Baring all: the impact of the hospital gown on patient wellbeing

Objectives
The importance of personalized and dignified care is increasingly being recognized in health care policy and practice. Despite the known impact of clothing on social identity and self-expression, the impact of hospital clothing on patient well-being has been widely overlooked. Patients are often required to wear hospital clothing, commonly a backless gown, during medical procedures and surgeries. The impact of wearing patient clothing on well-being, during this time of vulnerability, was explored.

Design
A sequential multi-method approach consisting of two studies.

Methods
Two studies were carried out to consider the impact of the hospital gown on well-being among adults with and without chronic health conditions. The first study consisted of conducting in-depth, semi-structured interviews (n = 10) with adults living with a lifelong chronic health condition (congenital heart disease). The second study was a cross-sectional online survey exploring adults' views (n = 928) and experiences of wearing the hospital gown.

Results
Qualitative analysis identified the following master themes: (1) symbolic embodiment of the ‘sick’ role, (2) relinquishing control to medical professionals, and (3) emotional and physical vulnerability. Quantitative analysis of the online survey data indicated that adults often reported wearing the hospital gown despite a lack of medical necessity. Its design was considered to be not fit for purpose and lacking in dignity.

Conclusions
The implications of these findings for health policy and practice are discussed, emphasizing the importance of challenging cultural norms in health care since dehumanizing aspects of care, as symbolically represented by the hospital gown, may adversely impact on patient well-being.