J Nurs Acad Soc.  1973 Dec;3(3):97-110.

Study of the Effect of comprehensive Nursing Care on the Adjustment of Children to Hospotalization

• Lee JH

Abstract

The goal of Modern nursing is to provide comprehensive nursing care to patients. If comprehensive nursing care to children (within the hospital setting) is to be provide, consideration of the stage of growth and development of the child is especially important. From clinical observation, it appeared that nurses often disregarded individual requirements of children in giving nursing care. Therefore, the purpose os this study is to show that comprehensive nursing care which is based on an understanding of the growth and development of the child contributes to both the child and the mother's adaptability to the child's hospitalization. METHOD: Sixty children, three to twelve year of age, hospitalized at the Yonsei University Pediatric Ward were studied. From April 1, 1973 to May 5, 1973 children admitted to the hospital were assigned to either an experimental or a compare groups. There were 30 children in each group. The sex and age of the children in each group was similar. In both groups were more male than female children. In the experimental group, each mother stayed with her child continuously during his hospitalization. In the compare groups, the mother or some other member of the family stayed with the child. Each day on the child's admission the investigator visited the ward from 1-2 P.M. to 9-10 P.M., in order to provide comprehensive care for the experimental group. The assistance given the nurses by the investigator was in the from of conferences regarding care and in giving direct care to the child and his mother. The compare group of children received nursing care as usually provided by the hospital. The instrumental used to obtain the data for analysis were as follows : 1. The fear and anxiety reaction of the child was recorded by observation of the investigator for four areas : 1) separation from parent and relatives 2) reaction to Doctor and Nurse with white gowns 3) reaction to nursing care 4) reaction to injection and tests, etc. 2. Regression in area of eating, sleeping, and elimination were recorded by the investigator by questioning the mother and by observation. 3. Adaptability to the hospitalization was reordered by direct questioning of the children for areas of emotional and social adjustment. For children older than 3 years of age or children not seriously ill, using the simple I.Q. test this was possible for only 35 of the total 60 children.
RESULTS
: 1. 55 percents of the total 60 children had been prepared by their patents for hospitalization. The children who had received prior preparation accepted hospitalization more readily than those who had received no preparation. ( x2 4.6 P<0.05 ) 2. On admission 31.7 percent of the children expressed verbal fear of their disease or treatment. 25 percent felt that the disease was due to their mistake. 3. There was a significant difference in the reaction of the child to separation from the parent or relatives, between the two groups. The experimental groups showed less anxiety due to separation than the compare group. ( x2 4.34 P<0.05 ) In both groups there was less anxiety due to separation among school age(6-12 years) children than among preschool age(3-5 years) children. 4. More than half of the children in both groups reacted with fear and avoidance to doctor and / or nurses wearing white gowns. ( x2 0.06 P<0.05 ) 5. The experimental group reacted more favorably to nursing in general than the compare group. ( x2 4.8 P<0.05 ) 6. There was no difference in the fear and refused reaction to special tests and / or such as X-rays and injections, etc. between the groups. ( x2 3.77 1>P>0.05 ) 7. More children in the compare group showed regressive tendencies in eating, sleeping, and elimination habits than in experimental groups. ( x2 2.3 P>0.05 x2 3.88 P<0.05 x2 4.9 P<0.05 ) 8. There was a significant difference in the adaptability to hospitalization between the two groups. The experimental groups adapted more readily. ( x2 2.02 P<0.05 ) 9. For children who had higher I.Q.s the adaptability to hospitalization was better regardless of the group. However, because of the small number of cases(60), this finding cannot be extrapolated without further verification. The data demonstrates that there was a greater adaptability to hospitalization by the child when comprehensive nursing care was given. By planning care and applying knowledge of growth and development to meet, nurses are in a position to prevent some of the psychological trauma associated with ospitalization.

MeSH Terms

Anxiety
Child*
Congresses as Topic
Eating
Female
Growth and Development
Hospitalization
Humans
Male
Mothers
Nursing Care*
Nursing*
Parents
Research Personnel
Social Adjustment