RESTORATIVE BENEFITS OF PAEDIATRIC WARD AS A PLAY ENVIRONMENT IN NIGERIAN HOSPITAL

1. PROGRESS REPORTUsman Bukar WakawaPB 123031Dept, of Landscape Architecture, Faculty of Built Environment.SUPERVISORSAssoc. Prof. Dr. Ismail Bin SaidEnd of Semester 1. Presentation. January, 03-2013

2. RESTORATIVE BENEFITS OF PAEDIATRIC WARD AS A PLAY ENVIRONMENT IN NIGERIAN HOSPITAL The study intends to increase the awareness on the Restorative benefits of paediatric hospital ward as a play environment from the children points of view, contrary to traditional hospital design that delivers healthcare in connection to medical ethics, protocols and codes (Ulrich, 1989). When children walk into a hospital environment, away from their home (loving and familiar) to a new environment (unknown and unfriendly). They are introduced to foreign objects and different people potentially causing considerable fear and anxiety, as a result they consider the hospital environment threatening and they can develop additional stress and trauma during appointment or hospitalization (Said, 2006). INTRODUCTION

4. Definitions Restoration: The word “Restoration” refers to a persons return of strength, or health, by means of enhancing his/her renewing abilities.(Fischi,2012) one of the accepted approaches to understanding restorative experience is through the attention restorative theory (ART) Loose Parts: They are items or materials that children and young people can move, adopt, control, change, and manipulate within their play. (Oxfordshire, 2012) Children are drawn to new, interesting and novel items and have a natural drive and ability to decide what to do with them in their play.

5. Play: Means physical contact with elements of the environment and social interaction with peers, all children and young people need to play , the impulse of play is innate. Play is a biological, psychological , and social necessity and is the fundamental to the healthy development and well-being of individuals and communities. (Said, 2008. Kellert, 2002. Mathew, 1992. Wolff, 1997.)

6. LITERATURE REVIEW AND RELATED FIELDS OF STUDY. PLAY THERAPY SALUTOGENIC AND PATOGENIC THEORIES OF PLAY AND RESTORATION BIOPHILIA HYPOTHESIS LITERATURE REVIEW. AREAS THAT ARE RELATED TO STUDY

7. STUDY FOLLOWED PREVIOUS FINDINGS IN RELATED FIELDS OF STUDY. 90’s 80’s 00’s Keep. Kellert Ulrich Jay Cooper Effect of healthcare on Environment The Biophilia hypothesis Moore Windows in the intensive Therapy unit The experience of Landscape Moore Healing Gardens Plant for play said A prison Environments effect on healthcare Ulrich. Restorative Gardens Ulrich. Moore Effects of hospital environment On patient wee-being R.Kaplan Influence of passive experiences Reasons to smile at Tear drops R.Kaplan Kelly Accessible play: No more watching from sideline S.Kaplan. S.Kaplan. With people in Mind Psychological benefit of a wilderness experience Perkins Using the physical environment as a therapeutic tool Jay Perkins The physical environment as a therapeutic Epstein “Getting serious about therapeutic practice” Housing as if people mattered Cooper. Cooper. Healing Gardens smith Jane. Health and nature Effects of hospital environment On patient wee-being Kamp Healing environment, Restorative Gardens Dijkstra Stress reducing effect of indoor plants in the built environment Thoday Epstein Use of Garden for disable Therapeutic Gardens in the Acute Garden Bowers Incorporating Experiential l Restorative Qualities Fried Hartig Therapeutic Gardens in the Acute Garden Landscape view and prison response Burt The comfort of nature Calkins. Mooney Kate West From their Perspective Edward

8. Background/Problem Statement The paediatric ward design guidelines and protocols does not allow for the following: - Enabling environment for children feeling of well-being. - Address their needs for comfort and engage them positively. - Lack of facilities that can enhance individual choice, control and self help. - No features to indicate child friendliness, this include age appropriate activities in the environment. - Lack of welcoming and friendly social environment.

9. Playing from elements and materials from “Loose Parts” based on theory, in a planned environment under monitoring can increase their ability to cope with stress, and improve their trust and acceptance of routine medication as a result of the settings. PLAY INTERACTION ACTIVITIES CREATIVE SOCIAL ATTACHMENT INDEPENDENCE EFFICIENCY COMMUNITY S P I C E ACTIVE ADULT RESTORATION PEERS ENVIRONMENT CARE GIVERS FAMILY. Ward as Play Environment Factors Influencing health (Bischoff, 2011)

10. Aim of research To determine an the restorative benefits inherent with play in a paediatric hospital settings, looking at the ward as play environment. Objectives 1 • To identify the importance of using “loose parts” in a hospital setting, and how it affects children restoration and feeling of well-being. • Question • Is there any plan or arrangement used in providing children with indoor play experience in the paediatric hospital wards?

11. Objectives 2 • To develop a model of design using children's views and perception on in cooperating play element and features as part of the hospital environment settings. Question Does a paediatric ward being conceived as a play environment from children's perception have an effect on health outcomes and feeling of well-being.? Hypothesis Play environment as a determining factor to restoration in children paediatric ward, to them its not a ward but a play environment.

12. Methodology • Literature Review on related field of study: • Hypothesis and Theories. • A participatory method (using children, Family and care-givers) UNDERPINNING ANALYSIS FINDINGS

13. THEORY FORMULATION AS BASIS FOR Human Development theory UNDER-PINNING Lev Vygotsky (1896-1934) Jean Piaget (1896-1980) Psychoanalytic theory Behavioral theory Humanistic theory Cognitive theory Sociocultural theory Abraham Maslow (1908-1970) Sigmund Freud (1856-1939) Ivan Parlor (1847-1939) Human Development Carl Rogers (1902-1987) John Watson (1878-1958) Erik Erikson (1902-1994) Jay Appleton (1975) Prospect Refused theory Environmental psychology Attention Restorative theory and Environmental Preference Theory Kaplan and kaplan (1989) Healthcare Stress coping Reduction theory Ulrich, Rogers . S. (1999)

14. The connection between the Human development Theory, Environmental Theory and Health development Theory are as follows: • The prospect Refuge Theory is derived from information processing theory(cognitive) and the response to stimuli in human environment (behavioral). • 2. ART and EPT where developed from the PRT which was form from CT and BT showing the separation of Attention into two components by important of stimuli (involuntary) and Attention is directed by cognitive control process (voluntary). • 3. Stress coping reduction Theories was developed from ART and EPT.

15. Stress coping Reduction Theory: proposed that stress is mitigated when a person perceives unthreading natural environment , and the environment affords him or her the following factors. Sense of security, Sense of control, social support, physical movement and exercise, and Access to nature and positive distraction. Play: Means physical contact with the elements of the environment and social interaction with peers in young children and middle childhood.

17. Usman, Bukar Wakawa bwusman@live.utm.my Thank you