🏥 Diverse Settings Cram
Chapter 33 · highest-yield points
1Why hospitalization hurts
Separation · lost routine · lost control
Pain · strangers · no sleep
Affects child AND family. Response depends on developmental stage, prior experiences, support, illness severity.
2Separation anxiety — 3 stages
PROTEST: crying, screaming, searching
DESPAIR: withdrawn, sad, won't play
DETACHMENT: seems fine — ISN'T
Detachment looks like adjusting but is the deepest distress. Prevent it: keep caregivers close.
3Infant in hospital
Fears: separation · broken routine
Fix: caregiver presence · consistent nurses
Holding, touch, soothing. Stranger anxiety in older infants = normal.
4Toddler in hospital
Fears: separation · lost control
Watch for: regression (lost skills)
Limited choices, safe independence, simple concrete explanations. Keep routines.
5Preschooler in hospital
Magical thinking → "illness = punishment"
Takes words literally
Reassure: NOT punishment. Explain shortly before procedures. Dolls + medical play. Protect body integrity.
6School-age in hospital
Fears: falling behind · losing control
Strengths: understands · can help
Truthful explanations, explain equipment, let them participate, keep up schoolwork + friends.
7Adolescent in hospital
Fears: no privacy · no peers · "treated like a child"
May show: anger · nonadherence
Respect privacy, involve in decisions, explain directly to the teen, allow peer contact, address body image.
8Procedure prep
Honest · concrete · timed to age
NEVER false reassurance
Cover what they'll see, hear, feel, smell, do. Toddler: immediately before · preschool: shortly before · school-age: days ahead.
9Therapeutic play
Express feelings · cut fear
Understand procedures · gain control
Medical play, dolls, drawing, stories, art — play with a purpose, matched to development.
10Family + priorities
Family feels: guilt · fear · exhaustion
Give: clear info · roles · rest
DEVELOPMENT + FAMILY + SAFETY: right communication, caregiver involved, routines kept, choices, honest prep, privacy + dignity.