A hospitalisation experience is serious for every toddler, and implies physical and emotional trauma of one kind or another. The reaction of the toddler in terms of this trauma in effect is a normal reaction to an unnatural situation, through which he tries to be in control of himself and his unknown environment. His lack of experience, incomplete cognitive reasoning, and lack of insight cause anxiety and stress for the toddler. Misbehaviour because of account of his anxiety and fear which the form part of the toddlers attempts to control and get hold of this unknown situation. The research is primarily aimed at how the therapist, parents and hospital personnel can prepare, assess and support the toddler, in terms of handling the hospitalisation process. Seeing that there is normally no one to blame for the toddlers admission to hospital, the child directs his anger and anxiety at himself, resulting in inner conflict and intense feelings of guilt. The research project aims to focus on preparation of the pre-primary toddler for hospitalisation, by using playtherapeutic intervention, in order to lessen the fear and anxiety of the experience. This goal was achieved by a literature study, an empirical study with the aid of application of a preparatory intervention program, as well as an assessment and an evaluation of the program, in order to make recommendations, regarding the research. Optimal care, and preparation of sick toddlers for admission in hospital, includes more than satisfying the child’s physical needs. It also asks for gratification of the toddler’s psychosocial needs. Support and preparation of both the child and his/her parents form an integral component of the sanitary care process. Therapeutic activities with the child that is going to hospital, can, according to the goals of the research study, be instrumental in reducing fear, promote self-esteem, become acquainted with the medical setting and procedures, as well as providing in the toddlers physical, emotional, psychological and psychosocial needs. A complete and refined play therapeutic preparation program was developed and evaluated through the findings of the empirical and literature study. The process of intervention research was followed in the empirical study, where data was obtained with the aid of a purposive sample, of 20 hospitalised toddler respondents. Creswell’s dominant-less-dominant model was utilised. A dominant quantitative approach was being followed, through witch data was assembled by a self developed structured observation instrument, as a post-test for both the experimental as well as the comparative group. The less dominant, but equally important qualitative approach, that consisted of 9 playtherapeutic sessions with experimental group, field notes and interviews with parents, enrich and verified the quantitative data. According to the integration of the quantitative and qualitative findings, the conclusion can be made that the preparatory playtherapeutic program had a positive impact on the way fear and the toddlers handled anxiety during hospitalisation, with less misbehaviour. The findings show that the developed preparatory playtherapeutic program can be implemented with great success and confidence, with toddlers that are going to be hospitalised. It is recommended that further research can be done on development and evaluation of preparation programmes for toddlers from less fortunate communities. Seeing that individual sessions may due to financial difficulties be less tenable, group sessions and community work can be recommended to reach larger groups of children, as well as creating community awareness for the needs of toddlers, related to hospitalisation. / Thesis (DPhil (Play Therapy))--University of Pretoria, 2005. / Social Work / unrestricted

Text in Afrikaans / Die doel van hierdie studie was om te bepaal hoe volwasse enkel-tweelinge hul lewens ervaar na die verlies van hul mede-tweeling. ‘n Kwalitatiewe empiriese ondersoek is gedoen met die doel om die behoeftes van enkel- tweelinge tydens die hantering van tweelingverlies en die rouproses te bepaal. Literatuur toon aan dat die oneffektiewe hanteringsvaardighede wat gebruik word tydens tweelingverlies kan lei tot emosionele, kognitiewe, identiteits-, verhoudings- en gedragskwessies. Die literatuur dui verder aan dat daar agt temas is wat bepaal of hierdie kwessies tydens die lewe van die enkel-tweeling gaan voorkom. Die agt temas is naamlik die effek van ouerlike gesindheid, negatiewe aspekte om ‘n tweeling te wees, skuldgevoelens, polarisasie, die tweelingband, versagtende omstandighede en die effek van die verlies op die verhouding met ander. ‘n Meervoudige gevallestudie met ‘n narratiewe analitiese proses is in die studie gevolg. Agt deelnemers het ‘n self-opgestelde vraelys voltooi. Daarna is semi-gestruktureerde onderhoude gevoer om die temas wat verband hou met die vraelys verder te ondersoek. ‘n Opvolg in-diepte onderhoud is ‘n maand later met elke deelnemer gevoer waartydens hulle hul ervaring as enkel-tweeling bespreek het. Die eerste verwagte uitkoms was om die behoeftes van die enkel-tweeling wat tweelingverlies hanteer, te verstaan. Die tweede verwagte uitkoms was om by te dra tot kennis oor tweelingverlies en rou by die enkel-tweeling. Die bevindinge toon aan dat vier onverwagse temas vanuit die studie na vore gekom het, naamlik geheimhouding rakende die bestaan van ‘n mede- tweeling, voel soos ‘n aangenome kind, die kwessie van geloof as prominente faktor in die genesingsproses en die tweeling identiteit wat behou wil word. Riglyne is aan opvoedkundige sielkundiges gegee om hul toe te rus om die enkel-tweeling se verlies en rou te verstaan. ‘n Bydrae ten opsigte van kennis oor tweelingverlies en rou by enkel-tweelinge is gemaak. / The purpose of this study was to determine how adult twinless twins experience life following the loss of their co-twin. A qualitative empirical investigation was conducted in order to establish the needs of twinless twins in dealing with twin loss and the bereavement process. Literature indicates that ineffective coping mechanisms used in the loss of a twin, could result in emotional, cognitive, identity, relationship and behavioural issues. The literature further indicates that there are eight themes which determine whether these problems will culminate during the life of the twinless twin. These eight themes are: the effect of parental attitude, negative aspects of being part of a twin, feelings of guilt, polarisation, the twin connection, mitigating circumstances and the effect of loss on the relationship with others. The study followed a multiple case study research design with a narrative analytical approach. Eight participants completed a self-structured questionnaire. Thereafter semi-structured interviews were conducted to further explore themes related to the questionnaire. A follow-up in-depth interview was conducted with each participant one month later during which they described their experiences of being a twinless twin. The first anticipated outcome was an understanding of the needs of a twinless twin in dealing with loss of his or her twin. The second expected outcome was to add to the body of knowledge about twin loss and bereavement in twinless twins. The findings show that four unexpected themes emerged from the study, namely: secrecy regarding the existence of a co-twin; feeling like an adopted child; the issue of faith as a prominent factor in the healing process, and maintaining a twin identity. Guidelines are given to equip educational psychologists to understand twin loss and bereavement in twinless twins. The study contributed towards knowledge of twin loss and bereavement in twinless twins. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)