Attractions to Fuel the Imagination: Reframing Understandings of the Role of Distraction Relative to Well-Being in the Pediatric Hospital

Abstract

Objective: Ulrich’s (1991) definition of “positive distraction” includes that which “elicits positive feelings and holds attention,” implying that the capacity of an environmental feature to hold attention is a necessary component. This article examines whether, in the context of a pediatric hospital, a distraction needs to “hold attention” to secure positive benefits for patient well-being. Background: Data collected from 246 patients at Melbourne’s Royal Children’s Hospital (Australia) revealed a discrepancy between what children and young people told us they did, and valued, within the hospital, relative to the time they spent engaging in, or paying attention to, these same features. This motivated a closer interrogation of the relationship between well-being, distraction, and socialization within the pediatric context. Method: Data were collected using a mixed-methods approach that included 178 surveys, 43 drawings contributed by patients/siblings within the outpatient waiting room, 25 photo-elicitation interviews with patients, and 100 hr of spatial observations within public and waiting room spaces. This was supplemented by interviews with architects and hospital staff. Conclusions: The mechanism by which we have understood positive distraction to contribute to well-being within the pediatric hospital environment is more complex than existing models accept. Within this context, environmental features that can positively transform expectations of visiting the hospital—that can ignite the imagination and incite a desire to return—can offer significant benefits to well-being. This is particularly relevant in the context of absenteeism from outpatient appointments and in reducing patient resistance to future, or ongoing, treatments.

Mapping Healthcare Spaces: A Systematic Scoping Review of Spatial and Behavioral Observation Methods

“…Many of the publications in our sample, however, used complimentary data collection methods, such as interview or questionnaire, to supplement and enhance their observation (see right-hand column Table 2). Some of the studies which produced nonspecific findings from their observation data were able to draw more specific conclusions once these findings were merged with results from other data collection methods (Johnson & Delaney, 2006; Macdonald et al, 2012), especially where mixed methods were used (Anåker et al, 2018; Broom et al, 2019; McLaughlan et al, 2019; Shepley, 2002). For example, McLaughlan et al used surveys, drawings, and photo-elicitation interviews to complement spatial observation methods in their study of children’s behavior in waiting areas of a pediatric hospital (2019).…”

Hope Springs: Moderating the Link Between Racial Discrimination and Depressive Symptoms for African American Emerging Adults

“…High levels of distractive coping can be a risk factor for depressive symptoms and may be indicative of avoidance and maladaptive responses in the presence of stressful life events (Gross & John, 2003;Korpela et al, 2018;Tull et al, 2004). Likewise, an overreliance on rumination is characteristic of perseverating on negative events, a known precursor of depression (Hudson Banks et al, 2006;McLaughlan et al, 2019) in the context of racial discrimination. These extremes in coping response may paralyze assets that would have otherwise been useful when facing stress like racial discrimination.…”

“…There is a large body of literature examining the role of coping strategies for adolescents and the consensus is that adolescents and emerging adults use distraction (i.e., refocusing one's attention away from the stressful event) to negate negative mood states leading, in turn, to better psychological wellbeing (Broderick, 2005;Ito et al, 2003;Korpela et al, 2018). The literature suggests that distractive coping can decrease the severity of depressive symptoms in adolescents and adults in the short term (Gaylord-Harden, Gipson, Mance, & Grant, 2008;McLaughlan, Sadek, & Willis, 2019;Nolen-Hoeksema et al, 1994;Wolgast & Lundh, 2017), but may cause harm in the long term in the form of avoidance or suppression of distress (Blalock & Joiner, 2000;Gross & John, 2003;Tull, Gratz, Salters, & Roemer, 2004;Wolgast & Lundh, 2017).…”

Evidence-Based Design for Waiting Space Environment of Pediatric Clinics—Three Hospitals in Shenzhen as Case Studies

“…It has been reported that passive distraction can reduce patients' anxiety and pain and reduce perceived waiting time [31]. In a study conducted at the Royal Children's Hospital in Melbourne, environmental characteristics were found to enhance patients' willingness to visit the hospital and even improve their health [32]. Exposure to nature, music and art, as well as uncrowded and peaceful environments, can enhance the pediatric healthcare building environment [33].…”