Figure 42.1 Challenges of hospitalization
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Minimizing the effects of hospitalization
Hospitals can be threatening, frightening and painful environments where children are faced with strangers who want to ‘do’ things to them. Illness, trauma and hospital care are often the most traumatic things children experience, even with the presence of their parents. In addition, hospitals present a conflict for children who are taught about ownership of their body and to be wary of strangers. Nonetheless, changes in the way health care is provided, giving rights to patients, improvement in staff knowledge and increasing knowledge of children and parents about medical issues, mediated through the internet, has impacted on how hospitalization is experienced. Similarly, the concept of hospitalization has changed with shorter bed stays, development of primary care, avoidance of hospital care and overall improved health of children.
The experience of hospitalization
Hospitals used to be places of long stays, routine, rigidity, restricted visiting, limited emotional care and often painful experiences for children. Much of this has changed; however, it does not necessarily alleviate how children experience what is happening to them. What is trivial to an adult can be a major stressor to a child.
Experience of the child
While much of hospital is anxiety-producing, one experience has the potential to cause trauma for children and this is separation from their parents. Parents can usually stay with their children but other responsibilities may prevent this and so the child becomes separated. The impact of separation is dependent on circumstances, age and development but may be displayed in specific stages:
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