Alvarez Evelyn N, Pike Megan C, Godwin Hilary
Department of Environmental Health Sciences, UCLA Fielding School of Public Health, USA.
Chase Child Life Program, USA.
Clin Child Psychol Psychiatry. 2020 Apr;25(2):401-418. doi: 10.1177/1359104519838016. Epub 2019 Apr 16.
To date, there has been a paucity of studies conducted on the experiences of children under hospital contact isolation precautions. Furthermore, the studies that have examined children's experiences at the hospital typically reflect the perspectives of their parents, and few have directly involved interviews with children themselves, and even fewer with children in isolation.
To address this gap, we conducted semi-structured, open-ended interviews with hospitalized children to assess their experiences of being placed in isolation. Where possible, the children's parents also completed written surveys to assess parental perspectives on their child's experiences.
Two important findings of the study were the children's resilience during a difficult time and children's varying awareness of the pathophysiology of infections as it relates to isolation precautions. Examination of the parent-child dyads elucidated some discordance between parents' and children's perspectives on how children experienced their isolation, on what the children's preferred activities were while in isolation, and how much children understood about the reasons they were in isolation.
This study supports earlier studies that suggest that the benefits of isolation procedures may be outweighed by how negatively isolation is experienced by patients, particularly when the patients are children. It also highlights the need for child-friendly isolation signs. Because parental and child perceptions differed in cases where data from both were available, this study suggests larger studies on children's perspectives and/or on parent-child dyads are needed.
迄今为止,针对处于医院接触隔离预防措施下儿童经历的研究较少。此外,已开展的关于儿童在医院经历的研究通常反映的是其父母的观点,很少有直接涉及对儿童自身的访谈,而涉及隔离儿童的访谈更少。
为填补这一空白,我们对住院儿童进行了半结构化、开放式访谈,以评估他们被隔离的经历。在可能的情况下,儿童的父母也完成了书面调查,以评估父母对其孩子经历的看法。
该研究的两个重要发现是儿童在困难时期的恢复力以及儿童对与隔离预防措施相关的感染病理生理学的不同认知。对亲子二元组的研究揭示了父母与孩子在儿童如何体验隔离、隔离期间孩子喜欢的活动以及孩子对自己被隔离原因的理解程度等方面的一些不一致。
本研究支持了早期的研究,这些研究表明隔离程序的益处可能被患者,尤其是儿童对隔离的负面体验所抵消。它还强调了需要有儿童友好型的隔离标识。由于在可获得双方数据的情况下,父母和孩子的认知存在差异,本研究表明需要对儿童的观点和/或亲子二元组进行更大规模的研究。