Date Published: June 13, 2018
Publisher: Public Library of Science
Author(s): Caroline Roveri Marin, Renata Cristina Gasparino, Ana Claudia Puggina, Yu Ru Kou.
1) To identify the patient’s perception of invasion of territorial and personal space and 2) to evaluate whether personal characteristics, housing conditions and characteristics of the hospital unit affect this perception.
Analytical, cross-sectional and quantitative study. An adapted version of the “Anxiety Due to Territory and Space Intrusion Questionnaire” was applied with patients hospitalized in the internal medicine and maternity wards and in the ward for patients with private health insurance of a university hospital in the state of São Paulo.
The sample consisted of 300 patients. The mean total score of the questionnaire administered was 143.58 (SD = 18.88). The mean subscale scores for territorial space and personal space invasion were 89.10 (SD = 15.29) and 54.48 (SD = 10.58), respectively. The invasion of territorial space differed significantly between patients with and without children (p = 0.02) and for the number of people living in the residence (p < 0.01). Attitudes of the nursing staff, such as touching the patient’s possessions without permission and exposing the patient, caused discomfort and violated patient privacy. Patients who were lonelier and had more privacy at home perceived greater invasion of their territorial space by the nursing professionals.
The social meaning of space, i.e., how humans consciously or unconsciously structure their own space and its influences on interpersonal relationships, is studied by proxemics , which defines three types of space: fixed feature space (e.g., walls), semi-fixed feature space (e.g., arrangement of furniture, obstacles and decoration), and informal space (e.g., personal territory around an individual’s body) [1–2]. With respect to informal features, every human being have a private space around himself/herself, the size of which depends on the population density of the place where he/she was raised. The space of a person is therefore culturally determined  and, regardless of how much a person tries, it is impossible to disregard his/her culture as this determines how an individual perceives the world .
A cross-sectional, analytical and quantitative study was conducted at a public hospital in the interior of the state of São Paulo, in the internal medicine and maternity wards and in the ward for patients with private health insurance. The internal medicine ward has 22 beds and mainly attends patients undergoing minor surgeries in the hospital. The ward comprises 5 rooms with 2 beds and 2 rooms with 6 beds sharing the same physical space. The maternity ward has 34 beds and attends pregnant and postpartum women and newborns, having 11 rooms with 2 beds and 3 rooms with 6 beds. The ward for private patients has 16 beds divided into 8 rooms with 2 beds each.
The sample was composed of 300 patients, with a mean age of 30.9 years (SD = 7.8). There was a predominance of women (n = 279; 93%), married subjects (n = 122; 40.7%), patients with complete high school education (n = 166; 55.5%), and patients who had children (n = 262; 87.3%). The majority of participants were hospitalized in the maternity ward in the rooms with six beds (n = 126; 42%) (Table 1).
The greater perception of territorial invasion is probably due to the fact that patients are somehow prepared for personal invasion in the hospital as they are aware that the approximation by unknown people to perform procedures and to touch their body is part of the treatment. However, territorial invasion is less tolerated since the instinctive drive is stronger, directing the control to personal possessions. Territorial invasion could have been unconsciously interpreted by the patients as a threat due to their vulnerable and dependent condition. In fact, other authors  have reached a similar conclusion regarding the more frequent occurrence of work activities in the patients’ room.
The patients felt their space invaded in the hospital environment; with this perception of invasion being greater regarding the territorial space than the personal space.