Hektoen International

A Journal of Medical Humanities

Boredom in hospitalized patients

Aditi Mahajan
Sana Rahman
Washington D.C., United States

On Painting. Oil on canvas, Bryan Charnley, 1987. Welcome Collection. CC BY-NC 4.0

On my medical school psychiatry rotation, we were asked to see a patient who had many medical problems. After rounding on him for a week, we realized that he was suffering from sheer boredom. He was in a foreign country where nobody spoke his native language, had limited familial support, and had been bedbound for months. He had been pushed from room to room and from floor to floor with nothing to entertain him. Rather than the typical medical recommendations, we realized that the best way we could support this patient was through building a relationship and engaging him in recreational activities.

A 2021 integrative review suggests that hospitalizations negatively affect patients’ abilities to cope and adjust.1 ICU patients, in particular, are noted to have a sharp decline in emotional, functional, and physical well-being, in part because of the socially isolated environment.2 Feelings of powerlessness are commonly reported, and the longer patients are hospitalized, the worse they cope psychologically.3 Depression scores increase, while psychosocial skills, problem solving, and cognitive abilities decline.4

The phenomenon of “boredom” in hospital settings was well-documented. In a 1996 study of cancer patients, 86% reported they had time on their hands, and 50% stated they were bored.5 In another study of 160 stroke survivors in rehabilitation settings, 39% reported being “highly bored,” with depression and less socialization correlating with higher boredom levels.6 Acknowledging that patient wellbeing is an amalgamation of physical health and emotional health, we as future providers must draw attention to the deficits in care as well as take tangible steps to mitigate them.

For patients in the hospital, having avenues to express creativity, exercise the mind, and connect with other people can be highly grounding. Books, music, art, and movement are good for body, mind, and soul, and yet many hospitalized patients lack access to these activities. Arts in medicine has become a growing movement, a way for patients to take control of their thoughts and channel them into something meaningful while in the hospital.7 Historically, the arts and medicine movement has been focused on pediatric or cancer patient populations. However, expanding the movement to other hospitalized patients—notably in the ICU and rehabilitation centers—can help best serve these patient populations.

Hospitals have the ability to mobilize resources by partnering with local arts organizations, libraries, and volunteers. The benefit is twofold: it engages community groups as well as directly improving patient well-being. Medical students can also play a critical role in this process. They may be able to provide an additional level of company, care, and emotional support to patients. Building connections with patients includes conversation, but may also include activities such as playing games, reading, or participating in art projects to stave off the boredom.

For the patient on my psychiatry service, a week of afternoon coloring book sessions and frequent check-ins brought a new sense of light to his situation. Being engaged in a recreational activity that helped him feel both mentally and physically supported, he felt a little more equipped to move forward in his medical journey. Adding art therapy and human connection to patients’ hospital experiences can ensure an experience aimed at healing them holistically.

References

  1. Alzahrani N. The effect of hospitalization on patients’ emotional and psychological well-being among adult patients: An integrative review. Applied Nursing Research. 2021;61:151488. doi:https://doi.org/10.1016/j.apnr.2021.151488
  2. Chiarchiaro J, Olsen MK, Steinhauser KE, Tulsky JA. Admission to the Intensive Care Unit and Well-being in Patients With Advanced Chronic Illness. American Journal of Critical Care. 2013;22(3):223-231. doi:https://doi.org/10.4037/ajcc2013346
  3. Incalzi RA, Gemma A, Capparella O, Muzzolon R, Antico L, Carbonin PU. Effects of Hospitalization on Affective Status of Elderly Patients. International Psychogeriatrics. 1991;3(1):67-74. doi:https://doi.org/10.1017/s1041610291000534
  4. Raps CS, Peterson C, Jonas M, Seligman ME. Patient behavior in hospitals: helplessness, reactance, or both? Journal of Personality and Social Psychology. 1982;42(6):1036-1041. doi:https://doi.org/10.1037//0022-3514.42.6.1036
  5. Hyland C, F Labrom, Eardley A, Rawling C. Cancer care. Fighting the yawn factor. PubMed. 1996;106(5506):30-31.
  6. Kenah K, Bernhardt J, Spratt NJ, Oldmeadow C, Janssen H. Depression and a lack of socialization are associated with high levels of boredom during stroke rehabilitation: An exploratory study using a new conceptual framework. Neuropsychological Rehabilitation. 2022;33(3):1-31. doi:https://doi.org/10.1080/09602011.2022.2030761
  7. Daunt T. Creating art during cancer treatment allows patients to express challenging emotions. Uclahealth.org. Published March 19, 2024. Accessed November 22, 2024. https://www.uclahealth.org/news/article/creating-art-during-cancer-treatment-allows-patients-express

ADITI MAHAJAN, M. Ed, Georgetown University School of Medicine 

SANA G. RAHMAN, B.A., Georgetown University School of Medicine 

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