Environmental graphics design as visual communication in pediatric waiting area: a comparative observational study of
Rizka Rachmawati1,2, Mehrnoosh Mirzaei3, Augista Sesi Nastiti4
1Visual Communication Design Department, Telkom University Jakarta, West Jakarta, Indonesia.
Insights
Interactive play-based environments significantly improve children's engagement and emotional well-being in paediatric waiting areas, unlike passive Environmental Graphic Design (EGD). EGD alone has minimal impact on children's behaviour and emotions.
Area of Science:
- Pediatric Healthcare Design
- Environmental Psychology
- Child Development
Background:
- Waiting is a common stressor in pediatric healthcare.
- Limited evidence exists on the effectiveness of passive Environmental Graphic Design (EGD) in supporting children's engagement and emotional regulation during healthcare waits.
Purpose of the Study:
- To examine how different environmental graphic communication strategies influence children's observable behavioral and affective responses in pediatric waiting areas.
- To compare the impact of passive EGD versus interactive, play-based environments on children's experiences.
Main Methods:
- A comparative qualitative case-study approach was used in two Indonesian hospitals.
- Direct behavioral and affective observations were conducted on 43 children aged 2-9 years.
- Observed indicators included movement, interaction, screen engagement, social play, and expressions of calmness, enjoyment, restlessness, and distress.
Main Results:
- Passive EGD environments showed minimal child interaction, with children remaining caregiver-centered and disengaged.
- Interactive, play-based environments fostered sustained engagement, increased movement, and more peer interaction.
- Positive affective responses were more prevalent in the interactive environment.
Conclusions:
- Passive EGD contributes to the visual atmosphere but has limited impact on children's behavioral and affective responses during waiting.
- Interactive, play-based graphic environments are more effective in supporting children's engagement and emotional regulation in pediatric waiting areas.
Abstract:
Waiting is an unavoidable aspect of paediatric healthcare and is frequently experienced as stressful. Although child-friendly visual environments are widely implemented, there is limited empirical evidence on whether passive Environmental Graphic Design (EGD) effectively supports children's engagement and emotional regulation during real waiting situations. This study examines how different environmental graphic communication strategies shape children's observable behavioural and affective responses in paediatric waiting areas. A comparative qualitative case-study approach was conducted in two Indonesian hospitals, comparing waiting environments dominated by passive EGD elements (Hospitals X and Y). Direct behavioural and affective observations were carried out with total of 43 children aged 2-9 years. Behavioural indicators included movement patterns, interaction with environmental elements, screen engagement, and social play, while affective indicators included visible expressions of calmness, enjoyment, restlessness, and distress. Findings show that passive EGD environments have minimal physical interaction; children remained caregiver-centered and frequently exhibited disengagement. In contrast, the interactive play-based environment supported sustained engagement, increased movement and peer interaction, and more positive affective responses. These results suggest that passive EGD contributes to the visual atmosphere of paediatric waiting areas, with limited impact on children's behavioural and affective responses, whereas interactive, play-based graphic environments are more effective.
