Environmental issues in patient care management: proxemics, personal space, and territoriality.

Patient privacy issues play a significant role in healthcare policy. However, concern for patient privacy may not always carry over into patient care activities. An Association of Rehabilitation Nurses chapter research committee undertook a study to assess rehabilitation nurses' knowledge of proxemics, personal space, and territoriality and their application in rehabilitation nursing practice. The theoretical framework was Hall's 1966 theory of proxemics. A pretest-posttest design with a 1-hour educational intervention was used with a convenience sample of rehabilitation nurses (N = 43). The tests consisted of 12 multiple-choice questions and 1 open-ended question related to practice. Paired-samples t tests of pretest and posttest scores demonstrated improvement in posttest scores (p <.0005). Analyses of variance were conducted to determine whether there were any differences on the posttest scores when looking at education level, years of work experience, years of work experience in rehabilitation nursing, and certification. Higher education levels correlated with higher test scores (p < .005). Although findings are limited by sample size, results indicate that rehabilitation nurses are not familiar with the impact of proxemics. The nurses'application of these principles in the open-ended question indicates that a patient's personal space in a healthcare setting is determined by the nurse, not the patient. The implications that result from a call to action on these issues are discussed.