Hospitalization And Self-Determination: A Case Study

Coyne and Conlon (2007) state that children experience hospitalisation as stressful and frightening. This can be influenced by factors such as age, preparation given beforehand, family support at home, previous experiences of hospitalisation, stage of illness, uncertain outcomes and loss of self-determination. (Coyne, 2011) Historically, Frazier et al (2010) suggests that hospitalisation lead to once happy children becoming irritable and withdrawn due to restricted visitation and little if any family involvement in care. This can leave long-term physical and psychological effects on the child, where studies have shown that multiple hospitalisations of a chronically ill child can lead to emotional and behavioural problems in later life. (Hysing

Ball et al. (2012) show that during hospitalisation, adolescents can experience loss of independence, identity and privacy. They fear bodily injury, changes in body image, fear of disability or death and they, like previous stages, experience separation anxiety from peers, home and school. Eichner and Johnson (2012) illustrate that the nurse can acknowledge their self-image and self-determination by offering education on procedures, giving them control over certain aspects of their care if possible, protecting privacy by knocking on the door before entering and asking permission to perform assessments, and allowing them to make choices in music, food, and activities. Furthermore, Leifer (2011) indicates that peers are a major influence and comfort in adolescent’s life, so it is vital to allow flexible visiting hours, maybe even allowing a ‘sleepover’ and encouraging peer-to-peer interaction especially with children and families of similar cultural or linguistic backgrounds. Lastly encouraging participation in education, recreation, use of teen-lounge facilities will reduce effects of hospitalisation in the adolescent.

In conclusion, by providing patient and family centred care and play through different therapies, the nurse can easily reduce the effects of hospitalisation. By using this approach, health care resources are used more efficiently and Eichner and Johnson (2012) outline how studies have shown that it decreases unnecessary hospitalisations, decreases malpractice issues, improves patient safety and communication, and it gives a stronger alliance with the family in promoting each child’s health and