Eur Arch Paediatr Dent
DOI 10.1007/s40368-014-0142-z
ORIGINAL SCIENTIFIC ARTICLE
Children’s preferences concerning ambiance of dental waiting
rooms
A. Panda • I. Garg • M. Shah
Received: 9 May 2014 / Accepted: 17 July 2014
Ó European Academy of Paediatric Dentistry 2014
Abstract
Aim Despite many advances in paediatric dentistry, the
greatest challenge for any paediatric dentist is to remove
the anxiety related to a dental visit and have a child patient
to accept dental treatment readily. Minor changes made in
the waiting room design can have a major effect on the way
any child perceives the upcoming dental experience. This
study was carried out to determine children’s preferences
regarding the dental waiting area so as to improve their
waiting experience and reduce their preoperative anxiety
before a dental appointment.
Study design This was a cross-sectional descriptive study
using survey methodology.
Methods A questionnaire designed to evaluate children’s
preferences regarding the waiting room was distributed to
new paediatric patients, aged between 6 and 11 years of
age, attending an outpatient dental facility and was com-
pleted by 212 children (127 males, 85 females).
Statistics The analyses were carried out on cross-tables
using Phi (for 2 9 2 tables) or Cramer’s V (for larger than
2 9 2 tables) to assess responses to the questionnaire items
across age groups and gender.
Results A majority of children preferred music and the
ability to play in a waiting room. They also preferred
natural light and walls with pictures. They preferred
looking at an aquarium or a television and sitting on
A. Panda  M. Shah
Department of Paediatrics and Preventive Dentistry, Pad. Dr.
D. Y. Patil Dental College and Hospital, Sector 7, Nerul,
Navi Mumbai 400 706, Maharashtra, India
I. Garg (&)
Department of Paediatrics and Preventive Dentistry, A.C.P.M.
Dental College and Hospital, Dhule, Maharashtra, India
e-mail: itigarg84@gmail.com
beanbags and chairs and also preferred plants and oral
hygiene posters Repetious.
Conclusions The results obtained from this study may
help the dental team decide on an appropriate design of
their paediatric waiting room so as to make children
comfortable in the dental environment and improve
delivery of health care.
Keywords Waiting area  Children  Music  Playing
Introduction
The importance of first impressions has been documented
for many years. A paediatric waiting room is the first
impression children and their parents receive of a dental
surgery and its services. Patients spend a considerable
proportion of time waiting in hospitals and private prac-
tices. Despite many advances in paediatric dentistry, a
challenge for any paediatric dentist is to remove any anx-
iety related to a dental visit and enable a child patient to
accept the treatment readily. Attractiveness of the physical
environment in the waiting area can help put children at
ease and instill a positive attitude towards the upcoming
dental appointment. Once a child is comfortable in the
dental environment, coping with certain anxiety-producing
stimuli becomes easier, and this helps in delivering effec-
tive and efficient treatment (da Silva Pedro et al. 2007;
Eisen et al. 2008).
Patients frequently base their level of satisfaction with a
dental practice on its receptionist(s) and waiting room.
Studies have shown that the quality of waiting environment
influences the perception of quality of care and caregivers,
that the perception of waiting time is a better indicator of
patient satisfaction than actual waiting time, and that the
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waiting environment contributes to the perception of wait
time (Becker and Douglass 2008; Pati and Nanda 2011). In
fact, the attractiveness of the physical environment in
waiting areas has been shown to be significantly associated
with higher perceived quality and satisfaction, higher
reported positive interaction with staff, and reduction of
patient anxiety (Becker and Douglass 2008).
Silly fatuous statement, adults are usually make the
decisions when choosing the interior design of a waiting
area and the dental surgery. Instead of deciding on a design
based on adult preferences, it can be beneficial to use
studies which focus on what children enjoy as patients.
Hence, this study was carried out to determine children’s
preferences regarding the dental waiting area so as to
improve their waiting experience, reduce their preoperative
anxiety, and to make them more comfortable before a
dental appointment.
Materials and methods
Ethical approval
Before the start of the study, a protocol was approved from
the Ethics Committee of Padm. Dr. D.Y. Patil Dental
College and Hospital. A cross-sectional descriptive study
was conducted of new paediatric patients, aged between 6
and 11 years of age, attending an outpatient dental facility
of the department of paediatric and preventive dentistry of
Padm. Dr. D.Y. Patil Dental College and Hospital, Navi
Mumbai, Maharashtra, India. An informed written consent
was taken from the parents of each child before starting the
survey. A self-completion 16 item questionnaire was
developed to gather data on patients’ opinions on preferred
waiting room design, staff friendliness, and activities
preferred.
A literature search was carried out to find studies
assessing different methods and aids that help adult and
paediatric patients overcome preoperative anxiety and they
were adapted to form the questionnaire which was peer
reviewed to check the understanding and clarity of ques-
tions. A pilot study was conducted by asking 20 children
and members of staff to complete the questionnaire. Both
face- and content-validity were tested in this pilot study.
The participants were asked for their opinions on the
usability and clarity of the questionnaire. The response was
positive but indicated that use of the terms ‘white apron’
and ‘artwork’ was causing some confusion. As a result,
these were replaced with ‘white coat’ and ‘wall with pic-
tures’ respectively, to improve understanding. After this
revision the questionnaires were distributed to consecutive
new patients prior to an initial consultation appointment.
The questionnaire was accompanied by a consent form and
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Eur Arch Paediatr Dent
information sheet for the parents, explaining the purpose of
the research and providing an assurance of confidentiality.
The information sheet also advised parents that their child
was free to abstain at any time from participation if they
chose. Patients were excluded from the study if they were
unable to speak English, illiterate or for any other reason
which would impede their understanding of the question-
naire. The questionnaires were completed in the waiting
area prior to the participants’ appointments and were dis-
pensed by a non-clinical member of staff. The demographic
information collected from the questionnaire included the
child’s age and sex. A copy of the questionnaire is included
in Fig. 1. Sample size was estimated using the formula
(Daniel 1999).
Z 2 Pð 1  PÞ
n ¼
d2
and applying the correction for finite population (Daniel
1999).
N Z 2 Pð 1  P Þ
n0 ¼
d2 ðN  1Þ þ Z 2 Pð1  PÞ
where Z = 1.96, P = 0.5, d = 0.06 and N = 1,000.
Completed questionnaires were collected and passed
blind to an independent statistician where they were ana-
lysed for response frequency and the results tabulated. The
statistical analysis was carried out using Statistical Package
for Social Sciences (SPSS Inc., version 16.0 for Windows).
The analyses were carried out on cross-tables using Phi (for
2 9 2 tables) or Cramer’s V (for larger than 2 9 2 tables)
to assess responses to the questionnaire items across age
groups and gender. Statistical significance was determined
at P \ 0.05.
Results
A total of 212 children (127 males, 85 females) completed
and returned the questionnaire. Of these, 117 children
(55 %) were in the 6–8 years range and 95 children
(44.81 %) were in the 9–11 years range.
Graph 1 shows the statistically significant results
according to gender-based analysis where a significant
difference existed only in reply to six questions. Graph 2
shows the statistically significant results according to age-
based analysis existed in reply to nine questions.
Discussion
The study revealed that children had strong preferences
regarding the waiting room environment. The purpose of
identifying children’s likes and dislikes has to be to make
Eur Arch Paediatr Dent

Fig. 1 Questionnaire on We would be most grateful if you would take a moment to complete the following
children’s preferences regarding questionnaire. Please circle the response which best applies to you:
the dental waiting area
Are you: a. Male b. Female

Which age bracket do you fall into: a. 6-8 years b. 9-11 years

1. Whom would you prefer on the reception table?

a. Male b. Female
2. Would you prefer the receptionist to wear a white coat?
a. Yes b. No
3. Would you like music to be played in the dental waiting area?
a. Yes b. No
4. What kind of music would you prefer to be played in the dental waiting area?
a. Songs b. Poems c. Instrumental music.
5. Would you prefer a scented waiting room?
a. Yes b. No
6. Would you prefer the waiting area to have
a. Natural light b. Artificial light.
7. Would you like the waiting area to have
a. Bare walls b. Walls with pictures c. Does not matter
8. What is your preferred colour of walls for a dental waiting area?
a. Yellow b. Green c. Blue d. Red e. White
9. Would you prefer oral hygiene posters in the dental waiting area?
a. Yes b. No
10. Would you prefer plants in the dental waiting area?
a. Yes b. No
11. What would you prefer to sit on in a dental waiting area?
a. Bean bags b. Chairs c. Couches
12. What would you prefer looking at in the dental waiting area?
a. An aquarium b. A magic mirror c. Television
13. What would you prefer watching on the television in the dental waiting area?
a. Wild life channel b. Cartoon channel
c. Sports channel d. Oral hygiene instructions
14. Would you like to play in the dental waiting area?
a. Yes b. No
15. What would you prefer doing in the dental waiting area while you wait for your turn
to come?
a. Reading books b. Playing board games
c. Drawing on a white board d. Completing a jig saw puzzle
16. Would you like the dentist to receive you and see you off to the dental waiting area?
a. Yes b. No

children more comfortable in the dentist’s office, to reduce
anxiety, and improve the quality of dental visits.
Interaction with staff
The majority of respondents said that they would prefer a
woman receptionist. The first impressions of members of
the dental team based on their gender might affect a child
and could contribute to creating good or bad rapport with
the paediatric patient (Inglehart 2013). Research shows that
children as young as 3 years are well aware of their own
gender identity (Inglehart 2013). By the time they go to
preschool, they have a clear notion of which behaviour is
typical for a woman and which is typical for a man
(Sandberg et al. 1993). A review of the literature did not
reveal any study showing preference of patients for a
specific gender as ancillary staff in dentistry, so direct
comparison of these findings was not possible. Patients’
gender preferences for medical care do exist especially in
fields like gynaecology and obstetrics and urology, but
gender preferences for dental and ancillary care are rarely
acknowledged.

123

Graph 1 Showing results where a significant difference existed based on gender analysis
Graph 2 Showing results where a significant difference existed based on age analysis
A majority of the children preferred the receptionist or
other staff to wear white coats. A Study (Al Sarheed 2011)
has revealed that children may prefer their doctors/physi-
cians or dentists to wear a white coat as they may see it as a
symbol for healing. They may also favour the white coat as
they are conditioned to expect a dentist to be wearing a
white coat due to past experiences and hence expect the
other staff to wear the same. They may also favour a
uniform dress code so that they are able to identify the staff
easily. Studies related to adults in medical literature (Brase
and Richmond 2004) have concluded that patients felt that
this attire portrayed the qualities of cleanliness, profes-
sionalism, and authority in doctors, and the same may
apply to ancillary staff. Individual countries may have
developed specific policy positions or guidance in relation
to ancillary staff uniforms and readers should always refer
to their local organisational policies. A review of the lit-
erature did not reveal any study showing preference of
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Eur Arch Paediatr Dent
patients for white coat worn by ancillary staff, so direct
comparison of these findings was not possible.
When asked whether they would like to be greeted and
met by a dentist in the waiting area, most children
answered they did. The reason for this could be that they
feel cared for and comfortable in the presence of a friendly
dentist. The parents may also feel that their child is getting
personal attention and individual care. A review of the
literature did not reveal any study showing preference of
patients for such dental mannerisms, so direct comparison
was not possible.
Auditory and olfactory aids
A significant majority of the respondents preferred having
music in the dental waiting room. Over the past few decades
there has been a growing interest in the use of music in
healthcare, which has seen it used to achieve a diverse range
Eur Arch Paediatr Dent
of outcomes. Studies in medical settings have found that
day-surgery patients who listen to music during their pre-
operative wait have lower levels of anxiety than patients
who receive routine care (Cooke et al. 2005). In paediatric
dental patients there have been conflicting results with some
studies showing that audio music distraction did not result
in a reduction of pain, anxiety or uncooperative behaviour
during dental procedures, (Aitken et al. 2002) and some
studies showing a reduction in anxiety with music distrac-
tion (Parkin 1981). A review of the dental literature did not
reveal any study showing reduction of pre-operative anxiety
in paediatric dental patients. Given the inexpensive nature
of this intervention, and the lack of adverse effects, music is
recommended as an adjunct to other distraction aids in
paediatric dental waiting rooms.
When asked to choose the kind of music they would
prefer in the waiting area, a majority of the Indian children
listed songs as their preferred choice. Gender-based ana-
lysis revealed that boys preferred songs, whereas girls
preferred instrumental music (statistically significant).
Age-based analysis revealed that the younger age group
preferred songs, whereas the older age group preferred
instrumental music (statistically significant). Aitken et al.
(2002) reported no significant difference in reduction of
pain, anxiety or uncooperative behaviour during paediatric
dental procedures in three groups consisting of an upbeat
music group, a relaxing music group (instrumental) or a no
music group. Megel et al. (1998) found recorded lullabies
to be an effective distraction for reducing overall distress
scores in children receiving routine immunizations. Most
such studies have been conducted during treatment and
results may vary according to age of patients and in dif-
ferent cultures. As there are likely to be children of dif-
ferent ages at any given time in the waiting room, it might
be more appropriate to us non committal instrumental
music.
Aromatherapy has been widely recognised as an effec-
tive stress reduction technique. When asked whether they
would prefer a scented waiting room, less than half of the
children said they did and many felt it did not matter to
them. Previous studies have shown conflicting results
regarding reduction in anxiety by aromatherapy. Mahdi
Jaafarzadeh et al. (2013) investigated the effect of aroma-
therapy with natural essential oil of orange on child anxiety
during dental treatment and concluded that its use could
reduce salivary cortisol and pulse rate due to child anxiety
state, and hence could be effective in reducing anxiety. In
another study (Holm and Fitzmaurice 2008), determining
the effect of music and aromatherapy on anxiety levels of
adults accompanying children to a paediatric emergency
department waiting area, no difference in anxiety levels
was found on days when aromatherapy was present com-
pared with the non-aromatherapy days although the authors
do state that it could be due to environmental conditions or
imprecise application of the aromatherapy. Another study
(Lehrner et al. 2000) found that patients who were exposed
to orange fragrences had a lower level of state anxiety, a
more positive mood, and a higher level of calmness while
waiting for dental treatment. In the present study, the
respondents were in a non-scented environment. The
results may have differed had they been exposed to both a
scented and a non-scented environment and then asked to
decide which one they preferred.
Waiting room design
Light and colour are two aspects that can have the greatest
overall effect on a patient’s well being (McKahan 1993). A
majority of the children preferred natural light in the
waiting area. Studies in the medical literature (Diffey and
Storey 1988; McKahan 1993; Benedetti et al. 2001) sug-
gest that artificial light, in the absence of natural light, can
lead to fatigue, depression, and elevated systolic blood
pressure. Conversely, exposure to natural sunlight is
associated with improvement in mood and sleep, as well as
decreased use of pain medication and possibly even shorter
lengths of hospital stay for some patients. A review of
literature did not reveal any studies related to the effect of
light on dental patients so direct comparison of these
findings was not possible.
A majority of the children preferred walls with pictures
or artworks compared to bare walls. Age-based analysis
revealed that majority of the younger age group (70.1 %)
preferred walls with pictures whereas the older age group
preferred plain walls (44.2 %) or it did not matter to them
(32.6 %) (statistically significant). Gender-based analysis
did not reveal any significant results. These results are
consistent with previous studies in medical literature (Eisen
et al. 2008; Nanda et al. 2009) which found that children
appear to have varying preferences of artwork based upon
their ages. Eisen et al. (2008) found that nature art is the
preferred type of art by children aged 5–17, but it did not
have any healing effects on paediatric patients when
compared to abstract art or no art at all. Another study
(Nanda et al. 2009) surveyed 64 hospitalized children
concerning their artwork inclinations and concluded that
the combination of bright colours, engaging themes, and
nature content was rated highly by paediatric patients but
paediatric preferences vary significantly among the differ-
ent age groups, and child art, typically used in paediatric
wards, is better suited for younger children than for older
children. A review of literature did not reveal any studies
related to the effect of artwork on dental paediatric patients
so direct comparison of these findings was not possible.
Artwork and décor can be a distraction for patients and
family members and can put them at ease while they wait
123

for an appointment or diagnosis. Very often, art in the
waiting room may be outdated pieces from dentists’s home
or a collection of non-cohesive artwork. Artwork for pae-
diatric healthcare settings should be carefully and inten-
tionally chosen; most importantly, it should ease tension
and distract patients. Studies in medical literature indicate
that artwork that is realistic, bright and that utilises a nat-
ural setting is typically the artwork-of-choice for all age
categories of paediatric patients.
Research has shown that colour has an effect on both the
pituitary and thyroid glands and can influence the way we
feel. A majority of the respondents preferred yellow and
blue colour for the walls of the waiting room, as compared
to green, red or white. These results are consistent with a
previous study (Umamaheshwari et al. 2013) which eval-
uated the association between colour and emotions of
children in a paediatric dental setting and found that chil-
dren preferred yellow followed by blue for positive emo-
tions and black followed by red for negative emotions. In
medical literature, there have been conflicting results with
studies showing green, blue, yellow and orange as the most
preferred colours (Cimbalo et al. 1978; Park 2009). It has
been suggested that children do not prefer the colour red in
clinics or hospitals since they tend to associate it with the
colour of blood, hence increasing their anxiety before a
dental visit.
A majority of the Indian children in this study, irre-
spective of gender or age, preferred oral hygiene posters in
the dental waiting area. Research indicates that health
information framed in a poster presentation may be an
effective method of knowledge transfer, and posters in the
waiting room can increase awareness of health promotion
issues (Ward and Hawthorne 1994). The findings of this
study conflicted with a study on adolescent patients (Fitz-
gerald et al. 2004) which found that adolescents particu-
larly disliked posters in the dental waiting area that showed
‘gross pictures of people without teeth and other stuff’ and
were a particularly unpleasant aspect that caused serious
discomfort. This difference in results could be due to the
fact that the sampled population in the latter survey con-
sisted of adolescents (age range 13–18 years) and that the
children in the present survey were not exposed to any
posters with unpleasant pictures. An intermediary solution
can be that the dental team put up only those posters that
show people with healthy smiles.
The results indicated that a majority of the children,
irrespective of gender or age, preferred plants in the
waiting area. The range of benefits that has been docu-
mented to indoor plants is broad: air quality is improved,
stress and pain are reduced, recovery from illness is faster,
mental fatigue is reduced, mood is lifted, and productivity
is higher (Park and Mattson 2009). A review of the liter-
ature did not reveal any study on preference of paediatric
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Eur Arch Paediatr Dent
dental patients for plants in the waiting area and so direct
comparison of these findings was not possible.
The children preferred to sit on beanbags and chairs than
on couches. A review of literature did not reveal any study
on preference of patients for a particular type of seating
furniture. While selecting the furniture for a waiting room,
the dental team should keep in mind that it should be easy
to clean and be comfortable, not only for the children, but
also for their accompanying parents.
Activities
A majority of the respondents preferred playing in the
dental waiting area. These findings are consistent with
previous studies in medical literature that have found that
pre-operative anxiety is reduced when children participate
in playful activities in the waiting area, helping the child to
become pleasenter and relaxed, besides acting as a facili-
tator for interaction and communication among health
professionals, children and their companions (da Silva
Pedro et al. 2007; Weber 2010).
A majority of the respondents preferred to look at an
aquarium or a television in the waiting area. Previous
research has demonstrated that looking at an aquarium or
images of fish underwater in a dental surgery waiting room,
produces greater relaxation in paediatric patients compared
to other intervention techniques (Katcher et al. 1984). A
review of literature did not reveal any study showing
preference of children for televisions or specific channels
on televisions in waiting rooms. This study revealed that
males preferred watching cartoons followed by sports,
whereas females preferred cartoons followed by oral
hygiene instructions (statistically significant). Age-based
analysis revealed that irrespective of age children preferred
watching cartoons followed by wildlife and sports. The
dental team should review the type of material that is
shown on television to check whether it is age-appropriate
or not. In case the team decides to use cartoons, it might be
a good idea to use those which do not require a sound track
so as not to disturb the patients who are reading or engaged
in other activities. A Wildlife channel might also be a good
option since it can interest both the children as well as their
parents. Televisions can be a good way to distract children
who are too young to read or where the waiting area is too
small for the children to indulge in playful activities.
A majority of the children preferred to read books fol-
lowed by drawings in the waiting area. A review of the
literature did not reveal any study showing preference of
children for a particular activity in the waiting area. All
options may be used to keep the children busy while
waiting. Research in medical literature has demonstrated
that books and magazines in waiting rooms can be con-
taminated with potentially pathogenic bacteria (Charnock
Eur Arch Paediatr Dent
2005). Though this has more significance in medical
waiting rooms where there are greater chances of patients
having infectious diseases, nevertheless dental teams
should keep changing books and magazines after regular
intervals, to minimize chances of contamination as well as
to introduce recent material.
Conclusions
Children do have strong preferences related to the dental
waiting area.The findings may help the dental team decide
the appropriate design of the paediatric waiting room so as
to make children comfortable in the dental environment
and improve delivery of health care. Introducing distrac-
tions that children prefer in the dental waiting area, such as
books, music, aquarium, etc., can help relax them and can
reduce anxiety related to the upcoming dental visit.
References
Aitken JC, Wilson S, Coury D, Moursi AM. The effect of music
distraction on pain, anxiety and behavior in paediatric dental
patients. Pediatr Dent. 2002;24(2):114–8.
Al Sarheed M. Children’s perception of their dentists. Eur J Dent.
2011;5:186–90.
Becker F, Douglass S. The ecology of the patient visit: physical
attractiveness, waiting times, and perceived quality of care.
J Ambul Care Manag. 2008;31(2):128–41.
Benedetti F, Colombo C, Barbini B, Campori E, Smeraldi E. Morning
sunlight reduces length of hospitalization in bipolar depression.
J Affect Disord. 2001;62(3):221–3.
Brase GL, Richmond J. The White–coat effect: physician attire and
perceived authority, friendliness, and attractiveness. J Appl Soc
Psychol. 2004;34:2469–81.
Charnock C. Swabbing of waiting room magazines reveals only low
levels of bacterial contamination. Br J Gen Pract. 2005;
55(510):37–9.
Cimbalo RS, Beck KL, Sendziak DS. Emotional toned pictures and
color selection for children and college students. J Gen Psychol.
1978;133:303–4.
Cooke M, Chaboyer W, Schluter P, Hiratos M. The effect of music on
preoperative anxiety in day surgery. J Adv Nurs. 2005;52(1):
47–55.
Daniel WW. Biostatistics: A Foundation for Analysis in the Health
Sciences. 7th ed. New York: Wiley; 1999.
da Silva Pedro IC, Nascimento LC, Poleti LC, et al. Playing in the
waiting room of an infant outpatient clinic from the perspective
of children and their companions. Rev Lat Am Enferm.
2007;15(2):290–7.
Diffey BL, Storey A. Light and length of stay in hospital. J R Soc
Med. 1988;81(11):643.
Eisen SL, Ulrich RS, Shepley MM, Varni JW, Sherman S. The stress-
reducing effects of art in paediatric health care: art preferences of
healthy children and hospitalized children. J Child Health Care.
2008;12(3):173–90.
Fitzgerald RP, Thomson WM, Schafer CT, Loose MA. An explor-
atory qualitative study of Otago adolescents’ views of oral health
and oral health care. N Z Dent J. 2004;100(3):62–71.
Holm L, Fitzmaurice L. Emergency department waiting room stress:
can music or aromatherapy improve anxiety scores? Pediatr
Emerg Care. 2008;24(12):836–8.
Inglehart MR. Interactions between patients and dental care providers:
does gender matter? Dent Clin North Am. 2013;57(2):357–70.
Jafarzadeh M, Arman S, Pour FF. Effect of aromatherapy with orange
essential oil on salivary cortisol and pulse rate in children during
dental treatment: a randomized controlled clinical trial. Adv
Biomed Res. 2013;2:10.
Katcher A, Segal H, Beck A. Comparison of contemplation and
hypnosis for the reduction of anxiety and discomfort during
dental surgery. Am J Clin Hypn. 1984;27(1):14–21.
Lehrner J, Eckersberger C, Walla P, Pötsch G, Deecke L. Ambient
odor of orange in a dental office reduces anxiety and improves
mood in female patients. Physiol Behav. 2000;71(1–2):83–6.
McKahan DC. Healing environments: healing by design-therapeutic
environments for healthcare. J Healthc Des. 1993;5:159–66.
Megel ME, Houser CW, Gleaves LS. Children’s responses to
immunizations: Lullabies as a distraction. Issues Compr Pediatr
Nurs. 1998;21(3):129–45.
Nanda U, Chanaud CM, Brown L, Hart R, Hathorn K. Paediatric art
preferences: countering the ‘‘one-size-fits-all’’ approach. HERD.
2009;2(4):46–61.
Park JG. Color perception in paediatric patient room design: healthy
children vs. paediatric patients. HERD. 2009;2(3):6–28.
Park SH, Mattson RH. Ornamental indoor plants in hospital rooms
enhanced health outcomes of patients recovering from surgery.
J Altern Complement Med. 2009;15(9):975–80.
Parkin SF. The effect of ambient music upon the reactions of children
undergoing dental treatment. ASDC J Dent Child. 1981;
48(6):430–2.
Pati D, Nanda U. Influence of positive distractions on children in two
clinic waiting areas. HERD. 2011;4(3):124–40.
Sandberg DE, Meyer-Bahlburg HF, Ehrhardt AA, Yager TJ. The
prevalence of gender-atypical behavior in elementary school
children. J Am Acad Child Adolesc Psychiatry. 1993;32(2):306–14.
Umamaheshwari N, Asokan S, Kumaran TS. Child friendly colours in
a paediatric dental practice. J Indian Soc Pedod Prev Dent.
2013;31(4):225–8.
Ward K, Hawthorne K. Do patients read health promotion posters in
the waiting room? A study in one general practice. Br J Gen
Pract. 1994;44(389):583–5.
Weber FS. The influence of playful activities on children’s anxiety
during the preoperative period at the outpatient surgical center.
J Pediatr (Rio J). 2010;86(3):209–14.
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