Chapter 19: Family-Centered Care: Illness & Hospitalization

Family-Centered Care: Illness & Hospitalization details the classic phases of separation anxiety—protest, despair, and detachment—and explains how these manifest differently across developmental stages, from the physical aggression of toddlers to the withdrawal seen in school-age children. The text explores age-specific vulnerabilities, noting that preschoolers often interpret illness as punishment due to magical thinking, while adolescents experience significant stress regarding loss of peer status and body image changes. A core focus is placed on nursing interventions that mitigate these negative effects, such as maintaining home routines, encouraging parental presence through rooming-in, and utilizing admission assessments based on functional health patterns to plan individualized care. The chapter emphasizes the critical role of play in pediatrics, distinguishing between diversional activities and therapeutic play used to express fear or tension, and outlines the use of dramatic play and puppets to explain medical procedures. Additionally, it addresses the unique challenges presented by specific hospital environments, including the sensory deprivation of isolation, the sensory overload of the intensive care unit, and the rapid pace of emergency admissions. The content concludes by discussing the necessity of comprehensive discharge planning and family education to ensure a safe transition from the hospital to home care.