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Edit Comment Close Premium member Presentation Transcript REACTION TO HOSPITALIZATION : REACTION TO HOSPITALIZATION REACTION OF HOSPITALIZED CHILD : REACTION OF HOSPITALIZED CHILD MAMMAAAAA..!! MAJOR STRESSORS & REACTIONS TO THEM : MAJOR STRESSORS & REACTIONS TO THEM Separation anxiety Protest – Cry, scream, run Despair – Withdrawal, depressed, non-communicative, regression Detachment – Superficial adjustment/ relationships Loss of control – Additional stimuli, inconsistency, unfamiliarity of env./ daily rituals, rigid schedules, lack of privacy Bodily injury & pain REACTIONS OF CHILDREN TO HOSPITALIZATION AT VARIOUS AGES : REACTIONS OF CHILDREN TO HOSPITALIZATION AT VARIOUS AGES Children 3 years of age and younger : Children 3 years of age and younger Lack understanding about their illness Confused about the new change in their familiar environment Concerned with being away from family and home. Toddlers - Difficulty coping with the change in routines (especially - eating, sleeping and toileting). Help – Allow parents/ friends/ anyone known to child to be with the child Maintain close and continual parental contact during hospitalization Children 3 - 6 years old : Children 3 - 6 years old Usually view the hospital and procedures as punishment. Wants to be near the family Views hospital stay or procedure as punishment for something. Loss of control and fear of the unknown Help - Honest, simple, age-appropriate conversations can help your child feel more secure. Remember, young children learn best through play. - Reassure child that he/she hasn't done anything wrong. - Allow to bring a favorite toy; blanket or clothes from home - Encourage walking around or playing outside of his/her room. Children 7- 12 years old : Children 7- 12 years old Worried about painful procedures Believe that hospitalization and procedures are a form of punishment Experience a loss of control and independence Older children worry about painful procedures and changes to their body Help - Providing information is key at this age..very important - Inform in advance about procedures, changes in the environment etc.. - Do not mislead by saying something won't hurt if it will - Instead, talk about how to cope with possible pain and confusion. - give choices when they exist Adolescents 12 and up : Adolescents 12 and up Concern about loss of control; separation from friends Very self-conscious. Lots of questions about specific procedures. Help - Encourage to talk to doctors and nurses involved in care - allow to be part of discussions & decision making (this will give some degree of control) - Support social interactions with friends via phone, email and visits REACTION TO BODILY INJURY & PAIN : REACTION TO BODILY INJURY & PAIN 0 – 6 months – Cry, bodily movements 6/12 – 1 year – Resistance, uncooperative 1 – 3 years – Aggressive behaviour 3- 5 years – Fear of punishment/ mutilation/ death; verbal abuse 5–12 years – Fear of disability, concern for privacy, words to describe pain > 12 years – Effect on body image, questioning, privacy REACTION TO STRESSORS : REACTION TO STRESSORS Depends upon Developmental age Previous experience with illness Separation Coping skills (innate/ acquired) Seriousness of illness Support systems CARE OF HOSPITALIZED CHILD : CARE OF HOSPITALIZED CHILD Prepare for hospitalization Prevent/ minimize separation Minimize loss of control Prevent minimize bodily injury Allow for regression Provide pain management (= Atraumatic care) Provide for developmentally appropriate play activities Provide opportunities for play/ expressive activities Maximize potential benefit of hospitalization Focus on developmental age rather than chronological age REACTION OF CHILD’S FAMILY : REACTION OF CHILD’S FAMILY STRESSORS & REACTIONS : STRESSORS & REACTIONS Parents – Disbelief…anger…guilt…..fear… anxiety…frustration…depression Siblings Fear of contracting illness Missing the elder/ younger sibling Uncleared doubts about the sick child Perceived change in parenting Altered family roles Jealousy & anger CARE OF THE FAMILY : CARE OF THE FAMILY Assess – Seriousness of child’s illness Family’s previous experience Medical procedures involved in care Need for home care (discharge assessment) Encourage – Rooming In, positive attitude, include in child care, respect wishes/ values Support – Based on verbal/ non verbal messages Provide – Info’ on disease/ treatment, child’s/ sibling’s reaction SPECIAL SITUATIONS CAUSING STRESS : SPECIAL SITUATIONS CAUSING STRESS Isolation & isolation procedures Emergency admission Admission to Intensive Care Unit Remember ! Stress levels are high Need for post ’vention counseling ROLE OF PAEDIATRIC NURSE : ROLE OF PAEDIATRIC NURSE Primary concern – Welfare of child & family Family advocacy Disease prevention & health promotion Health teaching – Support/ counseling Therapeutic role Coordination & collaboration (for ‘Holistic care’) Research Health care planning – At political/ legislative level FUTURE TRENDS… : FUTURE TRENDS… Ambulatory care (stress on promotion & prevention) Home care & community health services – family assessment, anticipatory guidance, discharge planning Technological advances – ‘will’ > tech skill Role of ‘patient care educator’ Changing demographics – Knowledge of adolescent medicine CULTURAL INFLUENCES & FAMILY FACTORS IN CHILD CARE : CULTURAL INFLUENCES & FAMILY FACTORS IN CHILD CARE Social roles Guilt & shame orientation Child rearing practices – class/ mobility… Effects of religion Effects of schools Peer culture Bi culture Health concerns NURSING ALERT! : NURSING ALERT! Avoid making generalizations Avoid directly attacking traditional health beliefs Meet the child’s needs for spiritual support Remember – No culture is homogenous Slide 20: THANK YOU Making it all better… : Making it all better… Parents should be well informed Parents should give the child details and explanations about an upcoming hospitalization as soon as possible. Keep the lines of communication open Children have a good intuition. Let child know what's happening right away Withholding information gives the child time to imagine worse things than the truth, and develop a fear of what's going to happen. Telling the Child : Telling the Child About the condition he or she is experiencing, and what's going to happen in the hospital. Gear language to their age Children under the age of two understand only what is happening at that moment Children between two and seven can understand more about their conditions and the treatments needed. Children older than seven can understand more complex explanations, and should be encouraged to ask questions Reassure them that they'll be kept as comfortable as possible Preparations for the hospital stay can begin early - Start packing a bag and include some comfort items from home Pictures of family members, pets, or classmates can also help a child feel more at home in the hospital. Allow parents to stay with them throughout their hospitalization. Introduce them to the hospital staff Use interactive play to help children learn about their hospital stay. Talking with Providers : Talking with Providers Before the hospitalization even begins, it's important to communicate effectively with the child's physician and nursing staff Parents should prepare a list of questions (theirs and their child’s) Parents should work as partners with the treating saff Good parent- personnel communication can prevent dangers like medication errors Caring for the Caregiver : Caring for the Caregiver Have parents take lots of breaks Enable and empower parents through education and participation in child care activities Keep open lines of communication Charter of the hospitalized child : Charter of the hospitalized child The right to the best possible care is a fundamental right, especially for children. 1. Hospitalization of a child must take place only if the care cannot be administered at home, external consultation or out-patient care. 2. A hospitalized child, no matter his age or state, has the right to have his parents or an appointed one by his side day and night. 3. Encourage parents to stay with their child and offer all material needs Inform the parents about the rules that are specific to the ward in order to participate actively in the care of their child. Slide 28: 4. The children and their parents have the rigth to receive information concerning the illness and its care. Information adapted to their age and understanding in order to make their participation in decision making possible. 5. Avoid all treatment and examinations which are not necessary. Keep physical and emotional traumas to the minimum Slide 29: 6. Children must not be admitted to adult wards. They should be put in their age groups in order to benefit from games, leisure, educational activities, adapted to their age and in security. Their visitors should be accepted no matter their age. 7. The hospital must provide the children with an environment appropriate to their physical, emotional and educational needs; in regards as much to equipment, staff and security. Slide 30: 8. The care-giving team must be trained to respond to the psychological and emotional needs of the children and their families. 9. The care-giving team must be organized in a way to ensure continuity in care to each child. 10. Every child's privacy must be respected. Every child must be treated with tact and understanding in all circumstances. Helping Siblings Cope : Helping Siblings Cope Give the siblings as much honest information about the sick child’s health as they can understand. Provide opportunities for them to ask questions and express feelings. Let siblings prepare and help in the planning for the hospitalized child. Allow the sibling to: Take the hospital tour with the sick child, if possible; Act out experiences with people, dolls, or puppets. Set aside some private time each day just for them. Make it a point to recognize important events in their lives. When you have to be away from home with the hospitalized child: Arrange to have someone both you and they trust stay with them; Check in by phone as often as you can. Call at bedtime to read a bedtime story; Send letters or tapes. Slide 32: Nurture ongoing involvement between siblings and the hospitalized child throughout the hospital experience. Have siblings draw pictures or make cards to send to the hospital; Set up times for siblings to call the child in the hospital; When possible, give siblings the choice of visiting a brother or sister in the hospital. If they choose to visit, be sure to prepare them for what they will see, hear and feel. Inform school guidance counselors about what’s happening. Allow siblings to keep a balance between increased responsibility at home and maintaining their normal activities. REACTIONS TO HOSPITALIZATION : REACTIONS TO HOSPITALIZATION It’s normal for a 14-month-old to do this when their parent returns to the room. - cry This is the age group most likely to experience loss of privacy & independence as issues during hospitalization. - adolescence This is the age group to whom security, trust, bonding, & predictability are most important.- infancy An example of this behavior as a reaction to hospitalization is when a school-age child starts thumb-sucking again.- regression Most authorities agree that adverse reactions to hospitalization decline after children reach this age group.- school age Slide 34: hildren at different ages react differently to hospitalization. Here are possible age-appropriate reactions your child may have, as well as suggestions for comforting your child during his or her hospital stay: Ages 3 to 6 Ages 7 to 12 Teenagers You do not have the permission to view this presentation. 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Reaction to hospitalization aSGuest13812 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 2023 Category: Education License: All Rights Reserved Like it (1) Dislike it (0) Added: February 26, 2009 This Presentation is Public Favorites: 1 Presentation Description No description available. Comments Posting comment... By: kaurharpreet87 (15 month(s) ago) very nice.... Saving..... Post Reply Close Saving..... Edit Comment Close By: vins_cutestar (32 month(s) ago) i would like to download this ppt..pls help me do the same Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript REACTION TO HOSPITALIZATION : REACTION TO HOSPITALIZATION REACTION OF HOSPITALIZED CHILD : REACTION OF HOSPITALIZED CHILD MAMMAAAAA..!! MAJOR STRESSORS & REACTIONS TO THEM : MAJOR STRESSORS & REACTIONS TO THEM Separation anxiety Protest – Cry, scream, run Despair – Withdrawal, depressed, non-communicative, regression Detachment – Superficial adjustment/ relationships Loss of control – Additional stimuli, inconsistency, unfamiliarity of env./ daily rituals, rigid schedules, lack of privacy Bodily injury & pain REACTIONS OF CHILDREN TO HOSPITALIZATION AT VARIOUS AGES : REACTIONS OF CHILDREN TO HOSPITALIZATION AT VARIOUS AGES Children 3 years of age and younger : Children 3 years of age and younger Lack understanding about their illness Confused about the new change in their familiar environment Concerned with being away from family and home. Toddlers - Difficulty coping with the change in routines (especially - eating, sleeping and toileting). Help – Allow parents/ friends/ anyone known to child to be with the child Maintain close and continual parental contact during hospitalization Children 3 - 6 years old : Children 3 - 6 years old Usually view the hospital and procedures as punishment. Wants to be near the family Views hospital stay or procedure as punishment for something. Loss of control and fear of the unknown Help - Honest, simple, age-appropriate conversations can help your child feel more secure. Remember, young children learn best through play. - Reassure child that he/she hasn't done anything wrong. - Allow to bring a favorite toy; blanket or clothes from home - Encourage walking around or playing outside of his/her room. Children 7- 12 years old : Children 7- 12 years old Worried about painful procedures Believe that hospitalization and procedures are a form of punishment Experience a loss of control and independence Older children worry about painful procedures and changes to their body Help - Providing information is key at this age..very important - Inform in advance about procedures, changes in the environment etc.. - Do not mislead by saying something won't hurt if it will - Instead, talk about how to cope with possible pain and confusion. - give choices when they exist Adolescents 12 and up : Adolescents 12 and up Concern about loss of control; separation from friends Very self-conscious. Lots of questions about specific procedures. Help - Encourage to talk to doctors and nurses involved in care - allow to be part of discussions & decision making (this will give some degree of control) - Support social interactions with friends via phone, email and visits REACTION TO BODILY INJURY & PAIN : REACTION TO BODILY INJURY & PAIN 0 – 6 months – Cry, bodily movements 6/12 – 1 year – Resistance, uncooperative 1 – 3 years – Aggressive behaviour 3- 5 years – Fear of punishment/ mutilation/ death; verbal abuse 5–12 years – Fear of disability, concern for privacy, words to describe pain > 12 years – Effect on body image, questioning, privacy REACTION TO STRESSORS : REACTION TO STRESSORS Depends upon Developmental age Previous experience with illness Separation Coping skills (innate/ acquired) Seriousness of illness Support systems CARE OF HOSPITALIZED CHILD : CARE OF HOSPITALIZED CHILD Prepare for hospitalization Prevent/ minimize separation Minimize loss of control Prevent minimize bodily injury Allow for regression Provide pain management (= Atraumatic care) Provide for developmentally appropriate play activities Provide opportunities for play/ expressive activities Maximize potential benefit of hospitalization Focus on developmental age rather than chronological age REACTION OF CHILD’S FAMILY : REACTION OF CHILD’S FAMILY STRESSORS & REACTIONS : STRESSORS & REACTIONS Parents – Disbelief…anger…guilt…..fear… anxiety…frustration…depression Siblings Fear of contracting illness Missing the elder/ younger sibling Uncleared doubts about the sick child Perceived change in parenting Altered family roles Jealousy & anger CARE OF THE FAMILY : CARE OF THE FAMILY Assess – Seriousness of child’s illness Family’s previous experience Medical procedures involved in care Need for home care (discharge assessment) Encourage – Rooming In, positive attitude, include in child care, respect wishes/ values Support – Based on verbal/ non verbal messages Provide – Info’ on disease/ treatment, child’s/ sibling’s reaction SPECIAL SITUATIONS CAUSING STRESS : SPECIAL SITUATIONS CAUSING STRESS Isolation & isolation procedures Emergency admission Admission to Intensive Care Unit Remember ! Stress levels are high Need for post ’vention counseling ROLE OF PAEDIATRIC NURSE : ROLE OF PAEDIATRIC NURSE Primary concern – Welfare of child & family Family advocacy Disease prevention & health promotion Health teaching – Support/ counseling Therapeutic role Coordination & collaboration (for ‘Holistic care’) Research Health care planning – At political/ legislative level FUTURE TRENDS… : FUTURE TRENDS… Ambulatory care (stress on promotion & prevention) Home care & community health services – family assessment, anticipatory guidance, discharge planning Technological advances – ‘will’ > tech skill Role of ‘patient care educator’ Changing demographics – Knowledge of adolescent medicine CULTURAL INFLUENCES & FAMILY FACTORS IN CHILD CARE : CULTURAL INFLUENCES & FAMILY FACTORS IN CHILD CARE Social roles Guilt & shame orientation Child rearing practices – class/ mobility… Effects of religion Effects of schools Peer culture Bi culture Health concerns NURSING ALERT! : NURSING ALERT! Avoid making generalizations Avoid directly attacking traditional health beliefs Meet the child’s needs for spiritual support Remember – No culture is homogenous Slide 20: THANK YOU Making it all better… : Making it all better… Parents should be well informed Parents should give the child details and explanations about an upcoming hospitalization as soon as possible. Keep the lines of communication open Children have a good intuition. Let child know what's happening right away Withholding information gives the child time to imagine worse things than the truth, and develop a fear of what's going to happen. Telling the Child : Telling the Child About the condition he or she is experiencing, and what's going to happen in the hospital. Gear language to their age Children under the age of two understand only what is happening at that moment Children between two and seven can understand more about their conditions and the treatments needed. Children older than seven can understand more complex explanations, and should be encouraged to ask questions Reassure them that they'll be kept as comfortable as possible Preparations for the hospital stay can begin early - Start packing a bag and include some comfort items from home Pictures of family members, pets, or classmates can also help a child feel more at home in the hospital. Allow parents to stay with them throughout their hospitalization. Introduce them to the hospital staff Use interactive play to help children learn about their hospital stay. Talking with Providers : Talking with Providers Before the hospitalization even begins, it's important to communicate effectively with the child's physician and nursing staff Parents should prepare a list of questions (theirs and their child’s) Parents should work as partners with the treating saff Good parent- personnel communication can prevent dangers like medication errors Caring for the Caregiver : Caring for the Caregiver Have parents take lots of breaks Enable and empower parents through education and participation in child care activities Keep open lines of communication Charter of the hospitalized child : Charter of the hospitalized child The right to the best possible care is a fundamental right, especially for children. 1. Hospitalization of a child must take place only if the care cannot be administered at home, external consultation or out-patient care. 2. A hospitalized child, no matter his age or state, has the right to have his parents or an appointed one by his side day and night. 3. Encourage parents to stay with their child and offer all material needs Inform the parents about the rules that are specific to the ward in order to participate actively in the care of their child. Slide 28: 4. The children and their parents have the rigth to receive information concerning the illness and its care. Information adapted to their age and understanding in order to make their participation in decision making possible. 5. Avoid all treatment and examinations which are not necessary. Keep physical and emotional traumas to the minimum Slide 29: 6. Children must not be admitted to adult wards. They should be put in their age groups in order to benefit from games, leisure, educational activities, adapted to their age and in security. Their visitors should be accepted no matter their age. 7. The hospital must provide the children with an environment appropriate to their physical, emotional and educational needs; in regards as much to equipment, staff and security. Slide 30: 8. The care-giving team must be trained to respond to the psychological and emotional needs of the children and their families. 9. The care-giving team must be organized in a way to ensure continuity in care to each child. 10. Every child's privacy must be respected. Every child must be treated with tact and understanding in all circumstances. Helping Siblings Cope : Helping Siblings Cope Give the siblings as much honest information about the sick child’s health as they can understand. Provide opportunities for them to ask questions and express feelings. Let siblings prepare and help in the planning for the hospitalized child. Allow the sibling to: Take the hospital tour with the sick child, if possible; Act out experiences with people, dolls, or puppets. Set aside some private time each day just for them. Make it a point to recognize important events in their lives. When you have to be away from home with the hospitalized child: Arrange to have someone both you and they trust stay with them; Check in by phone as often as you can. Call at bedtime to read a bedtime story; Send letters or tapes. Slide 32: Nurture ongoing involvement between siblings and the hospitalized child throughout the hospital experience. Have siblings draw pictures or make cards to send to the hospital; Set up times for siblings to call the child in the hospital; When possible, give siblings the choice of visiting a brother or sister in the hospital. If they choose to visit, be sure to prepare them for what they will see, hear and feel. Inform school guidance counselors about what’s happening. Allow siblings to keep a balance between increased responsibility at home and maintaining their normal activities. REACTIONS TO HOSPITALIZATION : REACTIONS TO HOSPITALIZATION It’s normal for a 14-month-old to do this when their parent returns to the room. - cry This is the age group most likely to experience loss of privacy & independence as issues during hospitalization. - adolescence This is the age group to whom security, trust, bonding, & predictability are most important.- infancy An example of this behavior as a reaction to hospitalization is when a school-age child starts thumb-sucking again.- regression Most authorities agree that adverse reactions to hospitalization decline after children reach this age group.- school age Slide 34: hildren at different ages react differently to hospitalization. Here are possible age-appropriate reactions your child may have, as well as suggestions for comforting your child during his or her hospital stay: Ages 3 to 6 Ages 7 to 12 Teenagers