You don’t have to be a fashionista to know that what you wear impacts how you feel about yourself. Yet, fashion is unrepresented in contemporary psychology. Of the studies that have been done we know that clothing impacts self-esteem (e.g. Creekmore, 1974). Getting dressed is a process of self actualisation in which the individual strives to achieve fusion between the self and the outfit. Yet, hospital clothing can be the opposite, a distinctly failed fusion of self and dress (e.g. Topo and Iltanen- Tähkävuori, 2010). The instruction to wear a backless gown for medical interventions (e.g. for x-rays or theatre) may add to a sense of disempowerment. We know from psychological literature that such loss of control and autonomy can increase vulnerability to post traumatic stress, anxiety and depression. The clothing worn by the attendant medical provider may further any power imbalance between patient-medical professionals which is inconsistent with the ‘Person Centered’ approach advocated by NHS policy to safeguard patients from depersonalised care (Morton, in Press, 2015a, 2015b, 2012). Hospital clothing can also impact on physical health. The recent #EndPJparalysis social media campaign led by NHS-trained nurse, Brian Dolan focused on encouraging patients in hospitals, where possible, to stop wearing their pyjamas or hospital gown based on the idea that wearing pyjamas can reinforce the ‘sick role’ and prevent a speedier recovery.
This concern seems of particular relevance to people living with a serious illness from birth. Heart problems are one of the most common congenital conditions affecting 1 in every 125 live births. Thanks to medical advances there is a growing population of adults living with these conditions. Survival rates have increased from around just 20% in the 40’s to around 90%. This population includes people with a variety of heart conditions varying enormously in complexity and lifelong care is recommended. A growing body of research has shown that people living with congenital heart conditions are more vulnerable to mental health difficulties including anxiety, depression and post-traumatic stress. Studies have shown that one of the main issues for people with congenital heart disease is growing up feeling different. Members of this population frequently have to undergo numerous medical interventions, from infancy, such as ECG’s, ECHO’s, surgeries, cardiac catheterisation, X-Rays, 24 hour heart monitoring, to name a few. For many of these tests and interventions individuals are required to strip off and wear a backless hospital gown which is potentially disempowering during a time of vulnerability. It seems likely that having more choice about clothing may contribute to better humanising medical care and addressing the power imbalance between the ‘patient’ and medical care providers. It would also facilitate feeling more in control about what was happening and enable people to feel more like themselves. We know from research that these are all important protective factors for mental wellbeing (Morton, in Press).
This is why I am excited to be leading a study in collaboration with Aurora Paillard and Zoe Shaughnessy from London College of Fashion, Claire Robinson of Inga Wellbeing, Manos Georgiadis from the University of Suffolk’s Congenital Cardiac Research Centre, The Somerville Foundation and Nicola Cogan of Strathclyde University to explore clothing and wellbeing in the patient journey. We propose to study how clothing could lead to enhancements for patient physical and mental health. Participants will be asked to take part in focus groups to “Explore the lived experience of patients and their relationship with 'patient' clothing”.
Watch this space, We will keep you posted!
Thanks to Zoe Shaughnessy, Aurora Paillard, Claire Robinson, Nicola Cogan & Manos Georgiadis.