Research progress Presentation
Restorative Benefits of Paediatric ward as Play Environment in Nigerian hospital
Candidate:
Usman Bukar Wakawa (PB123031)
PhD candidate Landscape Architecture
Semester 4/6
Supervisor:
Assoc. Prof. Dr. Ismail Said
Faculty of Built Environment, FAB
RESEARCH AIM:
The aim of this research is to determine the restorative benefits inherent with loose play items on
early and middle childhood paediatric patients indoors (aged 3-12) that can improve their physical,
social and cognitive performance in a paediatric hospital ward settings.
RESEARCH QUESTION:
How can a ward as play environment, using loose items (natural/conventional materials) along side
hospital protocols and norms improve children coping abilities, adjust their social, cognitive and
physical performance?
RESEARCH UNDERPINNING
Research is designed around the psycho-physiological stress reduction framework which involves two theories.
Attention restorative theory; (ART) by Kaplan and Kaplan, 1989 and Stress coping reduction theory, (SCRT) by
Ulrich, 1999. The third is the Psychological and Physiological harmony in child care center design; (PPH) by Anita
Rui Olds. And Participatory Strategies for the design of child care facilities by Henry Sanof.
RESEARCH BACKGROUND:
Studies have shown that hospitalised children are faced with psychological
challenges which affect their hospital stay? (Dise-Lewis, 1988; Varni & Katz, 1997; Varni,
Rappaport, and Talbot, 1991)
Most of the present paediatric ward settings in Nigerian hospitals deliver
healthcare in connection to protocols and medical codes.
Paediatric ward settings does not provide adequate bed spacing that can allow
for free movement and play activities.
RESEARCH PROBLEMS:
RESEARCH GAP
Environmental healthcare research that involves therapeutic, restoration and healing
are concentrated on the provision of outdoor facilities such as Garden, Landscape,
Playscape and Ecotherapy. Examples are:
80’s
Keep.
Windows in the intensive
Moore
Therapy unit
A prison Environments effect on healthcare
Ulrich.
Effects of hospital environment
On patient well-being
R.Kaplan
S.Kaplan.
Psychological benefit of
a wilderness experience
Jay
Cooper.
Housing as if people mattered
Effects of hospital environment
On patient well-being
Jane.
Thoday
Use of Garden for disable
Fried
Calkins.
Landscape view and
prison response
West
00’s
90’s
Kellert
Jay
Moore
Ulrich.
R.Kaplan
Cooper.
Kamp
The physical environment as a
therapeutic
Hartig
Mooney
Therapeutic Gardens
in the Acute Garden
Edward
Reasons to smile at Tear drops
Accessible play:
No more watching from sideline
“Getting serious about therapeutic
practice”
Epstein
Healing environment, Restorative Gardens
Therapeutic Gardens
in the Acute Garden
Restorative Gardens
Perkins
Healing Gardens
Epstein
said
Effect of healthcare
on Environment
Healing Gardens
Kelly
With people in Mind
S.Kaplan.
Cooper
Moore
Influence of passive experiences
Perkins
Ulrich
The Biophilia hypothesis
The experience of Landscape
Plant for play
smith
Health and nature
Stress reducing effect of indoor plants in
the built environment
Dijkstra
Bowers
Burt
Kate
THEORITICAL FRAME WORK
Human
Development
theory
Lev Vygotsky
(1896-1934)
Jean Piaget
(1896-1980)
Psychoanalytic theory
Sigmund Freud
(1856-1939)
Erik Erikson
(1902-1994)
Behavioral
theory
Humanistic
theory
Ivan Parlor
(1847-1939)
John Watson
(1878-1958)
Cognitive
theory
Abraham Maslow
(1908-1970)
Carl Rogers
(1902-1987)
Human Development
Prospect
Refused
theory
Attention Restorative
theory and
Environmental
Preference Theory
Sociocultural
theory
Jay Appleton
(1975)
Kaplan and kaplan
(1989)
Healthcare
Stress coping
Reduction
theory
Ulrich, Rogers . S.
(1999)
RESEARCH DESIGN:
Objective #1
General Knowledge
Research
Objectives
Objective #2
Context
Objective #4
Objective #3
Synthesis
To identify the problem of
children hospital ward
without positive
intervention distraction;
To investigate the behavioural
response of children due to norms
and protocols in the ward and the
level of their influence in a hospital
ward setting;
To examine the changes in behavioral
responses of children after
experiencing of natural play
materials indoors.
What are the challenges of
such wards on children
hospitalization experience?
What are the behaviour of children in
the ward without the natural play
intervention?
How can natural play indoors
influences children coping
abilities to hospitalization?
How can the ward as play
environment influence children’s
behaviour during hospitalisation?
How can natural play indoors
improves children hospitalization
experiences?
Research
Question(s)
Evaluation
To propose a guideline for ward
restoration process through
indoor natural play to enhance
on children physical, cognitive,
and social performance.
Objective #1
Objective #2
Objective #3
Objective #4
Data
Collection
Method
1. Literature review
2. Observation from Pilot
study
1. Background survey
1. Survey Questionnaire
2. Observation
- photograph
- video recording
3. Interview
1. Children’s Drawing
Analysis
Method
1.
2.
1. Content analysis
1. AHP
2. Content analysis
1. Synthesis
2. Content analysis
Expected
Findings
Have a better understanding
of the ward condition faced
by children, parents and their
caregivers.
Identify the shortcomings of the
existing paediatric ward setting.
To have the avenue of showing
stakeholders the benefits of
physical and social environment
given the needed stimulation on
patients health outcome and
coping abilities that may
reduced medication intake and
reduce the length of stay.
Hospital ward design framework
that may improve on children
physical, social and cognitive
performance.
Related
Theories
ART (Kaplan and Kaplan).
Being away, fascination,
extend, and compatibility.
SCRT (Ulrich).
Sense of security, Sense of control,
Social support, Physical movement
and exercise.
PPH in child care center design
(Olds). Where children develop by
interacting with the social and
physical environment upon
materials and events.
Participatory Strategies for the
design of child care facilities
(Sanof). Where research findings
can be integrated into design
decision processes.
Inference
Content analysis
Scope of Study
Study sites
- Paediatric Ward, ATBUTH Bauchi
* the hospital started from health Centre in the 1940s to general hospital, and later to
specialist
hospital and finally to a teaching hospital
* one out of the two teaching hospital in North-East of of Nigeria.
* Proximity to Data and source of information.
Respondents
1. Early childhood to Middle-childhood children (3-11 year old. n=17)
2. Caregivers (Nurses. and Doctors)
3. Parents
4. Other hospital staffs
The ward without play intervention
Children always stick to their beds almost all the day
Chidren frequently develop excessive fear, change in mood and facial expression.
Less cooperating to acceptance of routine medication, treatment and dressing of wound.
Children show the sign of being restless, bored and stressed
Findings
- The ward with play intervention provided six times more positive behavior and five times more
performances level than the ward without play intervention.
- Play intervention has provided a playful environment that enhances children behavior and
performances from low to higher level.
- Positive changes noticed in their physical, cognitive and social performances, from low in the ward
without play intervention to higher in the ward with play intervention.
- Children interaction with nature inclined activities such as sand, water, wooden logs and stones have
shown to improve on their hospitalization.
- Physically, they have changed from staying in their beds to being active with desire to run, jump, crawl
and manipulate the play items.
- Cognitively, they have changed from being depressed, bored, fearful, and restless in the ward to being
calm, relaxed, comfortable and cheerful.
- Socially, the change is noticeable from being alone and keeping to themselves to playing with peers
and cooperating with their caregivers and parents in the ward.
The play activities represent a useful technique for a more friendlier and restorative hospital
environment which can reduce the negative effect of children hospitalization experiences.
Result
Physical performance
Social performance
Cognitive performance
Stress coping
Reduction
theory
Restoration
Ulrich, Rogers . S.
(1999)
Play activity
Play activity
PPH in child care
center design (Olds).
PSD child care
facilities (Sanof).
Play activity
Hospitalization
Attention
Restorative theory
Kaplan and kaplan
(1989)
H. Sanof
(1989)
Anita Rui Olds
(1989)