Abstract | Hospitalizacija u dječjoj dobi bitno se razlikuje od hospitalizacije odraslog
čovjeka, jer se dijete odvaja od obitelji, poznate okoline, a neadekvatan
pristup i uvjeti tijekom hospitalizacije mogu učiniti štetu u emocionalnom
razvoju djeteta. U ne tako dalekoj prošlosti narušavanju odnosa između
roditelja i djeteta pridonosila su i bolnička pravila prema kojima roditeljima
zbog straha od infekcije nije bilo dopušteno držati ili dodirivati dijete dok je
bilo na odjelu intenzivne njege. Kako su istraživači sve više uviđali važnost
najranijih socijalnih interakcija između majke i djeteta, stvari su se počele
mijenjati.
Skupina istraživača sa Stanfordskog sveučilišta prva je učinila odvažan korak
i dopustila roditeljima dodir sa svojom djecom u jedinicama intenzivne njege.
Pored toga, oni su dokazali da se time ne povećava opasnost od infekcija. [1]
Reakcije i ponašanje djeteta u bolnici najviše ovise o njegovoj dobi.
Predškolska djeca najteže doživljavaju odvojenost od roditelja. Kako će dijete
reagirati na boravak u bolnici i da li će imati psiholoških poteškoća ovisi o
nekoliko varijabla. Neke od njih su: dob, priprema za odlazak u bolnicu,
prethodna iskustva, sposobnost prilagodbe, količina i vrsta potpore koju
dobiva od roditelja i medicinskog osoblja. Većina djece odvojene od roditelja
prolazi kroz tri faze prilagodbe na bolničku okolinu: fazu protesta, očajanja,
prividne prilagodbe. [2]
Odlazak u bolnicu predstavlja stres i za cijelu obitelj te je zato i vrlo važno
savjetovanje roditelja kako bi se ublažili i njihovi problemi jer emocionalno
stanje roditelja utječe na to kako se dijete osjeća. Vrlo je važna i
komunikacija između medicinske sestre i/ili doktora sa roditeljima koji ostaju
uz svoje dijete u bolnici, što može olakšati sam posao medicinskog osoblja u
vezi boravka djeteta u bolnici, dijagnostičkih i terapijskih postupaka. Iskustvo
je pokazalo da prisutnost roditelja u bolnici uz dijete pridonosi boljoj
djetetovoj prilagodbi na bolest i liječenje. Humanizacija bolničkog liječenja
koja se provodi kroz prepoznavanje i uvažavanje potreba i problema
bolesnog djeteta i njihovih roditelja, uz sustavan i organiziran rad na
usavršavanju komunikacije, postaje svakodnevnica. Vrijeme kada se djetetu
govorilo da ne ide liječniku, da neće ostati u bolnici, da mama ide “samo po
sok“ a zatim je više ne bi vidjelo, kad mu se tajilo da ide na operaciju i bilo
nepripremljeno za operaciju i u noći budilo napušteno, nemoćno i usamljeno,
bez potpore roditelja, srećom - vrijeme je prošlosti. [3] |
Abstract (english) | Hospitalization of children is very different from hospitalization of adults. First
of all because of the fact that children get separated from their families and
familiar environment, and also because inappropiate approach and
conditions can be very harmful to children's emotional development. Not so
long ago it was precisely because of the hospital rules that the relationship
between parents and children was undermined. Parents were not allowed to
hold or touch their children while in intensive care becuse of the fear of
infections. As the researchers started to see the importance of social
interaction between a mother and a child, the things started to change.
The group of researchers from Stanford university made the first big step and
allowed the parents' physical contact with their children while in intensive
care units. Also, they managed to prove that it does not increase the danger
of getting an infection. (Barnett and ass. 1970) [1]
A child's reactions and behaviour while hospitalized is mostly conditioned by
its age. Preschool children are the most difficult age group, they suffer the
most when separated from parents. Children's reactions to hospitalization
and possible psychological problems depend on several factors. Some of
them are: age, going to hospital preparation, previous experience, ability to
adjust, the type and amount of attention they get from their parents and
medical staff.Most of the children separated from their parents go through
three phases of adjustment to hospital environment: the phase of protest, the
phase of despair and the phase of illusory adjustment. [2]
Hospitalizing a child is very stressful for the whole family. It is very important
to have parents counseled in order to diminsh their stress, as the parents'
emotional state affects their child's feelings. The communication between
nurses and/or doctors and parents accompanying their child at the hospital is
extremely important and it can make medical staff's job and diagnostic as
well as therapeutic activities easier. Experience has shown that parents'
being present with their child at hospital contributes child's better adjustment
to illness and treatment. Humanizing hospitalization which is implemented by
recognizing and appreciating sick child's and its parents' needs and
problems, as well as by systematic and organized communication
improvement, is becoming more and more common. The times where we
used to tell a child that it is not going to see a doctor, that it is not going to
stay at hospital, that mummy is only ''going out to get some juice'' , where it
was a secret that a child is having an operation so it was not prepared, where
a child used to wake up in the middle of night, alone, abandoned, lonely,
without the parents' support – are luckily behind us. [3] |