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ORCID

Randall Vanadisson:https://orcid.org/0009-0004-0452-3447

Abstract

The significance of environmental design in emergency department (ED) waiting areas is increasingly acknowledged as a vital element affecting patient experience and stress levels, especially among veterans who may already encounter heightened psychological susceptibility. Aim: To investigate the impact of a non-operational television (TV) at a veteran's medical center emergency department waiting area on patient behavior, perceived stress, and environmental involvement. Methods: This naturalistic observation study employed non-participatory observation of 19 patients in the waiting area of a Veterans Affairs hospital. Field notes captured behavioral responses, seating patterns, and nonverbal stress cues. Observable engagement with the physical environment, particularly with inactive TV, was measured by the frequency of glances, seating preferences, social interactions, and signs of stress or coping behavior. Results: Patients repeatedly engaged with the turned-off TV (TOT), indicating an ingrained expectation for passive distraction. No patients requested the TOT be turned on, yet their behavior suggested its absence was noticed and possibly missed. Conclusion: This study provides preliminary observational evidence that a TOT, far from being a neutral absence, actively influences how patients interact with the environment and with one another. The findings support further mixed-methods or experimental studies to determine whether the removal or replacement of passive media can enhance patient-centered care and inform emergency department design policy.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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