Child's reaction to hospitalization

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Presentation Transcript

REACTION TO HOSPITALIZATION : 

REACTION TO HOSPITALIZATION Nirmala Roberts Paediatric Nursing

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 – Addl stimuli, inconsistency, unfamiliarity of env./ daily rituals, rigid schedules Bodily injury & pain

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 15: 

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