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Children's Drawings With Narratives in the Hospital Setting: Insights Into the Patient Experience
Maureen E Clark1, Megan E Carleton2, Brian M Cummings2
1Massachusetts General Hospital, Boston, Massachusetts meclark@mgh.harvard.edu.
Insights
Pediatric patients in the Pediatric Intensive Care Unit (PICU) used drawings and narratives to share their experiences. This method revealed key aspects of their hospital stay, aiding in improving care.
Area of Science:
- Pediatric critical care medicine
- Child psychology
- Patient experience research
Background:
- Pediatric Intensive Care Units (PICUs) provide critical care for children.
- Understanding patient perspectives is crucial for improving healthcare quality.
- Art-based methods offer unique insights into patient experiences.
Purpose of the Study:
- To explore Pediatric Intensive Care Unit (PICU) patients' experiences and perceptions.
- To utilize patient drawings and narratives as a method of data collection.
- To identify positive and negative aspects of PICU admissions from the patient's viewpoint.
Main Methods:
- A prospective, single-center study involving pediatric patients aged 6-17 years in a 14-bed PICU.
- Patients completed interviews about their PICU stay, drew pictures of their experiences, and provided explanatory narratives.
- Data collection occurred within 12 hours of transfer out of the PICU.
Main Results:
- Forty pediatric patients participated, with a median age of 11 years and a median PICU stay of 2 days.
- Positive aspects included staff, entertainment, and food; negative aspects involved IV lines, alarms, and discomfort.
- Drawings frequently depicted patients, monitors, IV lines, nurses, and televisions, with narratives offering deeper insights.
Conclusions:
- Drawing with explanation allows PICU patients to share unique descriptive information about their experiences.
- This communication method can enhance healthcare providers' awareness of PICU admission aspects.
- Facilitating this approach may lead to improved experiences for pediatric patients in hospital settings.
Objectives:
To explore PICU patients' experiences and perceptions through their drawings with explanatory narratives.
Methods:
Single-center prospective study in a 14-bed PICU in a tertiary care, academic-affiliated hospital. Pediatric patients age 6 to 17 years admitted to the PICU were approached to participate within 12 hours of transfer out of the PICU. Patients completed a brief study interview to identify the best and worst things about their PICU experience. Patients were asked to draw a picture of their experiences and then explain their drawings to study staff.
Results:
Forty patients (median age 11 [6-17] years) agreed to participate. The median length of PICU stay was 2 days. The best aspects of the PICU stay included staff (25%), entertainment devices (15%), and food (13%). The worst aspects of the PICU stay that were reported were the intravenous line (25%), alarms (10%), and physical discomfort (10%). The most common elements in drawings were self-depictions (88%), monitors (53%), the intravenous line (50%), registered nurses (35%), and television (33%). Patient narratives related to their drawings provided additional insights regarding patient experiences in the PICU and identified various coping mechanisms used by patients to adapt to their experiences.
Conclusions:
Drawing, along with explanation, enables patients admitted to a PICU to disclose additional unique descriptive information about their experiences as patients. Facilitating this mode of communication may increase providers' awareness of positive and negative aspects of a PICU admission and may be used to improve pediatric patients' experiences in the hospital setting.