Research Article
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A Study on the Psychological Status of Hospitalized Children and Their Perceptions of Hospital and Sickness Through Drawings

Year 2019, Volume: 13 Issue: 4, 283 - 291, 30.07.2019
https://doi.org/10.12956/tchd.518412

Abstract

Objective: Sickness and
hospitalization may have negative influences on the development and
psychological status of children. It is important to understand children’s perceptions
of sickness and hospital in order to reduce and eliminate the negative effects
of hospitalization experiences on the psychological well-being of the children.
From this perspective, the aim of this study was to examine the hospitalized
children’s psychological status and their perceptions of hospital and sickness.

Material and Methods: The study was based
on a both descriptive and content analysis approach. The study group consisted
of 31 children between the ages of 5 and 16 years who were recruited from a
public hospital in North Cyprus. The children’s experiences were examined
through their family and hospital drawings and draw-and-tell interviews.

Results: Anxiety, depression, and the
representation of the hospital as unsafe, need for a well-structured
environment, problems with social relations, difficulties with holding onto
life and lack of quality in the drawings were found to be the common findings
in the drawings. When the drawings of each child were evaluated individually,
it was found that regression increases in the hospital drawings.











Conclusion: The findings of this
study may be helpful in understanding the hospitalization experiences from the
children’s perspective and might have clinical implications for practice in
terms of supporting children in the hospitalization process.

References

  • 1. Wennstreom B, Teornhage C, Hedelin H, Nasic S, Bergh I. Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery. Journal of PeriAnesthesia Nursing 2013; 28(6): 361-367.2. Keene N, Prentice R. Your child in the hospital. U.S.A: O’Reilly & Associates, Inc, 1999.3. Vessey, J A. Children's psychological responses to hospitalization. Annual Review of Nursing Research 2003; 21(1): 173-201.4. Aujoulat I, Simonelli F, Deccache A. Health promotion needs of children and adolescents in hospitals: A review. Patient Education and Counseling 2006; 61: 23–32.5. Chesson R A, Good M, Hart C. Will it hurt? Patients' experience of X-ray examinations: A pilot study. Pediatric Radiology 2002; 32(1): 67-73.6. Atay G, Eras Z, & Ertem İ. Developmental support of children during their hospitalizations. Journal of Child 2011; 11(1): 1-4.7. Coyne I. Children's experience of hospitalization. Journal of Child Health Care 2006; 10: 326–336.8. Brewer S, Gleditsch S, Syblik D. Tietjens M, Vacik H. Pediatric anxiety: Child life intervention in day surgery. Journal of Pediatric Nursing 2006; 21(1): 13-22.9. Small L, Melnyk B. Early predictors of post-hospital adjustment problems in critically ill young children. Research in Nursing & Health 2006; 29: 622–635.10. Bennett D S. Depression among children with chronic medical problems: A meta-analysis. Journal of Pediatric Psychology 1994; 19(2): 149–169.11. Foster R, Park J. An integrative review of literature examining psychometric properties of instruments measuring anxiety or fear in hospitalized children. Pain Management Nursing 2012; 13(2): 94-106. 12. Salmela M, Salantera S, Aronen E T. Coping with hospital related fears: experiences of pre-school-aged children. Journal of Advanced Nursing 2010; 66(6): 1222–1231.13. Rennick J, Johnston C R N, Dougherty G, Platt R, Ritchie J. Children’s Psychological Responses After Critical Illness and Exposure to Invasive Technology. Journal of Developmental & Behavioral Pediatrics 2002; 23(3): 133-144. 14. Köçkar Ç, Gürol A. Anxiety, aggression and self-esteem analysis through pictures in children with cancer. Journal of F.N. Hem 2013; 21(1): 33-39. 15. Şen Beytut D, Bolışık B, Solak U, Seyfioğlu U. An examination of the effects of hospitalization on children through projective drawings. Journal of Maltepe University Nursery Science and Art 2009; 2(3): 35-44.16. Meijer S A, Sinnema G, Bijstra J, Mellenbergh G, Wolters W H G. Coping styles and locus of control as predictors for psychological adjustment of adolescents with a chronic illness. Social Science & Medicine, 2002; 54(9): 1453-1461.17. Petrillo M, Sanger S. Emotional care of the hospitalized child. 2nd ed. U.S.A.: Lippincott Company, 1980.18. Beyazıt U, Bütün Ayhan, A. Hasta Çocukların ruhsal özellikleri ve hasta çocuğa yaklaşım. In Hasta Çocukların Gelişimi ve Eğitimi. Eskişehir: Anadolu Üniversitesi Yayınları, 2015: 60-78. 19. Mash E, Wolfe D. Abnormal Child Psychology. 3rd ed. U.S.A.: Wodsworth Learning, 2007.20. Karaaslan T, Beyazıt U, Bütün Ayhan A. Gelişimsel dönemler açısından hasta çocuklar ve hastane ortamının düzenlenmesi. In A Hasta Çocukların Gelişimi ve Eğitimi. Eskişehir: Anadolu Üniversitesi Yayınları, 2015: 26-56. 21. Karabekiroğlu K. Çocuğuma nasıl davranmalıyım. İstanbul: Say Yayınları, 2011. 22. Zeev N K, Mayes L C, Caramico L A. Preoperative preparation in children: A cross-sectional study. Journal of Clinical Anesthesia 1996; 8: 508-514. 23. Luborsky L, Diguer L, Luborsky E., McLellan A T, Woody G, Alexander L. Psychological health-sickness (PHS) as a predictor of outcomes in dynamic and other psychotherapies. Journal of Consulting and Clinical Psychology 1993; 61(4): 542-548.24. Eminson D M. Somatising in children and adolescents. Clinical presentations and aetiological factors. Advances in Psychiatric Treatment 2001; 7(4): 266-274.25. Malchiodi C A. Understanding Children’s Drawings. New York: Guilford Publications, 1998.26. Landsdown R. More Than Sympathy. The Everyday Needs of Sick and Handicapped Children and Their Families. London: Tavistock Publications, 1980.27. Lerwick J L. Psychosocial implications of pediatric surgical hospitalization. Seminars in Pediatric Surgery 2013; 22: 129-133.28. Kortesluoma R, Punamäki R, Nikkonen M. Hospitalized children drawing their pain: the contents and cognitive and emotional characteristics of pain drawings. Journal of Child Health Care 2008; 12(4): 284-300. 29. Coyne I, Kirwan L. Ascertaining children’s wishes and feelings about hospital life. Journal of Child Health Care 2012; 16(3): 293–304.30. Corsano P, Majorano M, Vignola V, Cardinale E, Izzi G, Nuzzo M J. Hospitalized children’s representations of their relationship with nurses and doctors. Journal of Child Health Care 2012; 17(3): 294-304.31. Metin Aslan Ö, Üstün E. Sytles and actions in kinetic family drawing test. The Journal of Academic Social Science Studies 2013; 6(4), 599-614.32. Kim J K, Suh J H. Children’s kinetic family drawings and their internalizing problem behaviors. The Arts in Psychotherapy 2013; 40: 206–215.33. Burns-Nader S. Examining children’s healthcare experiences through drawings. Early Child Development and Care 2017; 187(11): 1809–1818.34. Yavuzer H. Resimleriyle çocuk. İstanbul: Remzi Kitabevi, 2013. 35. Withrow R. . The use of color in art therapy. Journal of Humanistic Counseling, Education and Development 2004; 43: 33–40.36. Stuyck K. Art therapy helps children affected by cancer express their emotions. Oncology 2003; 48(12): 1-4.37. Skybo T, Ryan-Wenger N, Su Y. Human figure drawings as a measure of children’s emotional status: Critical review for practice. Journal of Pediatric Nursing 2007; 22(1): 15-28.38. Cherney I D, Seiwert C S, Dickey T M, Flichtbeil J D. Children’s Drawings: A mirror to their minds. Educational Psychology 2006; 26(1): 127-142.39. Hamama L, Ronen T. Children’s drawings as a self-report measurement. Child and Family Social Work 2009; 14: 90–102.40. Merriman B, Guerin S. Using Children’s Drawings as Data in Child-Centred Research. The Irish Journal of Psychology 2006; 27(1-2): 48-57.41. Ortega A N, Huertas S E, Canino G, Ramirez R, Rubio-Stipec M. Childhood Asthma, Chronic Illness, and Psychiatric Disorders. Journal of Nervous & Mental Disease 2002; 190(5): 275-281.42. Colette J. Le Desin De La Famille. Paris: Editions Et Applications Psychologiourd, 2000. 43. Terr L. Oyun çocuklar için neden önemlidir. İstanbul: Literatür yayıncılık, 2000. 44. Dolidze K, Smith E, Tchanturia K. A clinical tool for evaluating emotional well-being: Self-drawings of hospitalized children. Journal of Pediatric Nursing 2013; 28: 470–478.45. Livesley J, Long T. Children’s experiences as hospital in-patients: voice, competence and work. Messages for nursing from a critical ethnographic study. International Journal of Nursing Studies 2013; 50: 1292–1303.46. Sherman-Bien S A, Malcarnei V L, Roesch S, Varni J W, Katz E. R. Quantifying the relationship among hospital design, satisfaction, and psychosocial functioning in a pediatric hematology-oncology inpatient unit. HERD 2011; 4(4): 34–59.47. Utkan M S. Children hospital design in children picture. Procedia - Social and Behavioral Sciences 2012; 51: 110 – 114.48. Alzoubi H H, Al-Rqaibat S A. The effect of hospital design on indoor daylight quality in children section in King Abdullah University Hospital, Jordan. Sustainable Cities and Society 2015; 14: 449-455.49. Baykoç N. Hastanede çocuk ve genç. Ankara: Gazi Kitabevi, 2006. 50. Gültekin G, Baran G. Sickness and child. Family and Society 2005; 7(2): 61-68. 51. Boyd J R, Hunsberger M. Chronically ill children coping with repeated hospitalizations: their perceptions and suggested interventions. Journal of Pediatric Nursing 1998; 13(6): 330-342.
Year 2019, Volume: 13 Issue: 4, 283 - 291, 30.07.2019
https://doi.org/10.12956/tchd.518412

Abstract

References

  • 1. Wennstreom B, Teornhage C, Hedelin H, Nasic S, Bergh I. Child drawings and salivary cortisol in children undergoing preoperative procedures associated with day surgery. Journal of PeriAnesthesia Nursing 2013; 28(6): 361-367.2. Keene N, Prentice R. Your child in the hospital. U.S.A: O’Reilly & Associates, Inc, 1999.3. Vessey, J A. Children's psychological responses to hospitalization. Annual Review of Nursing Research 2003; 21(1): 173-201.4. Aujoulat I, Simonelli F, Deccache A. Health promotion needs of children and adolescents in hospitals: A review. Patient Education and Counseling 2006; 61: 23–32.5. Chesson R A, Good M, Hart C. Will it hurt? Patients' experience of X-ray examinations: A pilot study. Pediatric Radiology 2002; 32(1): 67-73.6. Atay G, Eras Z, & Ertem İ. Developmental support of children during their hospitalizations. Journal of Child 2011; 11(1): 1-4.7. Coyne I. Children's experience of hospitalization. Journal of Child Health Care 2006; 10: 326–336.8. Brewer S, Gleditsch S, Syblik D. Tietjens M, Vacik H. Pediatric anxiety: Child life intervention in day surgery. Journal of Pediatric Nursing 2006; 21(1): 13-22.9. Small L, Melnyk B. Early predictors of post-hospital adjustment problems in critically ill young children. Research in Nursing & Health 2006; 29: 622–635.10. Bennett D S. Depression among children with chronic medical problems: A meta-analysis. Journal of Pediatric Psychology 1994; 19(2): 149–169.11. Foster R, Park J. An integrative review of literature examining psychometric properties of instruments measuring anxiety or fear in hospitalized children. Pain Management Nursing 2012; 13(2): 94-106. 12. Salmela M, Salantera S, Aronen E T. Coping with hospital related fears: experiences of pre-school-aged children. Journal of Advanced Nursing 2010; 66(6): 1222–1231.13. Rennick J, Johnston C R N, Dougherty G, Platt R, Ritchie J. Children’s Psychological Responses After Critical Illness and Exposure to Invasive Technology. Journal of Developmental & Behavioral Pediatrics 2002; 23(3): 133-144. 14. Köçkar Ç, Gürol A. Anxiety, aggression and self-esteem analysis through pictures in children with cancer. Journal of F.N. Hem 2013; 21(1): 33-39. 15. Şen Beytut D, Bolışık B, Solak U, Seyfioğlu U. An examination of the effects of hospitalization on children through projective drawings. Journal of Maltepe University Nursery Science and Art 2009; 2(3): 35-44.16. Meijer S A, Sinnema G, Bijstra J, Mellenbergh G, Wolters W H G. Coping styles and locus of control as predictors for psychological adjustment of adolescents with a chronic illness. Social Science & Medicine, 2002; 54(9): 1453-1461.17. Petrillo M, Sanger S. Emotional care of the hospitalized child. 2nd ed. U.S.A.: Lippincott Company, 1980.18. Beyazıt U, Bütün Ayhan, A. Hasta Çocukların ruhsal özellikleri ve hasta çocuğa yaklaşım. In Hasta Çocukların Gelişimi ve Eğitimi. Eskişehir: Anadolu Üniversitesi Yayınları, 2015: 60-78. 19. Mash E, Wolfe D. Abnormal Child Psychology. 3rd ed. U.S.A.: Wodsworth Learning, 2007.20. Karaaslan T, Beyazıt U, Bütün Ayhan A. Gelişimsel dönemler açısından hasta çocuklar ve hastane ortamının düzenlenmesi. In A Hasta Çocukların Gelişimi ve Eğitimi. Eskişehir: Anadolu Üniversitesi Yayınları, 2015: 26-56. 21. Karabekiroğlu K. Çocuğuma nasıl davranmalıyım. İstanbul: Say Yayınları, 2011. 22. Zeev N K, Mayes L C, Caramico L A. Preoperative preparation in children: A cross-sectional study. Journal of Clinical Anesthesia 1996; 8: 508-514. 23. Luborsky L, Diguer L, Luborsky E., McLellan A T, Woody G, Alexander L. Psychological health-sickness (PHS) as a predictor of outcomes in dynamic and other psychotherapies. Journal of Consulting and Clinical Psychology 1993; 61(4): 542-548.24. Eminson D M. Somatising in children and adolescents. Clinical presentations and aetiological factors. Advances in Psychiatric Treatment 2001; 7(4): 266-274.25. Malchiodi C A. Understanding Children’s Drawings. New York: Guilford Publications, 1998.26. Landsdown R. More Than Sympathy. The Everyday Needs of Sick and Handicapped Children and Their Families. London: Tavistock Publications, 1980.27. Lerwick J L. Psychosocial implications of pediatric surgical hospitalization. Seminars in Pediatric Surgery 2013; 22: 129-133.28. Kortesluoma R, Punamäki R, Nikkonen M. Hospitalized children drawing their pain: the contents and cognitive and emotional characteristics of pain drawings. Journal of Child Health Care 2008; 12(4): 284-300. 29. Coyne I, Kirwan L. Ascertaining children’s wishes and feelings about hospital life. Journal of Child Health Care 2012; 16(3): 293–304.30. Corsano P, Majorano M, Vignola V, Cardinale E, Izzi G, Nuzzo M J. Hospitalized children’s representations of their relationship with nurses and doctors. Journal of Child Health Care 2012; 17(3): 294-304.31. Metin Aslan Ö, Üstün E. Sytles and actions in kinetic family drawing test. The Journal of Academic Social Science Studies 2013; 6(4), 599-614.32. Kim J K, Suh J H. Children’s kinetic family drawings and their internalizing problem behaviors. The Arts in Psychotherapy 2013; 40: 206–215.33. Burns-Nader S. Examining children’s healthcare experiences through drawings. Early Child Development and Care 2017; 187(11): 1809–1818.34. Yavuzer H. Resimleriyle çocuk. İstanbul: Remzi Kitabevi, 2013. 35. Withrow R. . The use of color in art therapy. Journal of Humanistic Counseling, Education and Development 2004; 43: 33–40.36. Stuyck K. Art therapy helps children affected by cancer express their emotions. Oncology 2003; 48(12): 1-4.37. Skybo T, Ryan-Wenger N, Su Y. Human figure drawings as a measure of children’s emotional status: Critical review for practice. Journal of Pediatric Nursing 2007; 22(1): 15-28.38. Cherney I D, Seiwert C S, Dickey T M, Flichtbeil J D. Children’s Drawings: A mirror to their minds. Educational Psychology 2006; 26(1): 127-142.39. Hamama L, Ronen T. Children’s drawings as a self-report measurement. Child and Family Social Work 2009; 14: 90–102.40. Merriman B, Guerin S. Using Children’s Drawings as Data in Child-Centred Research. The Irish Journal of Psychology 2006; 27(1-2): 48-57.41. Ortega A N, Huertas S E, Canino G, Ramirez R, Rubio-Stipec M. Childhood Asthma, Chronic Illness, and Psychiatric Disorders. Journal of Nervous & Mental Disease 2002; 190(5): 275-281.42. Colette J. Le Desin De La Famille. Paris: Editions Et Applications Psychologiourd, 2000. 43. Terr L. Oyun çocuklar için neden önemlidir. İstanbul: Literatür yayıncılık, 2000. 44. Dolidze K, Smith E, Tchanturia K. A clinical tool for evaluating emotional well-being: Self-drawings of hospitalized children. Journal of Pediatric Nursing 2013; 28: 470–478.45. Livesley J, Long T. Children’s experiences as hospital in-patients: voice, competence and work. Messages for nursing from a critical ethnographic study. International Journal of Nursing Studies 2013; 50: 1292–1303.46. Sherman-Bien S A, Malcarnei V L, Roesch S, Varni J W, Katz E. R. Quantifying the relationship among hospital design, satisfaction, and psychosocial functioning in a pediatric hematology-oncology inpatient unit. HERD 2011; 4(4): 34–59.47. Utkan M S. Children hospital design in children picture. Procedia - Social and Behavioral Sciences 2012; 51: 110 – 114.48. Alzoubi H H, Al-Rqaibat S A. The effect of hospital design on indoor daylight quality in children section in King Abdullah University Hospital, Jordan. Sustainable Cities and Society 2015; 14: 449-455.49. Baykoç N. Hastanede çocuk ve genç. Ankara: Gazi Kitabevi, 2006. 50. Gültekin G, Baran G. Sickness and child. Family and Society 2005; 7(2): 61-68. 51. Boyd J R, Hunsberger M. Chronically ill children coping with repeated hospitalizations: their perceptions and suggested interventions. Journal of Pediatric Nursing 1998; 13(6): 330-342.
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Details

Primary Language English
Subjects ​Internal Diseases
Journal Section ORIGINAL ARTICLES
Authors

İrem Erdem Atak 0000-0003-1155-8416

Utku Beyazıt 0000-0001-7334-9586

Gönül Taşçıoğlu This is me 0000-0001-7334-9586

Aynur Bütün Ayhan 0000-0003-3306-9672

Publication Date July 30, 2019
Submission Date January 27, 2019
Published in Issue Year 2019 Volume: 13 Issue: 4

Cite

Vancouver Erdem Atak İ, Beyazıt U, Taşçıoğlu G, Bütün Ayhan A. A Study on the Psychological Status of Hospitalized Children and Their Perceptions of Hospital and Sickness Through Drawings. Türkiye Çocuk Hast Derg. 2019;13(4):283-91.


The publication language of Turkish Journal of Pediatric Disease is English.


Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 10 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.


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