Family-Centered Nursing Care During Hospitalization

Psychosocial needs of pediatric clients during illness and hospitalization can be challenging for nurses and other caregivers to meet.

There are three main psychosocial effects that children experience during hospitalization, including fear, separation anxiety, and loss of control.First, fear may arise from an unexpected occurrence of illness, potential physical harm, injuries, and pain.

Children typically have a harder time adjusting to changes in the environment which may include scary equipment, smells, noises, other children crying, strange words, needles, and strangers in weird outfits, such as surgical gowns, masks, and caps.Next is separation anxiety, which refers to the anxiety or emotional distress that a child experiences when separated from their caregiver, or their family, home, and friends.

It can be characterized by anger and rejection of those who try to help. Anger can be followed by despair, where they become quiet and withdrawn.

Also, the child’s loss of control over decisions, usual everyday routines, self-care, and play, can adversely affect their coping mechanisms and decrease their ability to deal with new stressful situations.Now, a child’s reaction to illness and hospitalization can be affected by many things, including age, developmental and cognitive level, temperament, and coping skills.

Other important factors include recent stressful situations, the nature and severity of the illness, and whether the hospitalization is planned, unplanned, or if it’s an emergency situation.

Also, length of separation from parents, family members, and other familiar caregivers; their reaction to illness or hospitalization; as well as the child’s cultural, ethnic, and religious background, can all have an effect on a child’s reaction.Okay, in terms of clinical manifestations, how a child expresses their emotions during illness or hospitalization varies depending on their age and stage of development.

Starting with infants, children at this stage will often cry when left by their caregivers and turn away from strangers.

They are especially vulnerable to the effects of stressors like sensory overload and invasive procedures, which can disrupt their feeding and sleeping patterns.

They tend to convey emotions through facial expressions and gestures, such as a tense body posture and furrowed brow. Now, toddlers and preschoolers are also afraid of strangers, and when separated from their caregivers, they will ask for or call out for them.

They may throw temper tantrums, become sad and withdrawn, cry quietly, and be uncooperative with taking medications and food.

They can even regress in acquired skills, such as toilet training. Children at this stage begin to understand illness but not its cause, so they tend to believe it’s their fault for becoming sick.

School-age children are often able to deal effectively with separation from caregivers. They have a better understanding of the illness, ask questions about procedures and tests that are being performed, and they want to take part in decision making.

Children at this stage tend to have coping mechanisms that can help them deal with pain and discomfort related to invasive procedures; however, losing a sense of control can make them feel isolated, bored, or lonely.Finally, adolescent clients may often experience separation anxiety from their friends, rather than family.

They are most concerned about their body image and how the procedures, illness or injury will affect them. They tend to hide their fears and appear confident, but they often question everything and may not adhere to the plan of care as they strive for independence.

Finally, losing control can result in anger, withdrawal, and lack of cooperation.Alright, let’s look at the nursing care you’ll provide for a child during illness and hospitalization.

Your priority nursing goal is to provide supportive care. Begin by taking steps to minimize fear, anxiety, and loss of control.

Orient the child and their caregivers to their environment, and introduce them to the members of the healthcare team. While providing care, include the child as much as possible, and allow them to express their feelings and make choices whenever possible.

Be sure to maintain a calm and friendly voice and use age-appropriate words; and avoid using any medical terms while explaining what you are doing and how it will help them.

Modeling the procedure on a stuffed animal or toy can also be helpful. Then, to help reduce the child’s separation anxiety, encourage the caregivers to stay in the room with the child as much as possible.

You can also arrange to place them in a room with another child of similar age and developmental level to help them adjust to their new surroundings.

Providing a core group of consistent nurses to care for the child can also help ease fear and anxiety and promote a trusting relationship.

Lastly, enlist the help of the unit’s child life specialist for continued support, and ensure there’s a social work referral, as needed.Okay, moving on to client and family teaching.

Begin by explaining at a developmentally appropriate level about the child’s illness, procedures, and plan of care. Now, stress the need for adequate rest and nutrition for both the child and caregiver.

Encourage the caregiver to maintain their routine as much as possible, and teach them how to soothe the child without disrupting any hospital equipment.

Lastly, encourage them to bring a favorite toy or object from home to help promote a sense of security.Psychosocial needs of pediatric clients during illness and hospitalization can be challenging for nurses and other caregivers.

There are three main psychosocial effects that children experience, including anxiety and fear, separation anxiety, and loss of control.

Factors that affect their reaction to illness and hospitalization can include age, developmental and cognitive level, temperament, and coping skills development.

How the child expresses their emotions during illness or hospitalization varies depending on their age. The priority goal of nursing care is to provide supportive care.

Client and family education includes what to expect during their