Preparation for hospitalization and medical procedures
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Preparation for Hospitalization and Medical Procedures. Hospitalization. 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 painful

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Preparation for Hospitalization and Medical Procedures

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Preparation for hospitalization and medical procedures

Preparation for Hospitalization and Medical Procedures


Hospitalization

Hospitalization

  • 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 painful

    • They are usually not feeling well to begin with


Medical procedures during hospitalizations

Medical Procedures During Hospitalizations

  • 1/3 of hospitalized children suffer transient or long-term psychological reactions

  • What are some common medical procedures that children might experience while being hospitalized?


Methods of preparation

Methods of Preparation

  • Not empirically validated

    • Group tours and discussions

    • Bibliography

    • Puppetry

    • Play therapy


Types of programs

Types of Programs

  • Modeling

    • Filmed modeling

    • Puppetry

  • Coping skills training

    • Deep muscle relaxation

    • Imagery distraction

    • Positive self statements


Factors influencing effectiveness

Factors Influencing Effectiveness

  • 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

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 programs1

Goals for Preparation Programs

  • 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 programs2

Goals for Preparation Programs

  • Providing emotional support

    • “I understand” statements to communicate empathy

    • Reward children for specific cooperative behaviors

    • Reassuring physical touches may help relax child


Goals for preparation programs3

Goals for Preparation Programs

  • 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, sounds)


Preparing infants

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 infants1

Preparing Infants

  • Keep routines

  • Bring favorite security item

  • Let nursing staff know about baby’s schedule

  • Parents remain calm

  • Be patient with infant

    • Hard to comfort, console, clingy

  • Distract, rock, comfort


Preparing toddlers preschoolers

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 preschoolers1

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 long”

  • Establish “procedure free zones”

  • Stay with child during hospitalization


Preparing school age

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 age1

Preparing School Age

  • Take tour

  • Make sure child knows why is having surgery in words they understand

  • 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

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 teenager1

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


Website

Website

  • http://www.chop.edu/kidshealthgalaxy/khg.shtml


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