Is There an Association Between Nurses' Uniform Color and Feelings/Emotions in School-Age Children Receiving Hospital or Ambulatory Healthcare?

Tuesday, 13 July 2010

Nancy M. Albert, PhD, MSN, BSN, RN1
Janie Burke, MBA, BSN, RN2
James F. Bena, MS3
Shannon Morrison, MS4
Jennifer Forney, BSN, RN1
Ellen Slifcak, BSN, RN1
1Nursing Research and Innovation, Cleveland Clinic, Cleveland, OH
2Children's Hospital, Cleveland Clinic, Cleveland, OH
3Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
4Quantitative health Sciences, Cleveland Clinic, Cleveland, OH

Learning Objective 1: discuss associations between 20 emotions and 6 nurse uniform colors in school-age children receiving healthcare

Learning Objective 2: discuss the impact of current anxiety level on associations between uniform color and emotions

Purpose: To examine relationships between pantset uniform colors and feelings/emotions to learn if relationships exist between emotions and uniform color, if state anxiety level alters relationships between emotions and uniform color and preferences in uniform color in school-age children receiving healthcare.

Methods: Prospective, cross-sectional design using surveys measuring participant characteristics, state anxiety, and associations between 6 uniform color options and 20 emotions. Analyses included descriptive statistics and measures of association.

Results: Characteristics of 233 school-aged children treated in a Children’s hospital or ambulatory clinic of a large, Midwest tertiary care center were mean age 12.27 years, 40% boys, 56% hospitalized, 75% Caucasian, and mean anxiety level 1.54 ± 0.28 (low). Seven of 10 positive emotions were most often associated with solid blue, bold pink or yellow patterned uniform tops and least associated with solid white and small flowered print tops (all P ≤0.002). All 10 negative emotions were associated with “uniform color does not matter”, all P<0.001. However, when anxiety level was categorized into three groups, high anxiety participants compared to low anxiety participants were less likely to choose “uniform color does not matter” for the emotions jittery, frightened and bothered (all P≤0.03). No other differences in uniform colors to convey emotions based on anxiety or by subject characteristics were found. Bold pink patterned top (29.4%) and solid blue (28%) top/pant uniforms were preferred; and preferences varied by gender: girls preferred bold pink (44.9%), boys preferred royal blue (44.5%), P<0.001.

Conclusion: While nurses might believe that children fear a nurse wearing a white uniform, school-age children did not associate negative emotions with uniform color. Rather, school-age children associated positive emotions with solid blue or bold pink patterned uniforms and also preferred these same options.