title: A companionship between strangers - the hospital environment as a challenge in patient-patient interaction in oncology wards.
abstract: OBJECTIVE
  To present an identification and discussion of the impact of the hospital environment on interaction among people with cancer.
  
  
  BACKGROUND
  In recent years, researchers have focused on identifying and describing features of the hospital environment that promote healing, recovery and well-being. It has been discovered that architectural features affect hospitalized patients both positively and negatively. But the research has failed to include fellow patients as part of the hospital environment.
  
  
  METHODS
  A qualitative approach influenced by ethnography.
  
  
  METHODS
  Participant observation and individual qualitative interviews were used to collect data. From a total of 85 observed people with cancer 10 men and 10 women were interviewed. Data were collected over 6 months in 2010-2011 and analysed using inductive thematic analysis.
  
  
  RESULTS
  Patients had ambiguous views regarding their fellow patients and the hospital environment. The hospital environment imposed conditions that caused stress factors such as the loss of personal privacy and control, but it also offered the possibility of good company and support from fellow patients. Refuge from fellow patients was hard to achieve and the fact that personal conversations might be overheard by fellow patients caused patients to withhold important information from healthcare professionals. Nevertheless, patients accepted the hospital environment uncritically, with resignation or with silent rebellion. Despite the challenges, 18 of 20 patients preferred multiple-bed rooms with the company of fellow patients.
  
  
  CONCLUSIONS
  The influence of the hospital environment on hospitalized people with cancer and their interpersonal interaction needs to be acknowledged by healthcare professionals. In addition, evidence-based hospital design must include research into patient preferences and arguments. Further investigation is needed.
authors.affiliation: Centre of Nursing Research, Viborg, DK.
authors.forename: Lene Søndergård
authors.initials: LS
authors.lastname: Larsen
authors.forename: Birte Hedegaard
authors.initials: BH
authors.lastname: Larsen
authors.forename: Regner
authors.initials: R
authors.lastname: Birkelund
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003718:Denmark; D030881:Disclosure; D005260:Female; D006749:Hospital Design and Construction; D006760:Hospitalization; D006767:Hospitals, District; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing / Q000523:psychology*; D057240:Patient Preference; D010362:Patients' Rooms; D018907:Privacy
keywords: acceptance; healing environment; hospital environment; interpersonal interaction; loss of control; nursing; patient room preferences; patient-patient interaction; privacy