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Evaluation of an in-hospital recreation room for hospitalised children and their families

February 2022
The Center For Health Design

Why does this study matter?
We often hear about the importance of play in pediatric settings. We see programming for dedicated play to support both:

  • structured play with someone like a child specialist that is working through issues of treatment
  • and unstructured play, where kids control the activity – potentially a medical free zone, where treatment is NOT discussed.

While we sometimes focus on research measuring medical or experiential outcomes, sometimes we need to back up a step and figure out how spaces are even being used.
I thought it was important that this study took that step back. The first research question was who really uses these spaces and why? And then, do these rooms benefit the families?

How was the study done?
This was a mixed methods design conducted in two pediatric hospitals in Australia. In this case, the room is branded as The Starlight Express Room. Each room is equipped with games, video games, arts and crafts, and a tea and coffee space for parents. Professional performers are part of each room’s function — they create a place for escapism. The research team used 3 validated questionnaires. Quantitative measures included use of the recreation room, positive and negative associations of the room, parental stress, and the child’s quality of life. Quantitative data were analyzed data using t-tests and multiple regression 123 parents completed the questionnaires. There was also an optional 15-20 minute interview, which 13 parents completed. Inductive analysis was used for the interview data. Most of the patients were hospitalized for a chronic illness.

So what do we learn from the study?
From the interviews, the researchers found that parents saw the rec room as a place to ‘escape’ the rest of the hospital – whether it was for them, their child, or siblings. Parents also saw the rec room as a place for social support – from other parents and the staff, importantly that resulted in reduced isolation and improved mental health. The restorative experiences tool showed that more than 85% of parents reported no negative associations for themselves, the pediatric patient, or siblings. Even of those that reported a negative association, the positive associations were higher at a statistically significant level. The most common association for parents, hospitalized children and siblings were happy and playful, but also relaxed. From a statistical significance perspective, parents in higher states of distress used the room more often. In addition, families of pediatric patients with lower physical and psychosocial functioning used the room more than families with higher functioning kids.

Can we say the results are definitive?
The interviews were all with female participants, and it was small sample, but the researchers still reached saturation in content. While the study did look at the outcomes associated with parents, kids and siblings, the parent perceptions were proxies for the perceptions of their child and their siblings. So we don’t know from a first-person perspective what the kids thought, and this kind of proxy might be biased or influenced by other issues. The study was conducted in Australia and interestingly parents who were not born in Australia reported more positive associations with the recreation room than parents born in Australia and that could be a result of the availability of other family support.

What’s the takeaway?
The play room here is an escape room - the great escape. And I couldn’t help but think - we’ve heard a lot about escape rooms in the past few years. They’re big for team building, family reunions and birthday parties, and there’s usually a dramatic story line and you use the clues to get out in a set period of time. But this is an Escape Room of a different kind. There might still be a dramatic story line, but for this one, you actually want to stay in. And the benefits go beyond pediatric play. As a medical free zone, the room provides respite and support that can benefit the whole family’s mental health and well-being, especially for highly distressed parents. In the words of one mother, “I can finally switch off for 30 seconds. It's a place where the hospital doesn't matter... Sometimes I feel like I can finally breathe again.” So let’s use this research and design the great escape to get in, not get out.


Kelada, L., Wakefield, C. E., De Graves, S., Treadgold, C., Dumlao, G., Schaffer, M., O'Brien, T. (2021) Evaluation of an in-hospital recreation room for hospitalised children and their families. Journal of Pediatric Nursing, Volume 61, Pages 191-198


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