Current practice scenarios
Capturing current (problematic) situations
Based on the explorative methodologies, we gained more insight into the context. Creating scenarios improved our understanding of stakeholders and their needs, which were essential to working on the requirements.
Scenario 1: Child’s Perspective
Charlie has Cystic Fibrosis (CF) and goes to the hospital frequently. One of his parents has CF and at a young age, he had symptoms. He goes to a specialized hospital for treatment when needed, at least every three months he sees a doctor.
One day in the morning, Charlie wakes up with chest pain, he has a bit of difficulty breathing. He does not want to go to the hospital, so he doesn’t tell his parents about it. His parents immediately recognize the symptoms and they drive him to the hospital.
During the ride towards the hospital, Charlie is thinking about the last time he visited the hospital, this makes him afraid because he is thinking about all those tubes which went inside him during that visit. Arriving at the hospital, Charlie stays close to his parents. While walking to the waiting room, he sees those nice playing blocks, where he had so much fun last time. Other children are playing with the blocks and Charlie is currently a bit shy, so he stays with his parents. While waiting, the parents give Charlie a phone to play with. They recognize that Charlie is very withdrawn, playing with the phone should distract him and therefore improve the waiting time. Other children around the hospital are all playing, but Charlie doesn’t have the urge to join them.
During an inspection, the doctor comes inside the room with a present. The doctor, Charlie, and the parents start playing with the toy, after a few moments, Charlie joins in the play. The doctor asks the parents, without Charlie noticing it, to continue the play with Charlie. First, the doctor does some motoric tests based on plays with Charlie. Continuously the doctor does some inspections while Charlie is distracted by play.
The doctor notices some growths in the nose (nasal polyps). Because those are rare for children, and Charlie already had some bad signs, the doctor immediately wants to operate. While preparing for Chirurgie, Charlie and his parents went to a pedagogical expert. This expert tries to explain and prepare what is going to happen. Through the explanation, the expert noticed that Charlie became more and more afraid. Through playing with the tools of the operating room, the pedagogical expert tries to animate in a fun way what is going to happen. Charlie was calmed down by that and the parents were somehow relieved to see that. This way of communication was also clear for the parents in such a stressful situation.
Children are always brought under anesthesia, during the removal of nasal polyps. This was a good thing because Charlie was very nervous and then he could sleep during the operation. The operation was very short, and within a matter of time, Charlie woke up in his bed in the hospital. The parents called the pedagogical expert back to give further information. While Charlie was still somewhat confused waking up, the expert came inside the room with coloured clothes. The coloured clothes instead of white clothes were an indication for Charlie, that he did not have to expect another operation right away. The pedagogical expert gave Charlie his present, which he had before, back. Through the reaction of Charlie, which was no tremendous reaction at all, the expert noticed that Charlie was not feeling well. Through a conversation with the parents alone, the expert said that Charlie should stay for two days. That day, Charlie stayed in bed, not wanting to do anything because he was exhausted and a bit confused because of the resulting pain of the operation.
After waking up the next day, Charlie felt a lot better. He was still a bit tired, but after lunch, he asked if he was allowed to go outside of bed. First Charlie stayed in his room, playing with his own toys. After a few moments, he sneaked outside his room to play with other kids. The pedagogical expert saw this and observed Charlie for a few moments. Charlie was not fully recovered yet, but he showed initiative. Charlie was still playing when the parents came to visit. The pedagogical expert received the parents and showed that it was a good sign to see Charlie play again.
Scenario 2: Role of Play
Aafje had a major operation yesterday, which took a long period of time. Her parents were not able to be with her during the operation but went to Aafje immediately after she left the surgery room.
This was a very depressing experience for them, seeing their little girl being so tired and unreachable. The doctors said that the operation was successful, so the parents were a bit relieved then and went to their rooms to get a bit of sleep. The next morning, they were allowed to visit Aafje at her bed and stayed with her until the moment she woke up. Aafje is still a bit unconscious and not acting as she would, she says that she feels very tired. The nurse in the room confirms her behavior. It makes her parents feel a bit powerless. They feel happy, yet concerned, there is simply not much they can do.
The next day, Aafje is feeling a bit better. Her parents brought an iPad from home so that Aafje is able to spend her time playing games. At home, she would spend many hours playing on this device. Seeing Aafje playing as she does at home, makes her parents feel happy. To their reasoning, this is the best they can do for her at this moment.
The pedagogical employee, however, is not truly satisfied with the situation. Giving the child play as a distraction is very important when it comes to their ability to cope with this overwhelming environment, both for the children and the parent. Still, this could be improved by other types of play. By playing with an iPad, Aafje will stay in her bed for an unnecessarily long period of time. It is time to get her moving and make contact with peers. The employee invites Aafje to play in the living room.
Her parents carefully help Aafje out to bed and guide her to the living room. She is able to play there with peers and starts to interact with some children that are centered around the small kitchen. As Aafje enters a certain flow of playing experience, the employee faces the concerns of the parents and explains that healing includes many different aspects. This is a very diverse process, including physical and social capabilities, but most importantly, the employee’s aim is to let the children play as much as they can, as this will stimulate the development of the child.
After a certain amount of time, Aafje is called by her parents and runs toward them. Just seeing their child become more vital through physical play, makes Aafje’s parents realize that the employee was right and acknowledge their unawareness, they were a bit too stressed about the whole situation to be able to think in a clear way.
Scenario 3: Environment: Wilhelmina Children's Hospital
Tom has to stay in hospital for a while. He stays in a large room with enough space for his visitors like his parents, sister, grandparents, friends, and teacher. There is a playroom where he can play with his sister while his parents talk with the doctor. Sometimes he also plays with other hospitalized children in that room. The hospital has a nature theme; the top floor is like the sky, then it goes lower and lower to the earth and underwater. Different nature elements are considered in the hospital; for example, the main reception desk is a submarine. The hospital has a puppet theater so that children can play with puppets and dolls there. Tom asked his doctor to get permission to go to that gym. He also heard that the hospital has a little gym and swimming pool which sounds interesting. Tom loves sunny days where he can enjoy the delightful sunshine through the big windows of his room; sunny days make him feel better! Although he can play in the playroom with his sister or other children, and sometimes his friends visit him, he misses his friends and school and wants to go back to a normal situation soon.
Sara has a chronic disease so sometimes she has to stay in the hospital under the supervision of doctors. Usually she cannot get out of room because of her health, so she has to play alone in her room. It is so boring for her since she wants to play with other children, but the doctor does not let her get out of bed most of the time. The pedagogical brought her a box with some toys inside and she played with them. Also her mother reads story books for her and they sing songs together.
Scenario 4: Playing With Sister
Bram is 4 years old and has to stay in the hospital for two days due to his tonsils that have been removed. He does not bother that he has to stay in the hospital, his mom is with him and he is allowed to eat as many ice creams as he wants. After his first day, he became used to the situation in the hospital and he started to get a little bored. Ten children are hospitalized at the children's ward, but none of them is at the same age as him. This means that there are no playmates for him, he looks forward to the afternoon when his sister will visit him. He goes to the playroom, to see if there is someone to play with, besides the pedagogical employee no one is there. He quickly takes some toys and goes to his room again to play with them. At 14:00 his sister arrived, they played together the whole afternoon with lego. The day flew by and he was able to go home again.