Parents in pediatric RR TeriA Dew, RN Mary E Bushong, RN Robert S Crumrine, MD Studies on the effects of parent-child separation and the emotional response of parents and children to separation during hospitalization have helped promote an acceptance of unrestricted visiting for parents in children’s hospitals and increased parental participation in the care of their children.’ Vernon, in his review of the literature, identifies three particularly stressful periods in a child’s hospitali-
zation. The first is admission to the hospital, a time when there is little objection to parents being present. The second concerns examinations and painful procedures and the third is the immediate postoperative period. The benefits of permitting parents to be present at these times have been the subject of controversy.2 Although the preparation and premedication of children for anesthesia
“The greatest satisfaction of a parent is being there when your child is sick and really needs moral support.’’
266
AORN Journal, August 1977, Vol26, No 2
and surgery have been widely attended to, little has been done to reunite the family in the often strange and stressful postoperative environment.3 Children are surrounded by strange nurses and physicians in “funny clothes”; parents pace the hallways wondering, ‘(1s my child awake yet?” and “What has the doctor found?” Some factors to consider in helping prevent emotional trauma secondary to hospitalization are the relationship between the child and his parents, the preparation of the child and parents for the hospital experience, and the hospital’s ability to modify the experience to meet the adaptive capabilities of both the child and parent^.^ The child’s ability to adjust to the hospital is influenced by understanding and emotional support from physicians and nurses and provision for the parent to stay with the child.5 When we instituted parental visiting in our recovery room at University Hospitals of Cleveland, we were guided by observations made by May about children and parents in an intensive care unit. He found that children want to be free of pain and that pain can be diminished by decreasing fear of it. He noted a positive emotional response when this was done by someone the child trusted-the parents. The parents praised the “excellence of care” and were enthusiastic about “unlimited visiting and the emotional support given by the staff.”s Our pediatric recovery room is a n eight-bed unit located adjacent to the operating rooms and the main surgical floors of the children’s hospital. When we opened the unit, we decided to allow parents to be with their children as they awoke from anesthesia. Although the practice of permitting parental visiting in a recovery room is not widely recognized, it was theorized
Age range Table 7 Patient age I0 years ~~
# of patients 7 14 11 12
3 3 50
-
~
Breakdown into age groups of 50 pediatric patients ranging from 2 weeks to 14 years old.
that it could be a means of reducing stress for the pediatric surgical patient and the parents.’ Most of the physicians and nurses involved in caring for the children supported this visiting practice. However, a few felt the experience might be excessively disturbing for the parents. A study was designed to determine if parents believed that visiting in the recovery room served a useful purpose for them and their children. Children identified from the operative schedule were visited the day prior to surgery, and the study was discussed with their parents. Only parents of patients who had never received anesthesia and whose siblings had never had anesthesia were included in the study. Parents consenting to be included were asked to sign human investigation consent forms, and permission was obtained from the physician responsible for each child’s medical care. Written guidelines for visiting were given to the parents (Fig 1). After visiting in the recovery room, each parent was asked to fill out a questionnaire independently (Fig 2).It was stressed there were no right or wrong answers to the questions. The questionnaire was returned in a sealed envelope, and to insure confidentiality,
AORN Journal, August 1977, V o l 2 6 , No 2
267
a code number was assigned to each questionnaire. The study sample consisted of 57 parents (49 mothers and 8 fathers) of 50 patients (38 boys and 12 girls). The patients’ average age was 3.8 years (Table 1). Classes of surgical procedures (total of 57 procedures on the 50 patients) are shown in Table 2. All parents responded affirmatively when told they might visit their children in the recovery room. Eighty-four percent of the parents indicated they were very nervous while their children were in surgery and the wait before they could see them seemed very long. When the parents first saw their children, 86% felt better than before they visited. Although five parents felt worse, by the time they left the recovery room only one parent (2% of the total) felt worse. Ninety-eight percent thought it was helpful for them to have been with their children. When asked whether they would want to visit in the recovery room if surgery was ever again needed, 100% replied affirmatively. Questions attempted to distinguish what parents liked and did not like about visiting and to determine whether they felt visiting was beneficial to them and their children. Analysis of the responses revealed several recurring themes. When responding to what they liked about visiting, 54% indicated it was reassuring to the parent, 199’‘ indicated it was reassuring to the parent and child, and 25% indicated it was reassuring to the child. Similarly, the 56 parents who felt it was helpful to them to have been with their children explained it was due to the feeling of reassurance. The one mother who did not feel visiting had helped her personally indicated i t was because she had been “very nervous.” Overall, 88% of the parents indicated they felt their 268
Surgical procedures Table 2 Urology General pediatric surgery Otolaryngology Plastic surgery Diagnostic procedures Procedure cancelled after induction of anesthesia
# of patients 24 18 4 9 1 1 -
57
Classes of surgical procedures performed on 50 pediatric patients.
presence in some way had been helpful to their children. Of the nine parents who indicated there were aspects to visiting they did not like, five objected to the condition or appearance of their children (“seeing the IV in his arm”). One parent did not like the “condition” of some of the patients other than his own child. One parent was worried about being in the way, and two parents expressed embarrassment concerning their children’s “behavior.” Even though parents voiced these objections, some also included positive remarks in their responses, eg, “We do not go to the pediatric recovery room only to make ourselves feel better, but for the kids.” Forty-eight parents did not respond to this question or made a supportive response, eg, “There wasn’t anything I didn’t like” or “Nothing at all.” The vast majority of parents found the guidelines given to parents helpful, and only 7% offered suggestions for additional information. These parents wanted more warnings as to how the child might react, eg, “Would the child react mechanized or disoriented?” They also wanted explanations of equipment that might be used, such as fluid administration equipment and oxygen masks.
AORN Journal, August 1977, V o l 2 6 , N o 2
“Being able to hold him and comfort him. Letting him know I didn’t deseri him.”
This study indicates that visiting in a pediatric recovery room can be a positive experience for parents and that it can serve a useful purpose. Visiting had a reassuring effect for the parents, and parents also believed it had a similar effect on their children. Parents indicated they were reassured by (1) generally experiencing a feeling of relief, (2) seeing for themselves the child’s condition, (3) seeing the child sooner, and (4) seeing the care provided. Among the comments were: “Gives you and him a little more feeling of security.” “I felt much less apprehensive about his condition while with him than while waiting to see him.”
“I was relieved and less apprehensive at being able to see my child as soon as I did.” “I liked being a comfort, able to answer his questions, being visually assured of the constant care one gets immediately after surgery.” Parents also commented they were able to provide reassurance to their children by their presence, ability to comfort, and, in some instances, ability to hold their children physically. The remarks indicated that parents did not believe it was necessary to care for their children physically, but that their role was to be with and comfort the children. Some comments were: “I felt I could help him adjust to the room, help to comfort him, and also let him know his parents did not leave him alone to face this unfamiliar surrounding. If it helps the child-which I think it does-that’s what it’s all about.’’ “I think the parents can aid in the general comfort and calming of the child, thus easing any of their own tensions.” “Being able to hold him and comfort him. Letting him know I didn’t desert him.” Perhaps these are the comments that have the greatest significance when one considers the question, Would visiting in the recovery room be excessively disturbing for parents? Reassuring the child through comforting implies the parent did not desert the child, and the parent is fulfilling the need described as parenting by Temple. He states that with the hospitalized child, a n enormous gap is apparent between parent and child. No matter how much the parents would suffer for the child, they can only stand by as the child suffers for himself. Parenting has to include the sense of having gone
AORN Journal, August 1977, V o l 2 6 , N o 2
269
“lf it helps the child-which l think it does-that’s what it’s a// about.”
“all the way” with your child.s As one parent in the study expressed it: We felt we were really needed, and the greatest satisfaction of a parent is being there when your child is sick and really needs moral support. A factor often overlooked is that a child’s adjustment to the hospital experience may depend on how well the parents adjust to the hospital situation. This adjustment consists of the ability of the parents to control their anxiety about the child’s illness, to give emotional support to the child, to accept the realities of the child’s illness, and to handle visiting opportunities.9 Summary. The chief anxieties of hospitalization and surgery for children are related to separation from parents. To minimize the separation, parental visiting was instituted in the pediatric recovery room. A questionnaire to explore this issue was given to 270
parents who had been in the recovery room with their children. At the outset, lOoO/o liked the idea of visiting and 100% would visit again. Eighty-four percent were nervous while waiting, but 86% felt better when they first saw their child and when they left the recovery room. Although five felt worse when they first saw their child, only one felt worse when she left. Parents were reassured by (1) generally experiencing a feeling of relief, (2) seeing for themselves the child’s condition, (3) seeing the child sooner, and (4) seeing the care provided. Parents believed their children were reassured by the parents’ presence and ability to comfort. Children were also comforted by parents physically holding them. Comments indicated that parents did not believe it necessary to care for their children physically, but rather to place great emphasis on their roles as comforters. 0
AORN Journal, August 1977,Vol26, No 2
Guidelines for parents visiting in pediatric recovery room Figure 1 University Hospitals and the pediatric recovery room staff have made it possible in most instances for parents or legal guardians to be present in the pediatric recovery room soon after the child returns from surgery. Guidelines for visiting in the pediatric recovery room have been established by the nurses and physicians. The following illformation will give you some understanding of the recovery rcom routine and some helpful hints for those of you who may wish to visit the recovery room. Following surgery, your child is transported immediately to the pediatric recovery room. Exceptions include cardiac surgical patients and patients whose operative procedures are not completed before 4:30prn-these patients are cared for in the adult recovery room where visiting is not permitted. A recovery room nurse takes your child's temperature, pulse, and respiration; receives a report from the anesthesiologist; checks the physician's order; records her observations; and gets your child settled. The nurse makes an evaluation of each patient and decides when the parents may be called in. There are a number of factors taken into consideration. Please do not become alarmed i f you are not called immediately since the unit may be extremely busy, making it physically impossible to have parents in the area. Your child may be very sleepy, starting to wake up, or he or she may sleep for what seems a long period of time. This is not unusual as each child reacts to anesthesia in
an individual manner. You will not be called into the pediatric recovery room until your child has begun to wake up. We ask that parents do not come to the recovery room until they are called by a member of the nursing staff. We would like to emphasize that you are called to the recovery room to provide support for your child. We request that you stay at your child's bedside, do not walk around the room, and do not inquire about other children in the room. Chairs will be provided, and when physically possible, you may hold your child as he or she awakens. The nurses will be happy to answer any questions you may have about your child, and they will call the physician to talk with you if necessary. It is important that you know you are not required to stay. If you are uncomfortable, feel at liberty to leave the room, go for coffee or lunch, and either wait in your child's room or you may check back in the recovery room later. At any time during your visit, it may be necessary to ask you to leave. You will be given a reason at the time. Please respect the decision of the pediatric recovery room staff. Only parents or legal guardians are permitted to visit in the pediatric recovery room. Our lack of space necessitates that we limit the number of visitors. Every child stays in the pediatric recovery room at least one hour.
Notes 1. J Bowlby, "Separation anxiety," lnternationsl Journal of Psychoanalysis 41 ( 1 960) 89-1 13; Helen Gofman, Wilma Buckman, George Schade, "The child's emotional response to hospitalization," Journal of Diseases of Children 93 (February 1957) 157-163; Helen Gofman. Wilma Buckman, George Schade, "Parent's emotional response to child's hospitalization," Journal of Diseases of Children 93 (June 1957) 629-636; D G Prugh et al, "A study of the emotional reactions of children and families to hospitalization and illness," American
Journal of Orthopsychiatry 23 (January 1953) 70106. 2. David Vernon et al, The Psychological Responses of Children to Hospitalization and Illness (Springfield, Ill: C C Thomas, 1965) 36-38. 3. Barbara Korsh, "The child and the operating room," Anesthesiology 43 (August 1975) 251-257; Lewis Francis, Robert P Cutler, "Psychological preparation and premedication for pediatric anesthesia," Anesthesiology 18 (January-February 1957) 106-109; Madilon A Visintainer, John A Wolfer, "Psychological preparation for surgical
AORN Journal, August 1977, V o l 2 6 , N o 2
27 1
Visiting in the pediatric recovery room as viewed by parents Figure 2 1. How are you related to the child you visited in the pediatric recovery
room? -mother -father 2. When you were told that you might be able to visit your child in the pediatric recovery room, did you like the idea? yes Why? -no Why not? 3. Many parents have told us they are very nervous while their child is in surgery and that the wait before they can see their child again seems very long. Did you feel this way? yes -no 4. When you first saw your child in the pediatric recovery room, how did you feel? better than before I saw him/her worse than before I saw hirn/her about the same as before I saw him/her 5. By the time you left the pediatric recovery room, how did you feel? better than before I went there worse than before I went there ~. about the same as before I went there 6. What did you like about visiting your child in the pediatric recovery room? 7. What didn’t you like about visiting your child in the pediatric recovety room? 8. Now that you have actually been with your child in the pediatric recovery room, do you think it was helpful to you to go there? yes Why? no Why not? 9. Now that yau have actually been with your child in the pediatric recovery room, do you think it was helpful to your child for you to go there? .yes Why? no Why not? 10. Was the information contained in the “Guidelines for parents visiting in the pediatric recovery room” (the information sheet you were given yesterday) helpful in preparing you to visit your child? 11. Is there other information you think should be included in the “Guidelines for parents visiting in the pediatric recovery room”? -no yes If so, what? 12. If your child ever had to have surgery again, would you want to be able to be with hirn/her in the recovery room? yes -no Why not? ~
~
-
~
~
~
pediatric patients: The effect on children’s and parents’ stress responses and adjustment,” Pediatrics 56 (August 1975) 187-202. 4. Gofman, Buckman, Schade, “The child‘s emotional response to hospitalization,” 157. 5. Korsh, “The child and the operating room.” 6. Jack May, “A psychiatric study of a pediatric intensive therapy unit,” Clinical Pediatrics 11 (February 1972) 76-82. 7. L Coleman, “Children need preparation for tonsillectomy,” Child Study 29 (1952) 18-19, 42-44; E O’Connell, P Brandt, “Liberal visiting hours for parents,” American Journal of Nursing
272
60 (1960) 812-815;A Blau el al, “The collaboration of nursing and child psychiatry in a general hospital,” American Journal of Orthopsychiatry 29 (1959) 77-93. 8. P C Temple, “Children in hospital: Life, death, and learning,” Chicago Tribune Magazine (Nov 2, 1975). 9. Prugh 81 al, “A study of the emotional reactions of children.”
AORN Journal, August 1977, V o l 2 6 , N o 2
zation. The first is admission to the hospital, a time when there is little objection to parents being present. The second concerns examinations and painful procedures and the third is the immediate postoperative period. The benefits of permitting parents to be present at these times have been the subject of controversy.2 Although the preparation and premedication of children for anesthesia
“The greatest satisfaction of a parent is being there when your child is sick and really needs moral support.’’
266
AORN Journal, August 1977, Vol26, No 2
and surgery have been widely attended to, little has been done to reunite the family in the often strange and stressful postoperative environment.3 Children are surrounded by strange nurses and physicians in “funny clothes”; parents pace the hallways wondering, ‘(1s my child awake yet?” and “What has the doctor found?” Some factors to consider in helping prevent emotional trauma secondary to hospitalization are the relationship between the child and his parents, the preparation of the child and parents for the hospital experience, and the hospital’s ability to modify the experience to meet the adaptive capabilities of both the child and parent^.^ The child’s ability to adjust to the hospital is influenced by understanding and emotional support from physicians and nurses and provision for the parent to stay with the child.5 When we instituted parental visiting in our recovery room at University Hospitals of Cleveland, we were guided by observations made by May about children and parents in an intensive care unit. He found that children want to be free of pain and that pain can be diminished by decreasing fear of it. He noted a positive emotional response when this was done by someone the child trusted-the parents. The parents praised the “excellence of care” and were enthusiastic about “unlimited visiting and the emotional support given by the staff.”s Our pediatric recovery room is a n eight-bed unit located adjacent to the operating rooms and the main surgical floors of the children’s hospital. When we opened the unit, we decided to allow parents to be with their children as they awoke from anesthesia. Although the practice of permitting parental visiting in a recovery room is not widely recognized, it was theorized
Age range Table 7 Patient age I0 years ~~
# of patients 7 14 11 12
3 3 50
-
~
Breakdown into age groups of 50 pediatric patients ranging from 2 weeks to 14 years old.
that it could be a means of reducing stress for the pediatric surgical patient and the parents.’ Most of the physicians and nurses involved in caring for the children supported this visiting practice. However, a few felt the experience might be excessively disturbing for the parents. A study was designed to determine if parents believed that visiting in the recovery room served a useful purpose for them and their children. Children identified from the operative schedule were visited the day prior to surgery, and the study was discussed with their parents. Only parents of patients who had never received anesthesia and whose siblings had never had anesthesia were included in the study. Parents consenting to be included were asked to sign human investigation consent forms, and permission was obtained from the physician responsible for each child’s medical care. Written guidelines for visiting were given to the parents (Fig 1). After visiting in the recovery room, each parent was asked to fill out a questionnaire independently (Fig 2).It was stressed there were no right or wrong answers to the questions. The questionnaire was returned in a sealed envelope, and to insure confidentiality,
AORN Journal, August 1977, V o l 2 6 , No 2
267
a code number was assigned to each questionnaire. The study sample consisted of 57 parents (49 mothers and 8 fathers) of 50 patients (38 boys and 12 girls). The patients’ average age was 3.8 years (Table 1). Classes of surgical procedures (total of 57 procedures on the 50 patients) are shown in Table 2. All parents responded affirmatively when told they might visit their children in the recovery room. Eighty-four percent of the parents indicated they were very nervous while their children were in surgery and the wait before they could see them seemed very long. When the parents first saw their children, 86% felt better than before they visited. Although five parents felt worse, by the time they left the recovery room only one parent (2% of the total) felt worse. Ninety-eight percent thought it was helpful for them to have been with their children. When asked whether they would want to visit in the recovery room if surgery was ever again needed, 100% replied affirmatively. Questions attempted to distinguish what parents liked and did not like about visiting and to determine whether they felt visiting was beneficial to them and their children. Analysis of the responses revealed several recurring themes. When responding to what they liked about visiting, 54% indicated it was reassuring to the parent, 199’‘ indicated it was reassuring to the parent and child, and 25% indicated it was reassuring to the child. Similarly, the 56 parents who felt it was helpful to them to have been with their children explained it was due to the feeling of reassurance. The one mother who did not feel visiting had helped her personally indicated i t was because she had been “very nervous.” Overall, 88% of the parents indicated they felt their 268
Surgical procedures Table 2 Urology General pediatric surgery Otolaryngology Plastic surgery Diagnostic procedures Procedure cancelled after induction of anesthesia
# of patients 24 18 4 9 1 1 -
57
Classes of surgical procedures performed on 50 pediatric patients.
presence in some way had been helpful to their children. Of the nine parents who indicated there were aspects to visiting they did not like, five objected to the condition or appearance of their children (“seeing the IV in his arm”). One parent did not like the “condition” of some of the patients other than his own child. One parent was worried about being in the way, and two parents expressed embarrassment concerning their children’s “behavior.” Even though parents voiced these objections, some also included positive remarks in their responses, eg, “We do not go to the pediatric recovery room only to make ourselves feel better, but for the kids.” Forty-eight parents did not respond to this question or made a supportive response, eg, “There wasn’t anything I didn’t like” or “Nothing at all.” The vast majority of parents found the guidelines given to parents helpful, and only 7% offered suggestions for additional information. These parents wanted more warnings as to how the child might react, eg, “Would the child react mechanized or disoriented?” They also wanted explanations of equipment that might be used, such as fluid administration equipment and oxygen masks.
AORN Journal, August 1977, V o l 2 6 , N o 2
“Being able to hold him and comfort him. Letting him know I didn’t deseri him.”
This study indicates that visiting in a pediatric recovery room can be a positive experience for parents and that it can serve a useful purpose. Visiting had a reassuring effect for the parents, and parents also believed it had a similar effect on their children. Parents indicated they were reassured by (1) generally experiencing a feeling of relief, (2) seeing for themselves the child’s condition, (3) seeing the child sooner, and (4) seeing the care provided. Among the comments were: “Gives you and him a little more feeling of security.” “I felt much less apprehensive about his condition while with him than while waiting to see him.”
“I was relieved and less apprehensive at being able to see my child as soon as I did.” “I liked being a comfort, able to answer his questions, being visually assured of the constant care one gets immediately after surgery.” Parents also commented they were able to provide reassurance to their children by their presence, ability to comfort, and, in some instances, ability to hold their children physically. The remarks indicated that parents did not believe it was necessary to care for their children physically, but that their role was to be with and comfort the children. Some comments were: “I felt I could help him adjust to the room, help to comfort him, and also let him know his parents did not leave him alone to face this unfamiliar surrounding. If it helps the child-which I think it does-that’s what it’s all about.’’ “I think the parents can aid in the general comfort and calming of the child, thus easing any of their own tensions.” “Being able to hold him and comfort him. Letting him know I didn’t desert him.” Perhaps these are the comments that have the greatest significance when one considers the question, Would visiting in the recovery room be excessively disturbing for parents? Reassuring the child through comforting implies the parent did not desert the child, and the parent is fulfilling the need described as parenting by Temple. He states that with the hospitalized child, a n enormous gap is apparent between parent and child. No matter how much the parents would suffer for the child, they can only stand by as the child suffers for himself. Parenting has to include the sense of having gone
AORN Journal, August 1977, V o l 2 6 , N o 2
269
“lf it helps the child-which l think it does-that’s what it’s a// about.”
“all the way” with your child.s As one parent in the study expressed it: We felt we were really needed, and the greatest satisfaction of a parent is being there when your child is sick and really needs moral support. A factor often overlooked is that a child’s adjustment to the hospital experience may depend on how well the parents adjust to the hospital situation. This adjustment consists of the ability of the parents to control their anxiety about the child’s illness, to give emotional support to the child, to accept the realities of the child’s illness, and to handle visiting opportunities.9 Summary. The chief anxieties of hospitalization and surgery for children are related to separation from parents. To minimize the separation, parental visiting was instituted in the pediatric recovery room. A questionnaire to explore this issue was given to 270
parents who had been in the recovery room with their children. At the outset, lOoO/o liked the idea of visiting and 100% would visit again. Eighty-four percent were nervous while waiting, but 86% felt better when they first saw their child and when they left the recovery room. Although five felt worse when they first saw their child, only one felt worse when she left. Parents were reassured by (1) generally experiencing a feeling of relief, (2) seeing for themselves the child’s condition, (3) seeing the child sooner, and (4) seeing the care provided. Parents believed their children were reassured by the parents’ presence and ability to comfort. Children were also comforted by parents physically holding them. Comments indicated that parents did not believe it necessary to care for their children physically, but rather to place great emphasis on their roles as comforters. 0
AORN Journal, August 1977,Vol26, No 2
Guidelines for parents visiting in pediatric recovery room Figure 1 University Hospitals and the pediatric recovery room staff have made it possible in most instances for parents or legal guardians to be present in the pediatric recovery room soon after the child returns from surgery. Guidelines for visiting in the pediatric recovery room have been established by the nurses and physicians. The following illformation will give you some understanding of the recovery rcom routine and some helpful hints for those of you who may wish to visit the recovery room. Following surgery, your child is transported immediately to the pediatric recovery room. Exceptions include cardiac surgical patients and patients whose operative procedures are not completed before 4:30prn-these patients are cared for in the adult recovery room where visiting is not permitted. A recovery room nurse takes your child's temperature, pulse, and respiration; receives a report from the anesthesiologist; checks the physician's order; records her observations; and gets your child settled. The nurse makes an evaluation of each patient and decides when the parents may be called in. There are a number of factors taken into consideration. Please do not become alarmed i f you are not called immediately since the unit may be extremely busy, making it physically impossible to have parents in the area. Your child may be very sleepy, starting to wake up, or he or she may sleep for what seems a long period of time. This is not unusual as each child reacts to anesthesia in
an individual manner. You will not be called into the pediatric recovery room until your child has begun to wake up. We ask that parents do not come to the recovery room until they are called by a member of the nursing staff. We would like to emphasize that you are called to the recovery room to provide support for your child. We request that you stay at your child's bedside, do not walk around the room, and do not inquire about other children in the room. Chairs will be provided, and when physically possible, you may hold your child as he or she awakens. The nurses will be happy to answer any questions you may have about your child, and they will call the physician to talk with you if necessary. It is important that you know you are not required to stay. If you are uncomfortable, feel at liberty to leave the room, go for coffee or lunch, and either wait in your child's room or you may check back in the recovery room later. At any time during your visit, it may be necessary to ask you to leave. You will be given a reason at the time. Please respect the decision of the pediatric recovery room staff. Only parents or legal guardians are permitted to visit in the pediatric recovery room. Our lack of space necessitates that we limit the number of visitors. Every child stays in the pediatric recovery room at least one hour.
Notes 1. J Bowlby, "Separation anxiety," lnternationsl Journal of Psychoanalysis 41 ( 1 960) 89-1 13; Helen Gofman, Wilma Buckman, George Schade, "The child's emotional response to hospitalization," Journal of Diseases of Children 93 (February 1957) 157-163; Helen Gofman. Wilma Buckman, George Schade, "Parent's emotional response to child's hospitalization," Journal of Diseases of Children 93 (June 1957) 629-636; D G Prugh et al, "A study of the emotional reactions of children and families to hospitalization and illness," American
Journal of Orthopsychiatry 23 (January 1953) 70106. 2. David Vernon et al, The Psychological Responses of Children to Hospitalization and Illness (Springfield, Ill: C C Thomas, 1965) 36-38. 3. Barbara Korsh, "The child and the operating room," Anesthesiology 43 (August 1975) 251-257; Lewis Francis, Robert P Cutler, "Psychological preparation and premedication for pediatric anesthesia," Anesthesiology 18 (January-February 1957) 106-109; Madilon A Visintainer, John A Wolfer, "Psychological preparation for surgical
AORN Journal, August 1977, V o l 2 6 , N o 2
27 1
Visiting in the pediatric recovery room as viewed by parents Figure 2 1. How are you related to the child you visited in the pediatric recovery
room? -mother -father 2. When you were told that you might be able to visit your child in the pediatric recovery room, did you like the idea? yes Why? -no Why not? 3. Many parents have told us they are very nervous while their child is in surgery and that the wait before they can see their child again seems very long. Did you feel this way? yes -no 4. When you first saw your child in the pediatric recovery room, how did you feel? better than before I saw him/her worse than before I saw hirn/her about the same as before I saw him/her 5. By the time you left the pediatric recovery room, how did you feel? better than before I went there worse than before I went there ~. about the same as before I went there 6. What did you like about visiting your child in the pediatric recovery room? 7. What didn’t you like about visiting your child in the pediatric recovety room? 8. Now that you have actually been with your child in the pediatric recovery room, do you think it was helpful to you to go there? yes Why? no Why not? 9. Now that yau have actually been with your child in the pediatric recovery room, do you think it was helpful to your child for you to go there? .yes Why? no Why not? 10. Was the information contained in the “Guidelines for parents visiting in the pediatric recovery room” (the information sheet you were given yesterday) helpful in preparing you to visit your child? 11. Is there other information you think should be included in the “Guidelines for parents visiting in the pediatric recovery room”? -no yes If so, what? 12. If your child ever had to have surgery again, would you want to be able to be with hirn/her in the recovery room? yes -no Why not? ~
~
-
~
~
~
pediatric patients: The effect on children’s and parents’ stress responses and adjustment,” Pediatrics 56 (August 1975) 187-202. 4. Gofman, Buckman, Schade, “The child‘s emotional response to hospitalization,” 157. 5. Korsh, “The child and the operating room.” 6. Jack May, “A psychiatric study of a pediatric intensive therapy unit,” Clinical Pediatrics 11 (February 1972) 76-82. 7. L Coleman, “Children need preparation for tonsillectomy,” Child Study 29 (1952) 18-19, 42-44; E O’Connell, P Brandt, “Liberal visiting hours for parents,” American Journal of Nursing
272
60 (1960) 812-815;A Blau el al, “The collaboration of nursing and child psychiatry in a general hospital,” American Journal of Orthopsychiatry 29 (1959) 77-93. 8. P C Temple, “Children in hospital: Life, death, and learning,” Chicago Tribune Magazine (Nov 2, 1975). 9. Prugh 81 al, “A study of the emotional reactions of children.”
AORN Journal, August 1977, V o l 2 6 , N o 2
