PAEDIATRIC NURSING

1. CARING OF THE HOSPITALISED CHILD

1.3 Reaction of an ill child to

hospitalization
1.3 Reaction of an ill child to
Hospitalization
 LEARNING OUTCOMES

At the end of the one hour lecture the students will

be able to:-
State the children’s response to hospitalization
List the parental reaction to child’s hospitalization
List the sibling reaction to child’s hospitalization
State the factors influence the child’s reaction to
illness
Explain the measures to reduce the stress and
anxiety during hospitalization
Reaction of an ill child to hospitalization

Entering the hospital is somewhat like visiting

a foreign country / new environment

Each child responds to illness or

hospitalization differently.
 Children’s response to hospitalization
a. Fear of the unknown, injury and pain
 May wonder what is happen.
 Afraid to intrusive procedures.
 May try to delay the nurse’s implementation of a
procedures.

b. Separation anxiety
 Major distress:-( 3 stages)
i. Protest
ii. Despair
iii.Detachment
 Separation anxiety

i. Protest:
Cries, screams, rejecting anyone other than parents, agitated,
angry and upset, throwing and breaking their toys
ii. Despair:
The child feels hopeless and becomes quiet and withdrawn.
Sad and uninterested with environment.
iii. Detachment:
Children becomes interested in the environment, plays, and
seems to form relationships with caregivers and other
children. If parents reappear, the child may ignore them.
Increasing self-centered.
Interacts with strangers
 Children’s response to hospitalization

c. Loss of control:
When children are unable to do things
themselves, their sense of control and
autonomy is weakened.
Frustrated, may be temper tantrums.
 Children’s response to hospitalization

d. Anger
 Showing their tantrums of disliking
the situation. Try to win in that
particular situation.

e. Guilt
 Believe that their illness is somehow
related to a thought or deed.
 Lead to feelings of guilt, shame and
increase stress.
 Children’s response to hospitalization

f. Regression
 May regress in toileting or cry for a
bottle
 Want more attention at bedtime.
 React to separation by clinging or
crying
 Parental reactions to child hospitalization

 Disbelief
 Anger
 Guilt
 Fear
 Anxiety
 Frustration
 Depression
 Siblings reactions to child
hospitalization
 Loneliness
 Fear
 Worry
 Resentment
 Jealousy
 Guilt
QUESTIONS ?
THANK YOU
 Factors influence the child’s reaction to
illness
Child’s reaction to illness influence by:
Age of child
Personality of child and parents
Number of admissions before
Type of illness
 1. Age of child
Neonate –
 no crying
 distracted by surrounding
Toddler – fear of strangers
 protest, crying, searching for mum
 Then quiet ( despair)
 Cry again when sees mum during visiting
 1. Age of child
Preschool
 Anxiety – animalistic imagination

School going and adolescence

 Anxiety – outcome of illness
 Anxiety – catching up with school work
 Missing peers
 Body image
2. Personality of child and parents
 Insecure
 Quiet, fearful
 Consider admission as punishment
 Guilt feelings – not following parental
advise
 More secure child – admission less
traumatic
 Parents- guilt feelings, blaming others,
anger etc…
 3. Number of admission
Chronic illness
Eg. hemophilia
 Frequently every 4-6 weeks less stressful
 Know staff by name
 Less stressful
Eg. leukemia
 Stressful although know staff very well
 Pick and choose staff for procedure like
blood taking
 4. Types of illness
Acute – eg burnt by fire
 parent very remorseful, guilt
Very coopeartive , follow advice esp hand washing
Congenital eg cleft lip and cleft palate
Parent sad and disappointed
Chronic – parents try to assist nurses in whatever
way possible.
 Measures to reduce stress and anxiety
during hospitalization

A. An colorful, peaceful environment

Painted colorful walls with cartoons characters
Colorful furniture appropriate for child’s age
Play station. Cartoons TV show
music
Cool and safe environment
Allow child to have his “security” blanket
 Measures to reduce stress and anxiety
during hospitalization
B. Nurses
Play the bad and good guys
-one nurse assigned for the painful procedures eg
injections
Organized nursing care to disturb child as little as
possible
Speak to child slowly
Show respect for child – use his nickname
Let child handle the equipment before use
Play doctor /patient with child eg using teddy bears
 Measures to reduce stress and anxiety
during hospitalization
C. Parents
Established rapport with parents
Allow parent to room in
Allow free visiting hours
Let parents make some decisions in caring of their
child.
Let child to sit on parent’s lap during procedures if
possible eg nublisers
Allow parent to carry child instead of placing child on
a trolley if able to