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Trial registered on ANZCTR
Registration number
ACTRN12622000932763
Ethics application status
Approved
Date submitted
28/06/2022
Date registered
30/06/2022
Date last updated
4/08/2024
Date data sharing statement initially provided
30/06/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Patient Perceptions of Hospital Admission Interviews
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Scientific title
Patient Perceptions of Hospital Admission Interviews
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Secondary ID [1]
307335
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Nil Known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Studies of normal psychology
326621
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Studies of Behaviour
326623
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Dehumanisation
326844
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Quality Improvement of Health Services
326845
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Hospital Admission Experiences
326846
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Condition category
Condition code
Mental Health
323872
323872
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0
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Studies of normal psychology, cognitive function and behaviour
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Public Health
324058
324058
0
0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study aims to investigate the impact of wearing a patient hospital gown on the patient experience, specifically focusing on dehumanisation. The study will also look at the impact of wearing a patient gown on the patient-doctor relationship, and patient behaviour.
The randomised control trial will be a single-centre study conducted at The University of Auckland Grafton Campus.
72 participants for the trial will be recruited from The University of Auckland and wider community via online, email, and poster advertisements. A cover story will be used, whereby participants will be told that the study is looking to evaluate medical admission interview processes and that they will be supporting the researchers in this evaluation via the provision of feedback.
Once the potential participants respond to the advertisements for the study via email, a participant information sheet with study details will be sent to them. Upon meeting eligibility criteria participants will be asked to register via an online booking system to attend a medical interview at a date and time convenient to them. Participants will have a selection of dates and times available to choose from.
Once participants arrive at the research venue, they will be asked to read and sign a written consent form and be given the opportunity to ask any questions they may have about the study. Participants will also complete a baseline questionnaire collecting demographic details. Once paperwork is complete, participants will be randomised to either wear a patient hospital gown or remain in their own clothes. They will not know that there are two groups (gown or normal clothes), only that we are interested in their views of the admission interview. The researcher completing the pre-interview process with participants will be blinded to the randomisation process and will only know which group the participant will be in after opening a sealed envelope with the information post pre-interview procedures. The randomisation will be completed using randomiser.org by the second researcher who will not be present at the research venue during the interviews.
After randomisation of the participants to either the gown wearing or wearing own clothes group, participants will enter the medical interview room to meet the doctor and begin the interview.
The medical interviews will be carried out by either a female or male 5th or 6th year medical student from The University of Auckland. The medical students will be employed by the research team to conduct the interviews. The “doctors” too will be told that they are supporting a study looking to evaluate medical admission interview processes. Their role will be to conduct the interview following a script provided by the researchers. The medical students will be asked to wear what they would normally wear for hospital ward rounds. They will also be asked to sign a confidentiality statement requiring them not to discuss the study, the participants or share their thoughts about the admission interviews with others and each other. The medical interview will follow a standard interview structure and finish by taking the vital signs and listening to heart sounds. Participants will receive either the female or male doctor depending on which gender they identify with. Male participants will see the male medical student, female participants the female medical student and gender diverse participants can choose. The interview times available on the online booking system will reflect availability of the employed medical students and the researcher.
During the medical interview, participants will be asked to answer questions truthfully. It is likely that most participants will not have a specific presenting complaint to share with the medical student, but they will be asked about their current health and symptoms. If the “doctors” have any concerns about the health and wellbeing of the participants following the interview, they will be asked to share these with the researcher who will be able to take the necessary steps to ensure the participant is followed-up, informed and given an opportunity to seek professional support.
During the interview, the conversation between the participant and doctor will be recorded using a voice recorder. This data will later be transcribed and analysed using Linguistic Inquiry and Word Count (LIWC) software post-interview. The blood pressure of participants will also be measured as part of taking the vital signs. After completing the interview with the doctor, participants will be asked to complete The Patient Experience and Feedback Questionnaire.
It is expected that the participants will spend a total of 40 minutes at the clinical research centre. This will include 10 minutes upon arrival spent gowning up if required and completing the baseline questionnaire. The patient-physician consultation is expected to take no more than 20 minutes followed by 10 minutes to complete the post-interview questionnaires. Participants will receive a $20 gift voucher as a gesture of gratitude for volunteering their time for the study as they leave the venue.
Both participants and medical students will be debriefed at the end of the study once all 70 interviews have been completed.
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Intervention code [1]
323844
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Behaviour
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Comparator / control treatment
Half the participants will not be wearing patient hospital gowns. This group will complete the same process as the gown wearing group for the medical interview and completion of questionnaires.
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Control group
Active
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Outcomes
Primary outcome [1]
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Patient Experience and Feedback Questionnaire
This questionnaire looks to identify how the participants felt, their thoughts and emotions during the medical interview. The questionnaire was developed by the researchers based on proposed factors contributing to dehumanising experiences in healthcare settings. There are currently no other questionnaires available that measure experiences of dehumanisation in the context of healthcare.
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Assessment method [1]
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Timepoint [1]
331771
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Measured once, directly after the medical interview.
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Secondary outcome [1]
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Language Analysis
The language used by participants during the interviews will be analysed using LIWC’s student -academic version. Audio recorded language will be transcribed and entered to LIWC. LIWC will read and compare each word in the text to the list of dictionary words and calculate the percentage of total words in the text that match each of the dictionary categories. The study will look at the use of singular first person pronouns and positive/negative emotional language.
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Assessment method [1]
411078
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Timepoint [1]
411078
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Measured once - participant's speech is recorded during the interview, transcribed and analysed.
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Secondary outcome [2]
411079
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Blood Pressure
Blood pressure will be measured as an indicator of physiological arousal. The measure will be taken as part of the vital signs during the interview by the doctor.
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Assessment method [2]
411079
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Timepoint [2]
411079
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Measured once during the interview as part of the vital signs
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Secondary outcome [3]
411293
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Thematic analysis of the open-ended question in the patient experience questionnaire.
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Assessment method [3]
411293
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Timepoint [3]
411293
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This question will be completed once, directly after the medical interview has taken place.
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Eligibility
Key inclusion criteria
To be included in the study participants will have to be at least 18 years of age or older, and be able to speak, read and write in English. Participants will be required to attend the hospital admission interview in-person at The Auckland University Grafton Campus.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Those who cannot read, write or understand English. Those who are not able to attend the in-person interview at the research venue.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants in each arm of the study will be blinded to group allocation because knowledge of their allocation may influence and bias their responsiveness to the intervention. Allocations will be placed into opaque sealed consecutively numbered envelopes. These will be opened by the researcher after the participants have signed informed consent and completed baseline questionnaires. The PIS will state that participants may be asked to wear a gown as per the normal hospital admission process. They will not be told that there are two conditions. Participants will be debriefed along with a summary of the study findings once all statistical analyses are completed and the thesis is submitted.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Blinded (masking used). A computer-generated random list will be used to allocate participants to groups by an independent party.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
A power analysis was carried out using G*Power software with a power level of .80 and a two-tailed significance level of a =.05, with an effect size of d = 0.70. Using these parameters gives a required total sample size of 68. The lack of previous experimental data on gown wearing made an estimation of expected effect size more challenging. Research on the effects of submissive posture on self-esteem and first-person singular pronouns has demonstrated effect sizes of d = 0.79, and d = 1.16 (Nair et al., 2015). Given the study is cross-sectional, attrition does not need to be accommodated, but we will recruit 72 participants in case of missing data.
Descriptive statistics will be used to summarize sociodemographic information and baseline characteristics.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
6/07/2022
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Actual
10/07/2022
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Date of last participant enrolment
Anticipated
24/08/2022
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Actual
9/09/2022
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Date of last data collection
Anticipated
14/09/2022
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Actual
9/09/2022
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Sample size
Target
72
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Accrual to date
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Final
74
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Recruitment outside Australia
Country [1]
24849
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New Zealand
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State/province [1]
24849
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Auckland
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Funding & Sponsors
Funding source category [1]
311626
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University
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Name [1]
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The University of Auckland
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Address [1]
311626
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85 Park Road
Grafton
Auckland 1023
New Zealand
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Country [1]
311626
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New Zealand
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Primary sponsor type
University
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Name
The University of Auckland
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Address
85 Park Road
Grafton
Auckland 1023
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
313063
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None
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Name [1]
313063
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NA
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Address [1]
313063
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NA
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Country [1]
313063
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311082
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Auckland Health Research Ethics Committee
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Ethics committee address [1]
311082
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Auckland Health Research Ethics Committee, The University of Auckland, Private Bag 92019, Auckland 1142
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Ethics committee country [1]
311082
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New Zealand
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Date submitted for ethics approval [1]
311082
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25/05/2022
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Approval date [1]
311082
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27/05/2022
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Ethics approval number [1]
311082
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AH24293
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Summary
Brief summary
Given the importance of clothing in maintaining one’s identity, self-confidence, and self-esteem, it is very important to consider the psychological impact of gown wearing for patients in healthcare settings. This is especially true if patient hospital gown wearing creates an experience of dehumanisation impacting health outcomes. Very limited research currently exists exploring the impact of hospital gowns on dehumanising experiences in healthcare. Hence, this study hopes to extend what is known via conducting experimental research in this area that could allow conclusions around causation to be made more confidently. Using an experimental study design, this research will investigate the extent to which patient attire, specifically the hospital patient gown, contributes to the dehumanisation experience of patients. It is hoped that this study will help raise awareness of the effects gown wearing has on patient psychology. This study aims to investigate the impact of wearing a patient hospital gown on the patient experience, specifically focusing on dehumanisation. The study will also look at the impact of wearing a patient gown on the patient-doctor relationship (through language analysis), and patient blood pressure. Given previous research findings, it is hypothesised that the participants wearing patient hospital gowns will report more thoughts and emotions around the loss of identity, power, and dignity as well as greater identification with the sick role, compared to those participants wearing their usual clothes. It is also hypothesised that participants wearing gowns will behave in similar ways to a subordinate, relinquishing more power to the physician, than participants wearing their usual clothes, as measured by the language used by the participants. Physiological levels of arousal in participants wearing a patient gown may be higher than those of participants in their usual clothes, as measured through blood pressure readings.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Elizabeth Broadbent
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Address
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The University of Auckland
85 Park Road
Grafton
Auckland 1023
New Zealand
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Country
119878
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New Zealand
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Phone
119878
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+64 9 923 6756
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Fax
119878
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Email
119878
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[email protected]
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Contact person for public queries
Name
119879
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Chamilka Punchihewa
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Address
119879
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The University of Auckland
85 Park Road
Grafton
Auckland 1023
New Zealand
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Country
119879
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New Zealand
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Phone
119879
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+64 211329902
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Fax
119879
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Email
119879
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[email protected]
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Contact person for scientific queries
Name
119880
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Chamilka Punchihewa
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Address
119880
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The University of Auckland
85 Park Road
Grafton
Auckland 1023
New Zealand
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Country
119880
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New Zealand
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Phone
119880
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+64 211329902
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Fax
119880
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Email
119880
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
16436
Ethical approval
384205-(Uploaded-22-06-2022-09-54-52)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF