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The Influence of Two Hospitals Designs and Policies on Social Interaction and Privacy as Coping
Factors for Children With Cancer and Their Families
Judy Ann Rollins
Journal of Pediatric Oncology Nursing 2009; 26; 340 originally published online Aug 17, 2009;
DOI: 10.1177/1043454209339734
The online version of this article can be found at:
http://jpo.sagepub.com/cgi/content/abstract/26/6/340
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Citations http://jpo.sagepub.com/cgi/content/refs/26/6/340
States, four coping themes emerged among the 22 participants: (a) being prepared, (b) being connected, (c) shutting it out, and (d) working it through (Rollins, 2003).
Some of the coping strategies children use that reflect
these themes might be easier to initiate in a hospital environment that encourages social interaction; for others, an
environment that provides privacy might likely prove
more effective. In some instances, both social interaction
and privacy might be appropriate.
The purpose of this analysis was to explore how differences in designs of these two hospitals and their policies related to space might influence childrens ability to
use these coping strategies. The aim was to describe
some of the ways in which the physical aspects and policies of a UK hospital and a US hospital fostered coping
for children with cancer and their families.
Literature Review
Children and families need a hospital environment that
provides a balance of social interaction and privacy and
policies that support these conditions. Social support can
positively influence childrens coping and health care outcomes during hospitalization (Johnson, Jeppson, &
Corresponding Author:
Judy Rollins, PhD, RN, 1406 28th Street NW, Washington, DC 20007
E-mail: jar83@georgetown.edu.
341
Rollins
Redburn, 1992; Rollins, 2005; Shepley, 2005). Child-tochild and family-to-family support does not seek to replace
professionally mediated support but, rather, is a unique
resource that promotes individual and family strengths
through shared experience (Johnson et al., 1992).
Maintaining links to familiar environments, routines,
and activities is a critical factor in helping children cope
with hospitalization (Joseph, Keller, & Kronick, 2008).
Providing opportunities for children to interact with
peers who are hospitalized is one way to help achieve
this goal. Studies indicate that contact with peers results
in significant benefits in social and communication skills
and in the development of greater self-confidence and
independence among pediatric patients (Fels, Waalen,
Zhai, & Weiss, 2001; Said, Salleh, Abu Bakar, &
Mohamad, 2005). Peer-to-peer interaction is particularly
important for hospitalized adolescents (Hutton, 2002,
2003).
Parents also seem to benefit from interactions with
other parents sharing similar experiences. Peer-provided
support is unique, complements professional-provided support, and may have an impact lasting beyond the initial
reasons for contact (Ahmann, 1999). Parent-to-parent
support provides parents with information, emotional
support, a sense of being understood, friendship, mentoring, role modeling, assistance with problem solving, and
a base for advocacy efforts (Ahmann & Rollins, 2005).
Support from other parents is more likely to be accepted
than formal support because it makes parents feel less
needy (Dunst, Trivette, & Deal, 1988). Parents have
cited support from other parents as an essential factor in
helping them cope successfully with the stress of a hospital experience (Johnson et al., 1992). In one mothers
words:
Other parents provide me with a contextoften
just by listening without trying to reassure me;
sometimes by reinforcing half-formulated plans of
action; occasionally by confiding fears that mirrored my own. (Oster, 1985, p. 30)
Childhood cancer brings families into a new and different
world, with new routines, new experiences, new reality,
and a new circle of friends being brought into their existing lifestyle (Bradwell & Hawkins, 2000). According to
the American Cancer Society (2005), when dealing with
the fear at the time of a childs diagnosis, it is often helpful for children and parents to hear how other children
and parents have coped. Particularly with frequent and
lengthy hospital stays, parents, as do their children with
other children, establish friendships and networks of support with other parents. Bradwell and Hawkins (2000)
offer the following quote from a mother:
352
Acknowledgments
The author would like to acknowledge the International
Society of Nurses in Cancer Care and the Paediatric
Oncology Division of the Leicester Royal Infirmary for
funding this study, the children who so graciously shared
their experiences, and the assistance from the dedicated
team members in the United Kingdom and the United
States sites who lovingly care for these children and their
families.
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Bio
Judy Ann Rollins, PhD, RN, is President, Rollins & Associates, and adjunct assistant professor, Department of Family
Medicine and Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.