EFFECTS OF HOSPITALIZATION On PATIENT AND FAMILY

Hospitalization
Definition:
 Hospitalization is the act of placing a person in a hospital as a patient.
OR
 The act of taking someone to hospital and keeping them there for
treatment.

PURPOSE
 For investigations
 Procedures
 Surgery
 Emergency medical treatment
 Administration of drug
 Or to stabilize or monitor an existing condition

RISKS OF HOSPITALIZATION
 Medication errors
 Hospital acquired infections
 Hospital acquired Pneumonia
 Deep vein thrombosis
 Bleeding after surgery
 Anaesthesia complications

IMPACT OF HOSPITALIZATION ON DIFFERENT AGE GROUP

 Impact of hospitalization for children
 Separation anxiety
 Fear
 Loss of control(restraint of movement, sleep, feed)
 Pain
  body image

Stress response to hospitalization depends upon

 Pain
 Intensity
 Duration
 Coping ability

THE IMPACT OF HOSPITALIZATION IS DIFFERENT DIFFERENT AGE

GROUPS OF CHILDREN
Reaction of neonates:
 Interrupt the mother and child relationship And family integration
 Impairment of bonding and trusting relationship
 Inability of the parent to love and care the child
 Inability of the child to love the parents

Reaction of infant
 Separation anxiety disturbance in the development of basic trust 4-
8month - depression and withdrawal
 Interference of growth and delayed development
 -8-12 month- limited tolerance to separation Evidenced by excessive cry
and over dependence on mother

Reaction of toddler
 Protest: frequent crying, shaking crib, rejecting nurses attention, urgent
desire to find mother showing sign of distrust with anger and tears.
 Despair: helpless, apathetic, anorectic, looks sad cry continuously, use
comfort measures like thump sucking and tightly clenching the toys
 Denial: forget the absence of mother concentrate on play and other

Reaction of preschool child

 Like toddler preschooler will react. They will use defence mechanism like
 Regression,
 Repression
  Projection
 Displacement
 Aggression
 Denial
 withdrawal

Reaction of school age children

Defence mechanism used is Regression separation anxiety, negativism
Depression, Suppression denial, phobia- unrealistic fear

Reaction of adolescence
 Concerned with problem of privacy
 Separation from peers, family, and school,
 Interference with body image and independency or self-concept or
sexuality
 Show anxiety an insecurity in strange environment
 Anger and uncooperative behaviour
 Defence mechanism used are denial or withdrawal rejection and
depression

REACTION OF OLDER ADULTS

Hospitalization of older adults is often followed by an irreversible decline in
functional status affecting their quality of life and wellbeing after discharge

GENERAL IMPACT OF HOSPITALISATION

i. Psychological
ii. Physiological

PSYCHOLOGICAL EFFECT
 Anxiety - fear of unknown or depression
  Express anxiety - Patient may express his anxiety as frustration or
irritability or guilt
 Obsessed with her health problems
 Guilt may result from being unable to work and support one self
 Patient who are depressed may have suicidal ideas
 Copying skill may be challenged
 Loss of self esteem, loss of statues within the family
 Loss of independence
 Feeling of rejection
 Feeling of helplessness
 Emotional out burst
 Emotional pain, soma to form disorders, mental insufficiency, mental
exhaustion
 Perceptual disturbance.

PHYSIOLOGICAL EFFECT OF HOSPITALIZATION

 Stress response by brain after hospitalization
 Confusion
 Physical exhaustion
 Affects developmental milestones
 Sleep disruption
 Loss of appetite
 Socio cultural effects

IMPACT OF LONG-TERM HOSPITALIZATION ON FAMILY

 When serious illness or disability strikes a person, the family as a whole
is affected by the disease process and by the entire health care
experiencPatients and families have different needs for education and
counselling. Because each person in a family plays a specific role that is
 part of the family's everyday functioning, the illness of one family
member disrupts the whole family.
 When a family member becomes ill, other family members must alter
their lifestyle and take on some of the role functions of the ill person,
which in turn affects their own normal role functioning. If the person
who does most of the family's cooking has surgery and can't shop or
prepare meals for several weeks, other family members must take on
this responsibility in addition to the tasks they already do.
 When a working parent is up most of the night trying to console a child
with an ear infection, the parent not only loses sleep, but must either
arrange for emergent child care or take a day off from work.
 If a man who is the primary income producer in a family has a heart
attack, his wife may have to return to work, increase working hours if she
is already employed, or become the family's breadwinner. Middle aged
adults whose children have just left home may need to alter their plans
and goals to accommodate care needs for aging parents.
 Illness may cause additional strain as the result of economic problems
and interruptions in career development.
 If the patient is a young child, there may be additional strain to the
family if there are siblings whose needs must also be met.
 Illness in the middle stage of family life, when adolescents are trying to
break away from family ties and parents are going through their own
mid- life transitions, may put further strain on what is already a time of
potential family turmoil.
 Illness in later age may have an impact not only on grown children but
also on the older couple who had anticipated a time of enjoyment
together and are less able to care for each other because of their own
physical limitations associated with aging
 The extent of family disruption depends on the seriousness of the illness,
the family's level of functioning before the illness, socioeconomic
considerations, and the extent to which other family members can
absorb the role of the person who is ill.
 In some instances, a major illness brings a family closer together; in
others, even a minor illness causes significant strain.
 It is important to identify what the illness means, not only to the
individual but also to the family. Asking them what they consider major
 problems and how they plan to handle specific situations can help you
assess the meaning of the patient's illness to the family
 To achieve effective patient teaching outcomes, you should make the
family part of your teaching plan. For example, if your patient's wife does
all the cooking in the home, it is vital to include her in diet teaching.
 Involving family members may be an important future source of support
for the patient as he or she works at behavioural change.
 Obviously it will be difficult for a husband to be supportive of his wife's
blood pressure treatment program if he does not understand the
reasons for the recommendations and the consequences of not carrying
them
 Long-term illness, even in the most stable and supportive families, brings
changes in family relationships. Illness produces disequilibrium in the
family structure until adjustments can occur.
 If the nurse does not recognize the change, what it might mean to the
patient and family, and how it might affect the patient's willingness and
ability to carry out health care recommendations, the goals of the
teaching process will be diminished.
 When teaching the patient and family, it is important to identify patterns
of relationships and to be alert to attitudes of family members. You may
be able to identify resources within the group and help family members
mobilize their resources to help the patient.