Children in non-clinical healthcare environment: insights from a multi-method qualitative approach

Healthcare visits for children are often stressful. They , more than adults, rely on environmental cues to guide their behaviours in common areas. Despite this, healthcare research has largely focused on patient rooms and clinical spaces, with limited attention to non-clinical spaces. This highlights the need for research that explores children's experiences within non-clinical settings. .The study aims to explore children's behaviours and experiences within non-clinical healthcare settings, using a multi-method qualitative approach informed by Supportive Design Theory.

Study was carried out in the pediatric department of a general hospital in South India from July to December 2023. Convenience sampling was used for selecting 25 children aged 5-18 years across four common spaces: play area, waiting area, corridor, and lobby. Three qualitative methods - observation, drawing, and verbal elicitation were used. Observational data descriptively analyzed behavioural patterns, while drawings and verbal responses were thematically analyzed using ATLAS.ti. Three themes emerged: (1) Familiar environmental engagement, interaction with recognizable features; (2) Curiosity-driven environmental engagement, responses to sensory stimuli elements; and (3) Inspirational environmental engagement, imaginative and learning-oriented engagements . Triangulating three datasets deepened the qualitative interpretation.

Findings showed children's behavioural variations across healthcare settings. Sensory-rich and visually engaging environments, particularly the play area and waiting area, supported active behaviours, whereas settings with fewer environmental features predominantly passive engagements. Results suggest that visually familiar, , interactive, and curiosity-supporting elements appeared to support children's engagement during hospital visits.

Study highlights the importance of multi-sensory features within non-clinical settings. Consistent with supportive design theory, findings suggest familiar, sensory-rich, and engaging environmental features may support children's experiences during hospital visits. Study contributes to advancing environment-behaviour research in healthcare contexts.