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Influence of Positive Distractions on Children in Two Clinic Waiting Areas

Originally Published:
Key Point Summary
Key Point Summary Author(s):
Hui Cai
Key Concepts/Context
Studies show that the quality of waiting environments influences the perception of quality of care and caregivers, that perception of waiting time is a better indicator of patient satisfaction than actual waiting time, and that the waiting environment contributes to the perception of wait time. In fact, the attractiveness of the physical environment in waiting areas has been shown to be significantly associated with higher perceived quality of care, less anxiety, and higher reported positive interaction with staff. Can positive distractions in waiting areas improve the waiting experience, as indicated by the behavior and activities of children waiting for treatment?
This study aims to examine the influence of positive distraction on the behavior and activity of children in two clinic waiting areas. Specific goals are to conduct a comparative analysis of five distraction conditions to assess their impact on the behavior of children waiting for treatment and the waiting experience of accompanying family members. 
A quasi-experimental design was used in this study. Five distraction conditions were randomly introduced in the waiting area of the dental and cardiac clinics of a major pediatric tertiary care center through a single plasma screen intervention to compare with a control (no-distraction) condition. The attention, behavior, and activities of waiting children were systematically observed and recorded. Data on 158 pediatric patients were collected over 12 days during December 2008 and January 2009. Waiting areas for one dental and one cardiac clinic patient at a major pediatric tertiary care center were used in this study. A 20-minute window was used to collect data for each child. During each 20-minute interval, the positive distraction condition was presented for 10 minutes and the remaining 10 minutes had the no-distraction condition.
Design Implications
The findings demonstrated that using TV monitors with positive distractions, such as ambient art, images of natural scenery, natural aquarium, and soothing sounds will have significant calming effects on hospital waiting areas. 
Data analysis shows that the introduction of distraction conditions was associated with a significant increase in calm behavior in both clinics. Also the results demonstrated that there were less fine and gross movements, suggesting significant calming effects associated with the distraction conditions. In the cardiac clinic, the proportion of subjects’ attention to themselves reduced from 12% to 7%, which suggested that positive distraction diverted the attention from themselves and addressed the issue of boredom. Data also suggest that irrespective of the seating arrangement (theater-style or conventional) in two clinics, positive distraction conditions are significant attention grabbers and could be an important contributor to improving the waiting experience for children in hospitals by improving environmental attractiveness.
Some limitations identified by the authors include:
  • Future studies should compare other content, such as movies, cartoons, news, and so forth, which are typically projected on TV screens in hospital waiting areas.
  • Replication of this study in other clinical settings and other positive distraction media
Other limitations:
  • The ethnicity and the development levels of the patients in the dental and the cardiac clinics are different, which may have impacts on their observed behavior.
  • More studies are needed to evaluate the difference among five positive distraction conditions on the impacts on waiting behavior, attention, activities, and social behavior.
Design Category
Acoustic Environment|Furniture, Fixtures & Equipment (FF&E)
Ambulatory care facilities
Outcome Category
Patient satisfaction and comfort
Environmental Condition Category
Primary Author
Pati & Nanda