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J Nurs Acad Soc. 1976 Jun;6(1):72-79. Korean. Original Article.
Paik YC .
Department of Nursing, Graduate School of Ewha Womans' University, Korea.

Contempory nursing literature place much importance on human-centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communica-tion with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient, care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Scoial Readjustment Rating Scale and selected items from Volicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1 . The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4 % were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35. 8%). More than half of these (54.4%) were due to injury or accident. 2. Stress celated to illness revealed the highest score ( 4.97), followed by stress related to treatment environment and nursing care (4.34), isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3 . The perceived indifference of doctors and nurses was a serious cause of stress (mean = 4. 83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4. 71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6 .Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3. 7). 7 . Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P< 0. 05) 8 . Stress related to family problems was positively related to female and early a dolescent patients (P< 0. 05). Stress related to social problems was positively related to students and those preferring active pursuits (P< 0. 05). 9 .There were no correlation detween the high stress related to disease and any of the characteristic items. (P> 0. 05) 10. Stress related to treatment environment and nursing care was positively related of early adolesent and female and student patients. (P< 0. 05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.

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