 1980 Children in Hospital – problems meeting adolescents‟ needs for privacy 1993 Children First A Study of Hospital Services – peer company is very important for adolescents 2001 NAWCH – understanding adolescents‟ social needs 2003 Health Building Note 23 – socialising for long term patients only 2003 Friendly Healthcare environments – single bedrooms ideal plus designated social areas

(1) The significance of social interactions – our research
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Clear in interviews – past memories; favourite aspects of the wards; when children talked of the potential for space „on their own‟;

More than half of our sample of “experienced” and/or “regular” hospital inpatients cited a social element to their memories of previous hospital visits Mostly in terms of friendly staff also – friendships with other children in hospital

Teenagers included social elements in their responses about „best‟ things about the ward:

• Making friends with other children • Talking to a particular child in a nearby bed • Talking with “brilliant staff ” • Being in the playroom where you could: “get to know people, talk, chill”

Social interactions (or lack of them) were noticeable during observations and mapping sessions:
In outpatients, older children and teenagers almost never socialised with anyone other than parents. Activities for younger ones are often set out for solo engagement. In inpatients, very rarely were children observed socialising with each other. Adults were often the mediators or catalysts of many conversations/play situations.

Rarely were social interactions visible in children‟s drawings of hospital spaces

(2) Social interaction – opportunities and limitations
The space
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Public spaces Bed spaces Clinical spaces Outdoor space Recreation spaces

Children
MEDICAL CONDITIONS

“(making friends) is very difficult because you don‟t know what anybody‟s got…It‟s usually children with the same condition as yourself…that‟s how I met him. He‟s got the same thing as me. And somehow we got talking and it‟s just nice…” 15m
“I like talking to other people but I don‟t feel like it at the moment” 11f

Children
CUBICLES OR BAYS? For: Quiet, easier to sleep, be with family only, own TV, own bathroom

Against: Lack of social contact:
“Cos you don‟t get nobody to talk with” 6f “Because I feel quite lonely in like a room by myself, even if my dad was there” 11f “…at least being in a six bed thing, you‟re like, you‟re not just on your own, you can chat to people, but if you‟re in one room, I can understand if you‟re really ill and it‟s contagious” 14f

“Mum: I mean I think its nice that she‟s got her own room, her own toilet, bathroom, I just…”
“Yeah, but you‟re not in it every second of the day” 16f

HAVING A CHOICE… “like put people with similar ages like 15 and 16 near each other so they can have like a conversation” 15f “because if you are like my age, you want someone to talk to” 13m “Because if there was like one boy and all the rest were girls the boy would be left out really” 9m “…depend on how I felt…like if I was tired or didn‟t feel right” 13m “but he wasn‟t a speaking person…I was like do you want the TV on. He just nodded his head like that” 16m “I don‟t play with those people” 4f

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Other people
Family/Visitors

“I‟ve talked to my mum. I‟ve talked to someone who said where‟s your mum” 6m
Nurses Doctors Play staff Other staff

“Mum just started talking to her so I gave her some colours” 12m

9f Because if some of your family want to come, like your nana and most of your family, there‟s not…
14f Yeah, there‟s no chairs, there‟s no chairs. You have to nick all the others from around

Other people
Family/Visitors Nurses The nurses “are calm and they are good to have a laugh and stuff…if there‟s nowt to do you can talk to a nurse” 9m Doctors You‟re in “good hands” Play staff

Other staff

“There are just really nice to you and they‟re not like the teachers” (a bit strict) 11f

“You‟ve got doctors you can talk to…obviously they‟re having a little laugh – you can see on their facial expressions…” 12m

Other people
Family/Visitors Nurses

Doctors
Play staff “they are the people who bring round televisions and things to do” 5m Other staff

“I know that lady!” 8f

“you get to colour with the lady. Cos I like attention from lots of different people” 7f

(3) Children‟s recommendations
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Spaces to be with others the same age Personal space for privacy and quiet (all ages) AND space for talking to others and seeing other children A large enough social space (especially for teenagers) that is open, available, not locked or overly policed – both in outpatients and inpatients Working telephones and opportunities to text and use instant messaging – at the bedside to be in touch with friends and family at home Friendly and sociable staff who take time to talk with them

“And there‟s no one there and you can‟t talk to no-one and you don‟t feel happy and you don‟t want to be here and you don‟t want to come again” 14f


				
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