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published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

The research problem in this qualitative, pilot study explores a child's impressions of hospitalization while in hospital. / Nine children who were in-patients on a pediatric unit of an acute care hospital were interviewed using a semi-structured, self-constructed questionnaire. / The principal finding indicates that these children experienced a neutral emotional response to their hospitalization. Although the subjects were chosen randomly, all children resided in two parent families. This may be a significant factor in enhancing their ability to master hospitalization. Second, their neutral impression of hospitalization may be based on receiving a reasonable level of health care in a child centred environment with support from family.

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In partial fulfillment of the requirements for the degree of Master in Nursing, Faculty of Nursing.

The purpose of this study was to explore the experiences and needs of families during the admission of a child to a paediatric ward in an acute care hospital. Qualitative research methods were used to access the caregivers' and professionals' perceptions of the culture that families experience in a paediatric in-patient setting. For this project, data collection methods included a review of the literature in the area, individual interviews with caregivers, and focus groups with paediatric health care professionals. / In the study, both parents and paediatric professionals described a multitude of experiences and needs of families during a child's admission to a paediatric ward in an acute care setting. Understanding the experiences and needs of families is important for professionals. The information collected in this study provides some insight into the culture that families experience when their child is admitted to a paediatric ward in an acute care hospital.

D.Cur. / Hospitalisation can be very traumatic for children – and this is especially true for the child admitted to a haematology-oncology unit. These children are subjected to an environment which they do not understand, nor have any control over, they are faced with many unfamiliar sights, sounds and smells and they have to undergo frightening and often painful procedures. In South Africa, there are no associations responsible for monitoring the environment that children are subjected to in hospital; neither does any Child Life Specialists, Hospital Play Therapists or scientifically based programs exist that can ensure that the psychosocial needs of children in hospital are met. The purpose of this study was to develop and describe a model for the facilitation of support for children through the mobilisation of resources according to their needs in a haematology-oncology unit in the private healthcare sector of South Africa. The following research questions were asked: • What are the needs of children in a haematology-oncology unit? • What are the resources that can be mobilised so that the needs of these children can be met? • How can support be facilitated for children in a haematology-oncology unit? During this study a theory generating, sequential explanatory (consisting of a quantitative field study followed by qualitative model development), explorative, descriptive as well as contextual research design was used. A model was developed according to the method of theory generation as explained by Chinn and Kramer (1995:77-102) and involved the following steps: Concept analysis (which includes concept identification as well as concept definition and –classification); description of the links and relationships between the concepts and a description and evaluation of the model. It became evident that children in a haematology-oncology unit are robbed of all feelings of control and choice in the situation, resulting in a sense of powerlessness. For this reason, the focus point of the model was changed to include the empowerment of children in a haematology-oncology unit as the main focus of the model. The final model aims at the facilitation of support in order to empower children in a haematology-oncology unit in the private healthcare sector of South Africa.

The purpose of this study was to compare a tour-based preadmission preparation programme for young children to a video-tape-based programme. Subjects were 30 English speaking children who were admitted to Surrey Memorial Hospital, a community general hospital in Surrey, B.C. The children were admitted for elective surgery which required an overnight stay. The children and their parents participated in the programmes three days to two weeks prior to the child's scheduled surgery. Half of the children and their parents were taken on a tour of the paediatric ward and laboratory. The other group was shown a video-tape made at the Surrey Memorial Hospital, which depicted the hospitalization of a boy and girl for tonsillectomy and adenoidectomy. Both treatments were followed by a discussion and play period. The two groups were not found to differ on sex, previous hospitalizations, types of surgical procedure, length of stay, length of anaesthesia, or prehospital personality as measured by a modification of the Post-hospital Behavior Questionnaire (Vernon, Schulman, & Foley, 1966). However, the tour group was found to contain more younger children (under 6 years of age) than the video group. No significant differences were found between the two groups on the self-report, behavioural, or physiological outcome measures, except for incidence of postoperative vomiting. The video group vomited less than the tour group. Questions concerning the validity of the Hospital Fears Rating Scale and the modified Posthospital Behavior Questionnaire for this age group are raised in the discussion. Complicating factors, such as small sample size, lack of a control group, and lack of control over physiological data collection are addressed in this chapter. Confounding factors, such as a preoperative teaching class and the discussion groups, are also addressed. Finally, the impact of Preadmission Programmes and practical considerations in choosing a programme are discussed. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

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