Presentation on theme: "Restorative Benefits of Paediatric ward as Play Environment in Nigerian hospital Research progress Presentation Candidate: Usman Bukar Wakawa (PB123031)"— Presentation transcript:
Restorative Benefits of Paediatric ward as Play Environment in Nigerian hospital Research progress Presentation Candidate: Usman Bukar Wakawa (PB123031) PhD candidate Landscape Architecture Semester 4/6 Supervisor: Assoc. Prof. Dr. Ismail Said Faculty of Built Environment, FAB
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 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 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: Paediatric ward settings does not provide adequate bed spacing that can allow for free movement and play activities. 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. 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: Ulrich Cooper said Moore Kelly Perkins Epstein smith Dijkstra Kate Bowers Burt Kellert 00’s 80’s 90’s Effect of healthcare on Environment Restorative Gardens Reasons to smile at Tear drops Accessible play: No more watching from sideline Healing Gardens Health and nature Stress reducing effect of indoor plants in the built environment “Getting serious about therapeutic practice” Keep. Moore Ulrich. R.Kaplan S.Kaplan. Jay Cooper. Jane. Thoday Fried Calkins. West Cooper. Ulrich. Moore R.Kaplan S.Kaplan. Perkins Kamp Epstein Hartig Mooney Jay Edward Influence of passive experiences The physical environment as a therapeutic Healing Gardens Therapeutic Gardens in the Acute Garden With people in Mind Therapeutic Gardens in the Acute Garden Healing environment, Restorative Gardens Plant for play The experience of Landscape The Biophilia hypothesis Windows in the intensive Therapy unit A prison Environments effect on healthcare Effects of hospital environment On patient well-being Housing as if people mattered Effects of hospital environment On patient well-being Use of Garden for disable Landscape view and prison response Psychological benefit of a wilderness experience
Human Development theory Sociocultural theory Sociocultural theory Cognitive theory Cognitive theory Humanistic theory Humanistic theory Behavioral theory Psychoanalytic theory Prospect Refused theory Prospect Refused theory Attention Restorative theory and Environmental Preference Theory Stress coping Reduction theory Stress coping Reduction theory Healthcare Human Development THEORITICAL FRAME WORK Sigmund Freud (1856-1939) Erik Erikson (1902-1994) Ivan Parlor (1847-1939) John Watson (1878-1958) Abraham Maslow (1908-1970) Carl Rogers (1902-1987) Lev Vygotsky (1896-1934) Jean Piaget (1896-1980) Jay Appleton (1975) Kaplan and kaplan (1989) Ulrich, Rogers. S. (1999)
RESEARCH DESIGN : Objective #1Objective #2 Objective #3 Objective #4 General Knowledge Context Synthesis Evaluation Research Objectives 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. To propose a guideline for ward restoration process through indoor natural play to enhance on children physical, cognitive, and social performance. Research Question(s) 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?
Objective #1Objective #2Objective #3Objective #4 Data Collection Method 1.Literature review 2.Observation from Pilot study 1. Background survey1.Survey Questionnaire 2.Observation - photograph - video recording 3. Interview 1. Children’s Drawing Analysis Method 1.Inference 2.Content analysis 1.Content analysis1.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.
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.
Stress coping Reduction theory Stress coping Reduction theory Ulrich, Rogers. S. (1999) Attention Restorative theory Kaplan and kaplan (1989) Hospitalization Play activity Restoration Result Physical performance Social performance Cognitive performance PPH in child care center design (Olds). PSD child care facilities (Sanof). Anita Rui Olds (1989) H. Sanof (1989)