Preparation for Hospitalization and Medical Procedures

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					Preparation for Hospitalization
   and Medical Procedures
   Can be very scary experience
       Unknown medical staff approach children and are
        oftentimes wearing masks
       Unusual odors
       New environment
       Parents are sometimes absent
       Actual medical procedures can be frightening and
       They are usually not feeling well to begin with
Medical Procedures During
 1/3 of hospitalized children suffer
  transient or long-term psychological
 What are some common medical
  procedures that children might
  experience while being hospitalized?
Methods of Preparation
 Not   empirically validated
   Group  tours and discussions
   Bibliography

   Puppetry

   Play therapy
Types of Programs
 Modeling
   Filmedmodeling
   Puppetry

 Coping   skills training
   Deep  muscle relaxation
   Imagery distraction

   Positive self statements
Factors Influencing
   Age
       Knowledge
       Separation issues
   Prior experience
       Previous reaction
       Self-efficacy vs trauma
   Timing
       Abstract cognitive capacity in older kids
   Parents
       Anxious mothers
       Parenting style
Goals for Preparation Programs
 Expectations/Predictability
   Surgical  holding areas
   Hospital gown/shirt

   Identification bracelets

   Meet with surgical team

   Pre-Operation visit

   Waiting rooms
Goals for Preparation
   Encourage trusting relationships
       Child participates in procedure
       Child given control over rest periods
       Child given choices
       Staff make effort to know patient’s likes/dislikes,
        hobbies, school interests
       Child told truth
       Child has access to toys/blankets
       Allow parents to sleep in patient’s room
Goals for Preparation
 Providing   emotional support
   “Iunderstand” statements to communicate
   Reward children for specific cooperative
   Reassuring physical touches may help
    relax child
Goals for Preparation
 Providing   age-appropriate information
   Tell child what to expect (don’t lie)
   Specific information about how to behave
    is often better than detailed explanations
    about why certain things are done
   Provide sensory information (smells,
Preparing Infants
 Stressors:
   Separation  from parents
   Having many different caregivers

   Seeing strange sights, sounds, smells

   New, different routines

   Interrupted sleep

   Day and night confusion
Preparing Infants
 Keep  routines
 Bring favorite security item
 Let nursing staff know about baby’s
 Parents remain calm
 Be patient with infant
   Hard   to comfort, console, clingy
 Distract,   rock, comfort
Preparing Toddlers/Preschoolers
 Stressors
   Being left alone
   Having to stay in strange bed/room

   Loss of comforts of home, family

   Being in contact with unfamiliar people

   Painful procedures

   Medical equipment that looks scary
Preparing Toddlers/Preschoolers
   Read books about going to hospital
   Interactive play with dolls
   Simple explanations
       “The doctor will fix your arm” vs. “The doctor is going to
        make a cut in your arm.”
       Anesthesia is “being put to sleep” vs “help you fall asleep
        during operation and wake up afterwards”
 Tell the truth: “It will hurt (like…), but it won’t last
 Establish “procedure free zones”
 Stay with child during hospitalization
Preparing School Age
 Stressors
   Being away from school/friends
   Thinking he/she is in hospital because
    he/she is being punished
   Loss of control

   Pain

   Needles/shots

   Dying during surgery
Preparing School Age
   Take tour
   Make sure child knows why is having surgery in words they
   Have child explain back their understanding
   Read books
   Give as many choices as possible
   Explain benefits of surgery
        “after your knee is healed, you will be able to play soccer again.”
   Encourage child’s friends to visit
   Have someone stay with child as much as possible
   Let child know it’s acceptable to cry and be afraid
Preparing Teenager
   Stressors
       Loss of control
       Being away from school/friends
       Having a part of his/her body damaged or
        changed in appearance
       Fear of surgery and risks
       Pain
       Dying during surgery
       Fear of the unknown
       Fear of what others will think about them being
        sick in hospital
Preparing Teenager
   Allow teen to be part of decision making process (e.g.,
    encourage to make list of questions)
   Read books
   Ask friends to visit/send cards
   Journal
   Bring comfort/game items from home
        Personalize space
   Be patient with mood swings – allow them to be alone if needed
   Let them know it’s acceptable to cry/be afraid
   Be truthful
   Honor privacy requests

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