A is for anxious parents & children

Parents’ emotional response to child’s hospitalization
Helen Gofman, Wilma Buckman, George H. Schade

What was it like for children in hospital in the late 1950’s? This article is from the Pediatric Mental Health Unit, University of California Medical Center. In 1957, understanding of children’s emotional response to hospitalization as well as parents was little understood.

This interesting article looks at parents’ perceptions and what it was like for families with hospitalized children. Parents were interviewed and questions asked included what information was provided by doctors as well as admission procedures. Interestingly, as the study progressed researchers became aware of the impact of separating children from their parents without preparation of any kind and modified their admission procedure. There were one hundred parents who were interviewed at the time of their child’s admission and 68 parents were interviewed again at discharge from hospital.

This is a very touching article, with parent vignettes. Readers can see how difficult it was for both child and parent to be separated, vulnerable and fearful. The article describes the traumatic admission procedure where children were placed in bed in an isolation unit and parents were escorted to a nearby waiting room where they could hear their child crying calling for them but could not see or be with them. The modified procedure led to a more gradual separation. The changed procedure involved a nurse being assigned to the care of the child and parents, accompanying them to a room where the child was no longer isolated. The child shared a room with others of a similar age and the nurse acquainted the child with roommates before assisting parents to put the child in bed. Parents were encouraged to stay until the physician was available.
The article describes visiting hours and the success of a “further extension of visiting hours”, some of the nursing staff were sceptical about the extension.

In the summary section of the article major points made were children and parents needed adequate preparation for hospitalization;

  •  An admission procedure which allowed for a more gradual separation of parent and child;
  • During hospitalization health personnel needed to focus on both the child’s emotional and physical needs;
  • Continuing preparation of child and parent throughout hospital procedures and treatment;

At discharge, health professionals provide understanding of findings and implications both orally and in writing for further care of the child at home.

This article has been cited approximately 35 times, Google scholar.

Link to first page of article to read more:
http://archpedi.jamanetwork.com/article.aspx?articleid=498653

View the record in the AWCH catalogue or contact the AWCH Librarian for more information:
http://awch.intersearch.com.au/cgi-bin/koha/opac-detail.pl?biblionumber=13531


Jillian Rattray
AWCH librarian
August 2014

Painful paediatric practice

I was out to dinner with my girlfriends last night and at dinner the topic of pain relief in hospital came up. One of my girlfriend’s children had broken his arm and to fix the fracture pins had been placed in his humerus. To have pins removed, my friend took her son to the local paediatric hospital. Before Bob had his pins removed he was offered no pain relief and this is where the story really starts…..

To remove his pins Bob was placed in a chair. His mother was asked to sit next to him.  A clown doctor was there to distract the child whilst the pin was being removed. To remove the pin the doctor used pliers, which slipped as the pin did not come out easily. This process caused Bob a great amount of distress…. However, as this was happening, the clown doctor was attempting to put a red nose on the mother – impeding her ability to comfort Bob. In addition, there was still one more pin to be removed. Yet by this time the child was hysterical and distraught.

A comedy of errors, or a sheer lack of planning and consideration for the needs of Bob and his mother?

The reason I wish to share this story is that this type of situation exemplifies why AWCH is still relevant in 2014. In our 40 year history we have made lots of progress in advocating for children and their families as they navigate the health care system. However stories like Bob’s and Betty’s still exist.

Betty is an intelligent and articulate woman. She told me that she placed her trust in the medical staff and that if they said that this procedure did not require any pain relief then Bob would be fine. Once Bob became distressed she felt she had no control over the situation and that all she could do was comfort Bob to the best of her ability at that time.

This happened two weeks ago, and prior to the pin removal Bob was always a happy go lucky child with a ready smile and a cheeky sense of humour. Since the procedure he has been having nightmares, being argumentative at school and is scared to play footy or use him arm too much.

For me this story shows that AWCH is still very relevant today and the work we do is still needed.

Ally Hutton
AWCH President

Thanks to Bob and Betty for sharing their story (real names not used)

Social Media for Children in Hospital

Should children and young people have access to the internet and social media while they are in hospital?

Social support during hospitalisation has always been a critical factor for children and young people. The rights of children and young people in healthcare have been enshrined in polices and standards developed by AWCH and other like minded organisations over many years.

Reducing feelings of isolation from friends and family members, especially for older children and teens is an important consideration. For older children, contact with school friends and access to facilities they may have at home (e.g. the internet) can also help normalise the hospital experience. This is important to reduce the possible negative effects associated with childhood hospitalisation.

The new technologies can provide young patients with increased access to family, peers and entertainment and have been shown to enhance communication and social connection. With internet access, children can also keep up with their school work.

Recent surveys about technology and social media have found that:

It is clear that the internet is a huge part of young lives. Arguably young people who do not have such access may be disadvantaged. Strategies that enable equitable access to the internet for children and young people during hospitalisation have the potential to reduce isolation and interruption to education.

Should access to these important technologies, which enable social connectedness, as well as educational opportunities, be available to all children and young people while they are in hospital?

What do you think?