Interdisciplinary Journal of Nursing and Health (eISSN 3103-537X) continues Infermieristica Journal (eISSN 2785-7018).
Boredom and Health Literacy in Adolescents and Their Parents During Acute Hospitalization: Protocol for a Monocentric Observational Study
PDF

Keywords

Hospitalization
Health Literacy
Pediatrics
Adolescent
Boredom

How to Cite

Boredom and Health Literacy in Adolescents and Their Parents During Acute Hospitalization: Protocol for a Monocentric Observational Study. (2026). Interdisciplinary Journal of Nursing and Health, 5(2), 92-99. https://doi.org/10.82051/ijnh-2026-262

Abstract

Introduction. Adolescence is a critical developmental period characterised by profound physical, psychological, and social changes. Hospitalisation for acute illness may increase adolescents’ vulnerability, particularly when care pathways are not tailored to their specific needs. Among the emotional experiences reported during hospital stays, boredom has emerged as a frequent yet understudied phenomenon in adolescents. At the same time, hospitalisation may represent an opportunity to enhance health literacy, a key competence influencing adolescents’ current and future health behaviours. Understanding the relationship between boredom and health literacy may support the development of patient-centred interventions aimed at improving the hospital experience.

Methods. This is a single-centre, cross-sectional observational study conducted in the paediatric ward of Lodi Hospital (Italy). Adolescents aged 12–17 years hospitalised for acute medical or surgical conditions and one accompanying parent will be consecutively enrolled. Adolescent boredom will be assessed daily using the Multidimensional State Boredom Scale – Italian Adolescent Version, while parental boredom will be measured using the adult version of the same scale. Health literacy will be evaluated on the first day of hospitalisation using the Health Literacy for School-Aged Children (HLSAC) scale. Descriptive and inferential statistical analyses will be performed to explore predictors and associations.

Results. The study is expected to provide the first quantitative evidence on boredom levels among hospitalised adolescents and their parents, as well as adolescents’ health literacy levels. Associations between boredom, health literacy, and contextual factors may emerge, identifying subgroups at higher risk.

Discussion. Findings will contribute to a better understanding of the adolescent hospital experience and inform the development of targeted interventions to improve emotional well-being, engagement, and quality of care in paediatric settings.

PDF

References

Alderman, E. M., Breuner, C. C., & COMMITTEE ON ADOLESCENCE. (2019). Unique Needs of the Adolescent. Pediatrics, 144(6), e20193150. https://doi.org/10.1542/peds.2019-3150

Ben-Tovim, D. I., Dougherty, M. L., O’Connell, T. J., & McGrath, K. M. (2008). Patient journeys: The process of clinical redesign. The Medical Journal of Australia, 188(S6), S14-17. https://doi.org/10.5694/j.1326-5377.2008.tb01668.x

Ceylan, D., Akan-Çelen, F. N., Özkan, S., & Aycan, Z. (2022). Promoting adolescent health: Health literacy, self-efficacy and internet use. The Turkish Journal of Pediatrics, 64(1), 110–121. https://doi.org/10.24953/turkjped.2021.1264

Craparo, G., Faraci, P., Gori, A., Hunter, J. A., Hunter, A., Pileggi, V., Costanzo, G., Lazzaro, A., & Eastwood, J. D. (2017). Validation of the Italian version of the Multidimensional State Boredom Scale (MSBS). Clinical Neuropsychiatry, 14(2).

Fahlman, S. A., Mercer-Lynn, K. B., Flora, D. B., & Eastwood, J. D. (2013). Development and validation of the multidimensional state boredom scale. Assessment, 20(1), 68–85. https://doi.org/10.1177/1073191111421303

Fleary, S. A., Joseph, P., & Pappagianopoulos, J. E. (2018). Adolescent health literacy and health behaviors: A systematic review. Journal of Adolescence, 62, 116–127. https://doi.org/10.1016/j.adolescence.2017.11.010

Hybschmann, J., Sørensen, J. L., Thestrup, J., Pappot, H., Boisen, K. A., Frandsen, T. L., & Gjærde, L. K. (2024). MyHospitalVoice - a digital tool co-created with children and adolescents that captures patient-reported experience measures: A study protocol. Research Involvement and Engagement, 10(1), 49. https://doi.org/10.1186/s40900-024-00582-2

Kirwan, L., Apriyanti, E., Sheaf, G., DeVries, J., & Coyne, I. (2025). Experiences of Care for Adolescents With Mental Health Difficulties in Acute Paediatric Services: A Systematic Review. Journal of Clinical Nursing, 34(10), 4038–4054. https://doi.org/10.1111/jocn.17861

Larson, E., Sharma, J., Bohren, M. A., & Tunçalp, Ö. (2019). When the patient is the expert: Measuring patient experience and satisfaction with care. Bulletin of the World Health Organization, 97(8), 563–569. https://doi.org/10.2471/BLT.18.225201

Liuzzi, L., Pine, D. S., Fox, N. A., & Averbeck, B. B. (2023). Changes in Behavior and Neural Dynamics across Adolescent Development. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience, 43(50), 8723–8732. https://doi.org/10.1523/JNEUROSCI.0462-23.2023

Maiandi, S., Gualandi, R., De Benedictis, A., Gulotta, N., Zottarel, G., Giacchero, R., Cibra, C., Ivziku, D., & Tartaglini, D. (2026). The hospital patient journey experience from adolescents’ perspective: A multimethod study. Journal of Pediatric Nursing, 87, 451–459. https://doi.org/10.1016/j.pedn.2026.01.045

Massey, P. M., Prelip, M., Calimlim, B. M., Quiter, E. S., & Glik, D. C. (2012). Contextualizing an expanded definition of health literacy among adolescents in the health care setting. Health Education Research, 27(6), 961–974. https://doi.org/10.1093/her/cys054

Massimo, L., Rossoni, N., Mattei, F., Bonassi, S., & Caprino, D. (2016). Needs and expectations of adolescent in-patients: The experience of Gaslini Children’s Hospital. International Journal of Adolescent Medicine and Health, 28(1), 11–17. https://doi.org/10.1515/ijamh-2014-0070

Nordlind, A., Sundqvist, A.-S., Anderzén-Carlsson, A., Almblad, A.-C., & Ängeby, K. (2022). How paediatric departments in Sweden facilitate giving children a voice on their experiences of healthcare: A cross-sectional study. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy, 25(1), 384–393. https://doi.org/10.1111/hex.13396

Puntoni, M., Caminiti, C., Maglietta, G., Lanari, M., Biasucci, G., Suppiej, A., Marchetti, F., De Fanti, A., Caramelli, F., Iughetti, L., Ghizzi, C., Valletta, E., Vergine, G., Stella, M., Campana, B., Fainardi, V., Deolmi, M., Esposito, S., & Emilia-Romagna Paediatric COVID-19 Network. (2025). Pediatric healthcare service utilization after the end of COVID-19 state of emergency in Northern Italy: A 6-year quasi-experimental study using interrupted time-series analysis. Frontiers in Public Health, 13, 1575047. https://doi.org/10.3389/fpubh.2025.1575047

Samaranayake, P., Dadich, A., Fitzgerald, A., & Zeitz, K. (2016). Developing an evaluation framework for clinical redesign programs: Lessons learnt. Journal of Health Organization and Management, 30(6), 950–970. https://doi.org/10.1108/JHOM-07-2015-0109

Schulenkorf, T., Sørensen, K., & Okan, O. (2022). International Understandings of Health Literacy in Childhood and Adolescence-A Qualitative-Explorative Analysis of Global Expert Interviews. International Journal of Environmental Research and Public Health, 19(3), 1591. https://doi.org/10.3390/ijerph19031591

Spoto, A., Iannattone, S., Valentini, P., Raffagnato, A., Miscioscia, M., & Gatta, M. (2021). Boredom in Adolescence: Validation of the Italian Version of the Multidimensional State Boredom Scale (MSBS) in Adolescents. Children (Basel, Switzerland), 8(4), 314. https://doi.org/10.3390/children8040314

Tetteh-Quarshie, S., & Risher, M.-L. (2022). Adolescent brain maturation and the neuropathological effects of binge drinking: A critical review. Frontiers in Neuroscience, 16, 1040049. https://doi.org/10.3389/fnins.2022.1040049

Trbovich, P., & Vincent, C. (2019). From incident reporting to the analysis of the patient journey. BMJ Quality & Safety, 28(3), 169–171. https://doi.org/10.1136/bmjqs-2018-008485

Vargas-Rubilar, J., Richaud, M. C., Balabanian, C., & Lemos, V. (2023). Parenting, Gender, and Perception of Changes in Children’s Behavior during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 20(15), 6452. https://doi.org/10.3390/ijerph20156452

Vega-Díaz, M., González-García, H., & de Labra, C. (2023). Influence of parental involvement and parenting styles in children’s active lifestyle: A systematic review. PeerJ, 11, e16668. https://doi.org/10.7717/peerj.16668

Velasco, V., Gragnano, A., Gruppo Regionale Hbsc Lombardia, null, & Vecchio, L. P. (2021). Health Literacy Levels among Italian Students: Monitoring and Promotion at School. International Journal of Environmental Research and Public Health, 18(19), 9943. https://doi.org/10.3390/ijerph18199943

Vuyk, A., Montania, M., & Barrios, L. (2024). Boredom and its perceived impact in adolescents with exceptional mathematical talent: A sequential mixed-methods study in Paraguay. Frontiers in Sociology, 9, 1214878. https://doi.org/10.3389/fsoc.2024.1214878

Weiss, A. J., Liang, L., & Martin, K. (2006). Overview of Hospital Stays Among Children and Adolescents, 2019. In Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Healthcare Research and Quality (US). http://www.ncbi.nlm.nih.gov/books/NBK588376/

Westgate, E. C., & Wilson, T. D. (2018). Boring thoughts and bored minds: The MAC model of boredom and cognitive engagement. Psychological Review, 125(5), 689–713. https://doi.org/10.1037/rev0000097

Zavadina, I., Mondini, S., Lomuscio, S., Ghizzardi, G., Scognamiglio, D., Ledonne, G., Gualandi, R., & Maiandi, S. (2025). La noia dell’adolescente durante il ricovero ospedaliero: Revisione della letteratura. Dissertation Nursing, 4(2). https://doi.org/10.54103/dn/27680

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2026 Stefano Maiandi, Iryna Zavadina, Stefania Mondini, Anna Baldo, Ester Busca, Stefania Sciglitano, Debora Guerreschi , Domenico Scognamiglio, Greta Ghizzardi, Eleonora Aloi

Interdisciplinary Journal of Nursing and Health (eISSN: 3103-537X) continues Infermieristica Journal (eISSN 2785-7018).