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Lecture notes Contexts of Care (SHN169)
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Lecture notes on Psychological effects of illness and hospitalisation on CYP
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SHN169 – Psychological Effects of Illness and Hospitalisation on CYPThe psychological effects of Illness and Hospitalisation on CYP (From Birth to
Adolescence)
Introduction
Hospitalisation/illness is a potentially traumatic experience for all children
o This is regardless of whether the visit to hospital was expected or illness is
something they experience regularly
Disruption to routines
Hospital/illness poses a real or imagined threat
May react at any stage preadmission, during their stay, following discharge
See: Ben Amitay et al 2006; Jaaniste et al 2007; Foley 2000; Bossert 1994)
The effects will have a significant impact on the child
Responses and coping will mirror cognitive development
Child’s concept of illness is more important than age and intellect
Coping is dependant on a number of factors – age, information, experience (how
often have they had of medical/hospital settings), culture
o Consider whether English is the child’s primary language. If not how can you
more effectively communicate with that child (and also their family)
See: Gordon et al 2010; Jaaniste et al 2007; Coyne 2006)
Learning Outcomes
Aim:
o To enable the student to develop an understanding of the specific effects of
hospitalisation on the child and the young person
Learner Outcomes:
o Identify the specific effects of hospitalisation on the infant; the pre school
child, the school aged child and the adolescent.
o Outline how these effects may affect the development of the child and
adolescent
o Discuss how these effects may be minimized
o Discuss how the child/young person and family may be supported to
minimize these effects
History of effects
Why is knowing the history of effects important?
o Learning from the past; not just what not to do but also what is good practice
George Armstrong 1769 – role of parents
Catherine Wood 1888 – specialist nurses
West – establishment of GOSH
Spence 1926 – role of parents
Spitz 1945 – coined term hospitalisation
Levy 1947 – effects of surgery on children
Bowlby 1952 – maternal deprivation hypothesis
o Following the events of WWII and the separation of children from parents
(orphaned due to the war)
o Need to keep children and parents together
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, SHN169 – Psychological Effects of Illness and Hospitalisation on CYP
Robertson 1953 – practical application of Bowlby’s theory
o Looked at how children coped in nurseries and also hospital settings
o Drove forward government investigation into children and hospital settings
(Platt Report)
NAWCH 1961 – lobbied for better conditions
Wolfer & Visintainer 1976 – 5 categories of effects
Robertson 1989 – environment & care delivery criticised
Sainsbury and Cleary: Care by parent
Policy perspective
Platt report 1959
o First government report looking at the experiencing and care of children in
hospital
o First to recommend that parents remained with children
o Need for specialist nurses trained in the care of children
This didn’t come into practice until 1991 (2 RCN’s)
Court Report 1976 – Fit for the future
Welfare of Children & young people in hospital 1991
Just for the Day: Rosemary Thorne
o Day surgery – minimising the time that children had to spend in a hospital
setting
DoH 2004 – NSF
DoH 2007 Making it Better
DoH 2009: Healthy Lives Brighter Futures.
Why do we need to know?
Understand the impact of hospital
Insight into the child’s understanding
Provide appropriate care for the child
Provide ways to minimize the effects
o E.g. keeping the same routine that the child has had home (i.e. if they
normally have a bath before bed then schedule their bath to take place then
and not earlier during the day)
Work with family to minimize the effects
o Providing family with support to ease their worries and concerns so they in
turn can help the child deal with their worries
Provide anticipatory guidance and support
o Give realistic advice on what to expect; what the child might experience
Takes into account holistic nature of the experience
o Recognising that the child is an individual
0-1 years
Neonates
o Attachment issues
Key component to consider.
Need to be promoting ways for parents to form attachments:
Physically
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