The adolescent patient at discharge and in the post-hospitalization environment: a review

Whereas only cursory mention has been made in the literature concerning adolescent behaviors in relation to impending hospital discharge, implicit is the belief that some evidence of upset continues to emerge following discharge. Adolescent reactions following discharge would appear to be individual and may be related to the medical and surgical procedures used and possibly the method of pre-hospital preparation. Behaviors ranging from a reluctance to leave the hospital to a number of psychological benefits of hospitalization for adolescent patients have also been reported. Although adolescent patients in one recent study (Denholm, 1986) did not show evidence of negative behavior following discharge, this should not minimize the reported reactions, thoughts, and behaviors of adolescents which may occur during the hospitalization. Nor should it imply that, in the light of reduced or absence of upset following discharge as found in one study, all preparation for surgical and medical procedures should cease. What is suggested is that at discharge, the adolescent may perceive the hospitalization experience as a particularly positive event and feel relieved and even pleased with having successfully completed this difficult process. Perhaps having adolescents focus on realistic expectations and return to normal behavior and activities prior to discharge may promote a higher degree of readiness for this event. Adjustment to discharge may also be facilitated by providing information to parents that there is evidence which suggests that some adolescents leave hospital with elevated self-esteem and demonstrate certain psychological gains.