Article Text
Abstract
Aims Spatial aspects of hospitals have received scant attention in research on Family Centred Care (FCC). Presently, cubicles are used predominantly to isolate patients that present an infection risk or that require a heightened level of observation. Though shared bays remain a common feature on children’s wards, new builds tend to increase the number of cubicles at the expense of bays. This paper explores the experiences and expectations of nurses and family members as they provided and received care in hospital cubicles.
Methods A 10 month, focused ethnographic study was carried out in 2 medical and 2 surgical wards in a Children’s Hospital in the North of England. Data, focusing upon activities of daily living and the administration of oral medication, were generated via observation, interviews and focus group discussion with 144 family members (children aged up to 15 and their parent’s) and 65 nurses and Health Care Assistants. All data were subjected to thematic analysis.
Results Families receiving cubicle-based care appreciated the privacy afforded, but parents could feel isolated and bored. Parents were reluctant to leave their children in cubicles unsupervised. Parents in bays valued the informal supervision provided by both nurses and other parents and some children appreciated the social aspect of being around other patients. Nurses expressed concerns about the additional workload that could be associated with cubicle-nursing, finding it difficult to ‘get away’ from parents isolated from the rest of the ward.
Both nurses and parents expressed practical and medical concerns about increased numbers of cubicles in future ward configurations. A predominance of cubicles was thought to threaten the (highly valued) informal aspects of care and was expected to negatively affect dynamics between parents and nurses. Nurses were also concerned that their peer relations and team-working would be undermined.
Conclusions While family members saw advantages to cubicles in terms of privacy and enhanced resources, both parents and nurses raised concerns that a preponderance of cubicles may be detrimental to FCC. This paper will conclude by suggesting key issues that need to be recognised and addressed in planning for cubicle-based care.