title: The impact of single and shared rooms on family-centred care in children's hospitals.
abstract: OBJECTIVE
  To explore whether and how spatial aspects of children's hospital wards (single and shared rooms) impact upon family-centred care.
  
  
  BACKGROUND
  Family-centred care has been widely adopted in paediatric hospitals internationally. Recent hospital building programmes in many countries have prioritised the provision of single rooms over shared rooms. Limited attention has, however, been paid to the potential impact of spatial aspects of paediatric wards on family-centred care.
  
  
  METHODS
  Qualitative, ethnographic.
  
  
  METHODS
  Phase 1; observation within four wards of a specialist children's hospital. Phase 2; interviews with 17 children aged 5-16 years and 60 parents/carers. Sixty nursing and support staff also took part in interviews and focus group discussions. All data were subjected to thematic analysis.
  
  
  RESULTS
  Two themes emerged from the data analysis: 'role expectations' and 'family-nurse interactions'. The latter theme comprised three subthemes: 'family support needs', 'monitoring children's well-being' and 'survey-assess-interact within spatial contexts'.
  
  
  CONCLUSIONS
  Spatial configurations within hospital wards significantly impacted upon the relationships and interactions between children, parents and nurses, which played out differently in single and shared rooms. Increasing the provision of single rooms within wards is therefore likely to directly affect how family-centred care manifests in practice.
  
  
  CONCLUSIONS
  Nurses need to be sensitive to the impact of spatial characteristics, and particularly of single and shared rooms, on families' experiences of children's hospital wards. Nurses' contribution to and experience of family-centred care can be expected to change significantly when spatial characteristics of wards change and, as is currently the vogue, hospitals maximise the provision of single rather than shared rooms.
authors.affiliation: School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.
authors.forename: Penny
authors.initials: P
authors.lastname: Curtis
authors.affiliation: School of Healthcare Sciences, Cardiff University, Cardiff, UK.
authors.forename: Andy
authors.initials: A
authors.lastname: Northcott
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D017144:Focus Groups; D006749:Hospital Design and Construction; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010362:Patients' Rooms / Q000458:organization & administration; D011368:Professional-Family Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: children's experiences; children's hospitals; ethnography; family-centred care; nurses’ experiences; paediatric hospitals; parents’ experiences; shared rooms; single rooms; spatial characteristics