Factors influencing the pediatric hospitalization experience: a narrative review with recommendations for improvement

Pediatric patients view hospitalization as an overwhelmingly negative experience, and this has implications in treatment adherence, patient-provider relationships, and overall health outcomes. Children should be active agents and collaborate with doctors in their medical treatments, and yet, they are frequently excluded in practice and research, suggesting that insight into improving their hospital stay is underexplored. The purpose of this literature review is to understand hospitalization stress in pediatric populations and make recommendations in enhancing the experience.

A comprehensive literature review was conducted in the PubMed database in July 2025 to first understand the pediatric hospitalization experience from the perspectives of children, caregivers, and healthcare professionals. After identifying central themes and areas of improvement, secondary searches were made within each theme for completeness of available data. Papers were considered if they focused on pediatric populations and in the English language.

Results show that the built environment of hospitals may not adequately address the needs of children, leading to heightened stress and longer hospital visits. Play and art therapy often have positive impacts, though these services may be underutilized in hospitals or have unexpected negative effects. Children feel marginalized in communication from doctors, and both patients and caregivers feel frustrated with lack of information or unresolved concerns. Doctors may miss empathetic opportunities, compromising care outcomes and patient-provider relationships.

Children value developmentally appropriate physical spaces, play and art activities, and active involvement in their own treatment. Improving the hospitalization experience may lead to better healthcare outcomes through reduced psychosocial stress. Physicians are recommended to actively speak to children and assess their perspectives, provide toys and games, allow patients to modify their rooms whenever possible, and ask questions beyond the child's illness to demonstrate empathy. Future research should explore more narratives of hospitalized children, ways of incorporating patient preferences to the hospital, and developmentally-appropriate communication techniques.