Cause And Consequence Of Boredom Nursing

The purpose of this independent study is to identify a topic of my choice namely ‘The Cause and Consequence of Boredom: An exploratory study of Patients’ Perceptions within a Psychiatric Inpatient Unit’. A rationale will be given for the chosen topic, a literature review will be carried out and a Research Proposal formulated.Cause And Consequence Of Boredom Nursing

This essay will explore the concept of ‘boredom’ and the factors surrounding this issue, such as the causes, consequences and solutions from a patient’s perspective. These factors will constitute my learning outcomes. On completion of the essay I should be able to demonstrate a better understanding on the topic of boredom and from critically evaluating the literature will gain a more in-depth knowledge of the causal factors, the impact it has on patients and the suggested solutions to the problem identified within the literature. Additionally, on completion of the assignment I will have gained knowledge in writing an academic essay, thoroughly researching a topic utilizing critical analysis of academic literature and completing a research proposal thus achieving the stated outcomes. In completing a learning contract this will improve my incentive to focus on my essay and formulate and develop realistic aims and outcomes. In a study carried out by Wai-chi Chan & Wai-tong (2000) it was found that a learning contract could improve students’ autonomy and control over learning and increased motivation and sharing in learning.Cause And Consequence Of Boredom Nursing

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The rationale for choosing the topic is that as a student within an acute psychiatric admission ward I frequently encounter patients who complain of boredom, and some of the reasons they stated were, ‘having nothing to do’, ‘confinement to the ward’, ‘nothing going on within the ward’, ‘nothing in common with other patients’, amongst other perceived attributable factors. This prompted me to think about the legitimacy of their complaints and consider whether the ward environment was in fact hindering or promoting the patient’s recovery. Craig & Power (2010) highlights the problem of boredom within acute ward settings and the notion that it is bad for the patient’s recovery and that therapeutic intervention tailored to their need should be considered. Similarly, Binnema (2004) suggests that to reduce boredom and enhance the patients’ experience psychological, physical and personal factors which include therapeutic activities, exercise, physical health, financial and housing issues should be addressed during the patient’s hospital stay. Additionally, in consideration of the ward environment I realised that it was rather drab and space was extremely limited. Within the ward there is a large dayroom where social encounters can occur, but it is not conducive to enabling individual or group therapeutic interventions due to the common use of the facilities. Dijkstrak, Pieterse & Pruyn (2006) suggest that there is research to support the notion that the healthcare environment can make a difference to the patient’s recovery. It is therefore important to consider this when supporting patient’s therapy and recovery.

Consequently, it is important for nurses working within an acute environment to consider solution to these problems. Binnema (2004) purports that if nurses had a clear understanding of the concept of boredom, it would support them to enhance their ability to provide a more enhanced therapeutic environment. Therefore, Nurses have a pivotal role to play in improving both the therapeutic relationship with patients whilst ensuring that the environment is conducive to recovery.

From a professional perspective, the Department of Health (2002) published a policy on adult acute inpatient care provision in which they highlighted that high levels of interaction between staff and patients within the ward environment reduce boredom. Furthermore, they stressed that in response to a dearth of research on acute inpatient care there was a need for research in the effectiveness of acute services. Binnema (2004) also highlight that many psychiatric patients experience boredom and lack the opportunity to engage therapeutically within the hospital environment, and indicate therefore that there is a necessity for further research of this concept.Cause And Consequence Of Boredom Nursing

A concept map will be utilized to generate ideas and enable focus and structure within this essay. Concept maps can be used by students to both gain new knowledge and utilize prior knowledge breaking it down into ideas and put the information in order thus making sense of it and the connotations between and among the concepts (Hinck, Sims-Giddens et al, 2006). The central theme within the concept is ‘Boredom’, and this is illustrated along with the sub-themes in (appendix 1). The concept map constructed has particular reference to boredom within an acute psychiatric setting which has been shown to warrant further investigation.

Literature Review

The literature review was performed taking cognizance of the research topic chosen. Cormack (2000) highlights the importance of carrying out a ‘critical review’ of what has been known previously within the literature in order to prepare the ground for new research. A literature search was carried utilizing keywords such as ‘boredom’, ‘acute care’, ‘psychiatric inpatients’, ‘acute mental health’, ‘therapeutic environment’, ‘acute mental health nursing’. A systematic review was carried out within academic journals relating to the topic by accessing databases such as EBSCOhost, CINAHL Plus with Full Tex, Ovid, Science Direct, Wiley InterScience, IngentaConnect, to uncover relevant literature pertaining to the subject and to retrieve up-to-date studies to elucidate what research had already been carried and the value of carrying out further research.

To understand the concept of ‘boredom’ it will be of benefit to review the definition within the literature. Kass et al (2001) support the view that boredom proneness as a multidimensional concept and point out that the literature lacks differentiation between boredom as a ‘trait’ or a ‘state’, but that numerous writers suggest a distinction between ‘situational’ and ‘dispositional’ boredom. This would therefore pose a dilemma for researchers in proposing a solution to the problem. It is of no surprise therefore that concept of boredom has been studied from different perspectives and by diverse factions. Dahlenthe, Martin, Ragan et al (2004) state that boredom has generated a great deal of research in education, psychology, organizational behaviour, accident prevention and medicine.Cause And Consequence Of Boredom Nursing

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Anderson (2005) defines boredom as ‘the death of meaning’. Fahlman et al (2009) support this belief but are more conservative in their view suggesting it is a ‘lack of meaning and purpose’. Barbalet (1999, p.637) further describes boredom as ‘a type or form of anxiety about the lack of meaningfulness of an activity, a condition, and (possibly) a life. These beliefs would suggest that boredom has a significant dispositional component. In contrast, Todman (2003, p.147) describes ‘boredom’ as ‘an unpleasant state that is invariably accompanied by attributions of environmental sameness’, which would imply that it may be attributed to situational factors. As already stated boredom is a multidimensional concept many of which are too complex to address within this essay but those already described can offer a clearer understanding of the concept, that there may be both psychological and environmental components to boredom.

Martin, Sadlo & Stew (2006) state that ‘modern philosophers’ are of the opinion that boredom may arise from ‘over-stimulation’ rather than ‘monotony’ which originated from ‘ancient times’ and attribute this to ‘trivia’ in the modern world. Whereas some studies have suggested that boredom is a result of ‘enforced idleness’ (Meehan, McIntosh & Bergen, 2006). These beliefs would advocate that the origins of boredom may be attributed to environmental factors. Fahlaman et al (2009) have described the relationship between the experience of boredom and negative affect which denotes a psychological phenomenon. It is therefore valid to consider that these could have a significant impact on the behaviour of a patient within an acute inpatient ward. It will be of interest to compare these concepts with the findings from the experiences of the patient’s within an acute inpatient setting.Cause And Consequence Of Boredom Nursing

It is important to consider the impact of boredom within an inpatient setting regardless of the cause. There are significant similarities described within the literature. Beer et al (2001) purport that the negative consequences of overstimulation within acute psychiatric ward settings are violence and aggression. In contrast Stein & Wilkinson (2007) attribute these behaviours to under stimulation. However, Khan et al (1987) suggests that low stimulus within the environment is known to decrease psychotic symptoms in the individual. Bracke (2004) associates the provision of rewarding activities with the reduction of boredom. This would imply that involvement in activities of interest to the individual is a significant factor in reducing boredom. In contemplating these views the consequences are varied and complex and could pose a dilemma within an acute ward setting. Consequently it would appear that individual factors would require to be taken account of when considering the solutions to the problem.

On searching the literature it was found that there was a dearth of studies on the effects of ‘boredom’ within a healthcare setting. However, three studies were found where the researchers carried out research within an acute care psychiatric environment, a high-secure forensic setting and a day activity program in rehabilitation centres in which boredom emerged as a concept of both environmental and individual characteristics of participants in the first two studies, and in the third the determinants of boredom were primarily studied which showed that both environmental and individual factors played a part. These will be discussed respectively taking account of Polit et al (2001) method of critiquing research articles namely, methodological, ethical and interpretive dimensions, and will take account of their relevance to the Research Proposal.Cause And Consequence Of Boredom Nursing