II-12 The Hospitalized Child

Question 1

Summarize the findings of Janis (1958) and of Egbert et al (1964).

Answer 1

Janis (1958): This classic study compared the post-operative experiences of patients with low, medium, and high levels of anxiety. Patients who were moderately anxious prior to surgery coped most effectively with post-operative stress. High-anxiety patients remained anxious after surgery and were more likely to experience negative side effects such as pain, loss of appetite, and nausea. Low-anxiety patients also showed unfavorable reactions to post-operative stress, becoming angry and upset over symptoms that they were not prepared to face. The medium-anxiety patients had the right level of vigilance; they were prepared to expect post-operative stress but did not compound that stress with their own worries and fears.

Egbert et al (1964): In this study, half the patients were alerted to the likelihood of post-operative pain and were given information about its normality, duration, and severity. They were also taught breathing exercises that would help them control the pain. The other half of the patients received no such information or instructions. When examined post-operatively, patients in the instruction group showed better post-operative adjustment. They required fewer narcotics and were able to leave the hospital sooner than were the patients who had not received the preparatory instructions.

Question 2

Compare the anxiety response of children in different age ranges.

Answer 2

Ages 2 to 4: Children’s anxiety may arise from their wish to be with the family as much as possible and more than may be practical.
Ages 3 to 6: Children may become upset because they feel they are being rejected, deserted, or punished by their families.
Ages 6 to 10: Children experience free-floating anxiety that they cannot attribute to any specific issue but that makes them feel irritable and distracted.

Question 3

Describe the preparation interventions that are most effective for children

Answer 3

Children respond most positively to preparation interventions that lets them know what to expect of the hospitalization experience, that offers relaxation and coping skills, that teaches them positive self-talk, and that provides age-appropriate information related to their illness and treatment.

Question 4

control enhancing interventions

Answer 4

Interventions with patients who are awaiting treatment for the purpose of enhancing their perceptions of control over those treatments

Question 5

psychological control

Answer 5

The perception that one has at one’s disposal a response that will reduce, minimize, eliminate, or offset the adverse effects of an unpleasant event, such as a medical procedure.