Children and young people’s experience of source and protective isolation while in hospital

Abstract

Single room isolation is an essential part of transmission-based precautions for the purpose of infection prevention. Literature demonstrates that adults subjected to isolation precautions can experience loneliness, depression, feelings of stigma and confinement. The paediatric literature regarding the experience of isolation focuses on the parental perspective, or children with specific conditions, thereby having limited transferability to the general paediatric ward.

This study explored the experiences of children and young people in single room isolation whilst in hospital. Social constructivism was the underpinning philosophy, using a narrative inquiry method. Within this thesis the experiences of children in isolation were explored from the perspectives of the child (n=8), parents (n=11) and staff (n=21), recruiting participants from wards in a children’s hospital in the UK. Data were collected between 2011 and 2015 using retrospective interviews and video diaries. This timeframe allowed for adaptation of data collection methods in response to slow recruitment of children to the study.

The data were analysed using narrative analysis, with findings contributing important insights into the child’s experience of isolation whilst in hospital. Three themes were identified: control, community and coping. Control refers to the child’s feelings of control in relation to their illness and the environment of the isolation room, both of which varied according to familiarity with the ward and with being hospitalised. The theme of community encompasses the times when in isolation the child wanted social interaction or time away from the community of the hospital ward, and also the social contact of their family and peers outside of the hospital for distraction and alleviation of boredom. Coping denotes the ways in which the children understood their need for isolation and how they managed their time in isolation through distraction, parental presence and control of the space in the isolation room. This research makes a unique contribution to the field, in relation to the topic of the child’s experience of isolation, and also through the incidental findings regarding data collection methods in research studied with children within hospital. Although this study cannot give one structured approach to providing care for children in isolation, it encourages practitioners to consider the children’s narratives from this study within their own clinical setting and individualise care according to their needs.

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Identifiers

ORCID for Jacqui Prieto: orcid.org/0000-0002-5524-6775

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