Mixed methods study exploring the impact of the hospital gown on recovery and wellbeing

implications for policy and practice

Nicola Cogan, Liza Morton, Emmanouil Georgiadis

Research output: Contribution to journalConference Contribution

Abstract

Background: The importance of personalised and dignified care is increasingly being recognised in healthcare policy and practice. Despite the known impact of clothing on social identity few studies have considered the impact of hospital clothing on patient wellbeing and recovery. Whilst clothing can empower the wearer, it can also induce psychological distress, feelings of disempowerment and lowered self-esteem. Despite recent drives to empower patients with person centred health care provisions, the institutionalised acceptance of the hospital gown persists. Research has yet to explore the impact of wearing the hospital gown on patients' health, wellbeing and recovery. Methods: Two studies were carried out to consider the impact of the hospital gown on wellbeing and recovery among adults with and without chronic health conditions. The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with adults living with lifelong chronic health conditions, which were audio-recorded, transcribed and thematic analysis was used to identify themes from the qualitative data. The second study was a cross-sectional, online survey exploring adults' views (n = 700) and experiences of wearing the hospital gown. Findings: Qualitative analysis identified the following master themes: (1) loss of 'healthy' identity, (2) symbolic embodiment of the 'sick' role, (3) relinquishing control to medical professionals, and (4) vulnerability, disempowerment and embarrassment. Quantitative analysis of the online survey data indicated that adults often reported wearing the hospital gown despite lack of medical necessity. Its design was considered to be not fit for purpose and lacking in dignity. Interpretation: The implications of these findings for public health policy and practice are discussed, emphasising the importance of challenging cultural norms in healthcare since de-humanising aspects of care, as symbolically represented by the hospital gown, may adversely impact on wellbeing and recovery and increase patient distress. Alternatives to the hospital gown are discussed.
Original languageEnglish
Article numberS32
Number of pages1
JournalThe Lancet
Volume394
Issue numberSuppl. 2
Early online date28 Nov 2019
DOIs
Publication statusPublished - 30 Nov 2019

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Clothing
Delivery of Health Care
Health
Sick Role
Public Health Practice
Social Identification
Public Policy
Health Policy
Self Concept
Emotions
Cross-Sectional Studies
Interviews
Psychology
Research

Keywords

  • psychologically minded care
  • person centred care
  • hospital gown
  • mixed method
  • qualitative
  • cross-sectional

Cite this

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title = "Mixed methods study exploring the impact of the hospital gown on recovery and wellbeing: implications for policy and practice",
abstract = "Background: The importance of personalised and dignified care is increasingly being recognised in healthcare policy and practice. Despite the known impact of clothing on social identity few studies have considered the impact of hospital clothing on patient wellbeing and recovery. Whilst clothing can empower the wearer, it can also induce psychological distress, feelings of disempowerment and lowered self-esteem. Despite recent drives to empower patients with person centred health care provisions, the institutionalised acceptance of the hospital gown persists. Research has yet to explore the impact of wearing the hospital gown on patients' health, wellbeing and recovery. Methods: Two studies were carried out to consider the impact of the hospital gown on wellbeing and recovery among adults with and without chronic health conditions. The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with adults living with lifelong chronic health conditions, which were audio-recorded, transcribed and thematic analysis was used to identify themes from the qualitative data. The second study was a cross-sectional, online survey exploring adults' views (n = 700) and experiences of wearing the hospital gown. Findings: Qualitative analysis identified the following master themes: (1) loss of 'healthy' identity, (2) symbolic embodiment of the 'sick' role, (3) relinquishing control to medical professionals, and (4) vulnerability, disempowerment and embarrassment. Quantitative analysis of the online survey data indicated that adults often reported wearing the hospital gown despite lack of medical necessity. Its design was considered to be not fit for purpose and lacking in dignity. Interpretation: The implications of these findings for public health policy and practice are discussed, emphasising the importance of challenging cultural norms in healthcare since de-humanising aspects of care, as symbolically represented by the hospital gown, may adversely impact on wellbeing and recovery and increase patient distress. Alternatives to the hospital gown are discussed.",
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Mixed methods study exploring the impact of the hospital gown on recovery and wellbeing : implications for policy and practice. / Cogan, Nicola; Morton, Liza; Georgiadis, Emmanouil.

In: The Lancet, Vol. 394, No. Suppl. 2, S32, 30.11.2019.

Research output: Contribution to journalConference Contribution

TY - JOUR

T1 - Mixed methods study exploring the impact of the hospital gown on recovery and wellbeing

T2 - implications for policy and practice

AU - Cogan, Nicola

AU - Morton, Liza

AU - Georgiadis, Emmanouil

PY - 2019/11/30

Y1 - 2019/11/30

N2 - Background: The importance of personalised and dignified care is increasingly being recognised in healthcare policy and practice. Despite the known impact of clothing on social identity few studies have considered the impact of hospital clothing on patient wellbeing and recovery. Whilst clothing can empower the wearer, it can also induce psychological distress, feelings of disempowerment and lowered self-esteem. Despite recent drives to empower patients with person centred health care provisions, the institutionalised acceptance of the hospital gown persists. Research has yet to explore the impact of wearing the hospital gown on patients' health, wellbeing and recovery. Methods: Two studies were carried out to consider the impact of the hospital gown on wellbeing and recovery among adults with and without chronic health conditions. The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with adults living with lifelong chronic health conditions, which were audio-recorded, transcribed and thematic analysis was used to identify themes from the qualitative data. The second study was a cross-sectional, online survey exploring adults' views (n = 700) and experiences of wearing the hospital gown. Findings: Qualitative analysis identified the following master themes: (1) loss of 'healthy' identity, (2) symbolic embodiment of the 'sick' role, (3) relinquishing control to medical professionals, and (4) vulnerability, disempowerment and embarrassment. Quantitative analysis of the online survey data indicated that adults often reported wearing the hospital gown despite lack of medical necessity. Its design was considered to be not fit for purpose and lacking in dignity. Interpretation: The implications of these findings for public health policy and practice are discussed, emphasising the importance of challenging cultural norms in healthcare since de-humanising aspects of care, as symbolically represented by the hospital gown, may adversely impact on wellbeing and recovery and increase patient distress. Alternatives to the hospital gown are discussed.

AB - Background: The importance of personalised and dignified care is increasingly being recognised in healthcare policy and practice. Despite the known impact of clothing on social identity few studies have considered the impact of hospital clothing on patient wellbeing and recovery. Whilst clothing can empower the wearer, it can also induce psychological distress, feelings of disempowerment and lowered self-esteem. Despite recent drives to empower patients with person centred health care provisions, the institutionalised acceptance of the hospital gown persists. Research has yet to explore the impact of wearing the hospital gown on patients' health, wellbeing and recovery. Methods: Two studies were carried out to consider the impact of the hospital gown on wellbeing and recovery among adults with and without chronic health conditions. The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with adults living with lifelong chronic health conditions, which were audio-recorded, transcribed and thematic analysis was used to identify themes from the qualitative data. The second study was a cross-sectional, online survey exploring adults' views (n = 700) and experiences of wearing the hospital gown. Findings: Qualitative analysis identified the following master themes: (1) loss of 'healthy' identity, (2) symbolic embodiment of the 'sick' role, (3) relinquishing control to medical professionals, and (4) vulnerability, disempowerment and embarrassment. Quantitative analysis of the online survey data indicated that adults often reported wearing the hospital gown despite lack of medical necessity. Its design was considered to be not fit for purpose and lacking in dignity. Interpretation: The implications of these findings for public health policy and practice are discussed, emphasising the importance of challenging cultural norms in healthcare since de-humanising aspects of care, as symbolically represented by the hospital gown, may adversely impact on wellbeing and recovery and increase patient distress. Alternatives to the hospital gown are discussed.

KW - psychologically minded care

KW - person centred care

KW - hospital gown

KW - mixed method

KW - qualitative

KW - cross-sectional

UR - https://www.sciencedirect.com/journal/the-lancet

U2 - 10.1016/S0140-6736(19)32829-6

DO - 10.1016/S0140-6736(19)32829-6

M3 - Conference Contribution

VL - 394

JO - Lancet

JF - Lancet

SN - 0140-6736

IS - Suppl. 2

M1 - S32

ER -