One of the main issues in the healthcare system today is the presence of “hospital phobias” among the general population, such as the fear of hospitals and upcoming surgeries and medical procedures. These fears are referred to as nosocomephobia and tomophobia respectively. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), specific phobias such as these are characterized as anxiety disorders, which are highly prevalent among the general population. Nonetheless, nosocomephobia and tomophobia can be dangerous forms of anxiety because individuals who suffer from a fatal condition or are experiencing alarming symptoms may neglect to seek medical intervention when necessary. A famous case of this occurred in 1974: President Richard Nixon refused to go to the hospital to be treated for a blood clot by irrationally claiming, “If I go into the hospital, I’ll never come out alive”. Because of this reluctance to seek treatment, it is imperative that hospitals find solutions that will help alleviate fear in medically afflicted individuals because doing so will help to save lives. 

What causes hospital phobias?

Although studies have shown that genetics can play a role in developing nosocomephobia and tomophobia, a major cause of these specific phobias is trauma, especially childhood trauma. Children who are routinely exposed to hospital conditions as a result of a serious illness or a family member’s hospitalization may overtime become conditioned to being afraid of hospitals. In addition, one study has shown that the outbreak of the COVID-19 pandemic has resulted in fewer patients seeking necessary healthcare from hospitals. This finding was attributed to the development of nosocomephobia among individuals who were afraid of contracting the virus. It is also possible for nosocomephobia and tomophobia to develop alongside other comorbid mental health conditions, such as generalized anxiety disorder, obsessive-compulsive disorder, major depressive disorder, post-traumatic stress disorder, as well as related phobias. For example, individuals who suffer from germophobia (the fear of germs) may naturally be afraid of hospitals also since they are known for being “germ-infested” places. It is also important to address that one of the main determinants of health is socioeconomic status (SES). For instance, racism and discrimination against low-SES patients and minority groups contributes to hospital-dissatisfaction among these populations. This unequal view of different groups by healthcare institutions naturally results in a fear or distrust of hospitals. Furthermore, this constitutes a major source of the health inequities today; many times, low-SES patients will forgo seeking medical treatment when necessary as a result of their implicit bias against (or phobias) of hospitals.  

What healthcare professionals should do to look less scary

Sometimes, phobic patients will experience a temporary elevation in their blood pressure when they visit a hospital: this is called white coat syndrome or white coat hypertension. This condition is aptly named for the white coats that many healthcare professionals wear when attending to patients. It is likely that phobic patients may associate the stereotypical aspects of hospitals, such as white coats, with the hospitals’ overall anxiety-inducing ambience; for instance, patients may associate white coats with seriousness and pain, both of which may contribute to patient anxiety. In pediatric departments and hospitals, it is common for nurses to wear “kid-friendly scrubs” that are colorful and have designs. One study has shown that hospitalized children who were exposed to nurses wearing these fun uniforms experienced lesser levels of anxiety than the children who saw nurses wearing stereotypical, solid-colored white scrubs. In addition, the children in this study were seen to develop better relationships with their friendly-uniformed nurses than with their normally-uniformed nurses. If this variation in uniforms helps to alleviate fear in children, then it is worth considering the effect this may have on adult patients. Furthermore, fun uniforms help to soften phobic patients’ “serious” image of healthcare professionals. Hence, it may be beneficial for doctors to consider alternative uniforms that may help to establish more trusting relationships with their patients by eliminating their “intimidating” white coats. When circumstances permit it, it may also be beneficial for health professionals to minimize their use of face masks when interacting with phobic patients. A study assessing communication stress resulting from face mask use in hospitals suggests that there are negative psychological implications associated with this widespread usage. Not only are doctor-patient relationships limited by face masks, but the already-oppressive association with face masks may contribute to more profound phobias when all of the medical personnel in a hospital use them. Moreover, face masks take away individual human characteristics from healthcare workers, hence patients may be less reluctant to admit themselves to hospitals if they know that hospitals are replete with caring and sympathetic people. 

What hospitals should do to mitigate phobias

Hospitals that are financially willing to combat nosocomephobia and related hospital phobias may want to consider investing in one or more Vecta Deluxe Mobile Sensory Stations. These portable machines consist of multiple calming features, such as a color-changing bubble tube (regulated by a color controller that patients can use), a projector that displays visuals on hospital walls (where patients can choose which image wheels to use), Fiber Optic Tails, a Bluetooth stereo for music, and an aromatherapy diffuser. The Vecta also comes with a ping pong insert with beads that create additional visual effects when added to the bubble tube. The Vecta was originally marketed as a special needs tool to create a multi-sensory experience for autistic children in anxiety-inducing environments, however, these mobile sensory stations may also help to attenuate the anxiety suffered by admitted hospital patients. 

When an individual recognizes their own phobia

Although the most common approach recommended for individuals who have hospital-related phobias is exposure therapy, there are other strategies that patients can try to alleviate their fears. One of which is having a patient familiarize themself with the hospital space; this can be done by viewing maps or taking virtual tours of a hospital prior to entering one. Moreover, since hospitals are gargantuan places that come off as intimidating to many people, being able to gauge the hospital’s sheer size will make the notion of going to one less scary. In addition, understanding the layout of a hospital (e.g. the locations of the ER, the OR, and various departments) will help make the idea of navigating one less daunting. For patients who have tomophobia and are afraid of the medical procedures that they need to receive in hospitals, a special effort should be made by these individuals to ascertain information regarding the processes of such procedures; a patient scheduled for an upcoming medical procedure should make sure that the physician who is performing the procedure explains to them what it specifically entails. This information should be in addition to the possible risks and benefits explained for the patient to give informed consent. Furthermore, when a patient familiarizes themself with the knowledge of what will be done to their body, this helps to take away the fear of the unknown. 

There are a number of factors that can contribute to the development of hospital-related phobias, such as nosocomephobia and tomophobia. It is important for healthcare professionals, institutions, and patients to all make an effort to “fight” such phobias when they are recognized in order to prevent patient medical negligence. This can be done by eliminating some of the anxiety-inducing factors present in hospitals as well as increasing patient familiarity with them.