The effect of a non-talking rule on the sound level and perception of patients in an outpatient infusion center.

Emma Zijlstra,Cees P Van Der Schans,Mark P Mobach,Mariët Hagedoorn,Wim P Krijnen,Lars-Peter Kamolz

doi:10.1371/journal.pone.0212804

Abstract

Noise is a common problem in hospitals, and it is known that social behavior can influence sound levels. The aim of this naturally-occurring field experiment was to assess the influence of a non-talking rule on the actual sound level and perception of patients in an outpatient infusion center. In a quasi-randomized trial two conditions were compared in real life. In the control condition, patients (n = 137) were allowed to talk to fellow patients and visitors during the treatment. In the intervention condition patients (n = 126) were requested not to talk to fellow patients and visitors during their treatment. This study measured the actual sound levels in dB(A) as well as patients’ preferences regarding sound and their perceptions of the physical environment, anxiety, and quality of health care. A linear-mixed-model showed a statistically significant, but rather small reduction of the non-talking rule on the actual sound level with an average of 1.1 dB(A). Half of the patients preferred a talking condition (57%), around one-third of the patients had no preference (36%), and 7% of the patients preferred a non-talking condition. Our results suggest that patients who preferred non-talking, perceived the environment more negatively compared to the majority of patients and perceived higher levels of anxiety. Results showed no significant effect of the experimental conditions on patient perceptions. In conclusion, a non-talking rule of conduct only minimally reduced the actual sound level and did not influence the perception of patients.

Highlights

Patients visit an outpatient infusion center for treatments of various diseases, like cancer, vascular diseases, or muscle diseases
Some patients prefer a treatment environment to rest, whereas others prefer a social treatment environment with the opportunity to interact with fellow patients and visitors [1]
The results of this study showed that a rule of conduct reduced the sound level in an outpatient infusion center

Summary

Introduction

Patients visit an outpatient infusion center for treatments of various diseases, like cancer, vascular diseases, or muscle diseases. An increase of 10 dB(A) is generally perceived as twice as loud [18] These intervention studies manipulated multiple variables, such as a restriction of visitors, restriction of staff movements, promotion of closing doors, reduced light intensity, and lowered volume of technical equipment. We hypothesize that patients with a preference for non-talking perceive less anxiety, proximity, crowdedness, and noise, and perceive more environmental satisfaction, privacy, pleasantness of the room, and satisfaction with healthcare treatment when there is a rule of conduct not to talk than when there is no rule of conduct (hypothesis 2). Patients with a preference for talking perceive less anxiety, proximity, crowdedness, and noise, and perceive more environmental satisfaction, privacy, pleasantness of the room, and satisfaction with healthcare treatment when there is no rule of conduct than when there is a rule of conduct not to talk

Participants

Study design

Procedure

Discussion