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Adjustment and homesickness in hospitalised children: A systematic review
Eleni Andrea Demetriou1, Kelsie Anne Boulton1, Michael Russell Bowden2
1Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia.
Insights
Hospitalized children often experience distress due to psychosocial factors affecting their adjustment. Understanding these factors, like homesickness, is key to improving pediatric hospital experiences and outcomes.
Area of Science:
- Pediatric Psychology
- Child Health Outcomes
- Hospital Environment Adaptation
Background:
- Hospitalization causes significant distress in children due to treatments and psychosocial challenges.
- Limited research exists on psychosocial factors influencing pediatric hospital adjustment and distress.
- Understanding these factors is crucial for developing effective support strategies.
Purpose of the Study:
- To synthesize qualitative and quantitative literature on psychosocial factors in pediatric hospital adjustment.
- To identify risk and protective factors impacting children's adjustment during hospitalization.
- To inform future research and interventions for hospitalized children.
Main Methods:
- Systematic literature search across major databases (CINAHL, Embase, Medline, PsychINFO, Web of Science) from 1980 to February 2024.
- Inclusion of thirty-four studies employing qualitative and quantitative methodologies.
- Synthesis of findings to identify key psychosocial correlates of hospital adjustment.
Main Results:
- Majority of hospitalized children reported poor adjustment, anxiety, depression, and homesickness.
- Child age, temperament, attachment style, prior negative experiences, homesickness, and fear cognitions were linked to poor adjustment.
- Homesickness emerged as a significant, yet understudied, factor influencing adjustment.
Conclusions:
- Psychosocial factors significantly impact pediatric hospital adjustment and distress.
- Targeting factors like homesickness and fear cognitions may improve children's hospital experience.
- Further research is recommended to develop targeted support for inpatient children and their families.
Abstract:
Children can experience significant distress during hospitalisation, as a result of the treatment process and due to psychosocial factors impacting their adjustment to the hospital environment. Such factors can contribute to negative outcomes for the child. Despite this, limited research focus has been placed on understanding the psychosocial factors that contribute to a child's distress to inform support strategies that can improve the experience of hospitalisation across paediatric conditions. The objectives of this review were to synthesise the qualitative and quantitative literature on psychosocial factors associated with hospital adjustment and to identify risk and protective factors that influence the adjustment process. The literature search (1980 to February 2024: CINAHL / Embase / Medline / PsychINFO and Web of Science databases) identified thirty-four studies. Poor hospital adjustment, anxiety, depression and homesickness, were reported by the majority of hospitalised children. Several demographic and psychosocial factors were identified in the quantitative synthesis to contribute to poor adjustment. Child age, temperament, attachment style, past negative hospital experiences, homesickness and fear cognitions, were all associated with adjustment to the hospital environment. Homesickness was identified as a particularly understudied and important construct. Theoretical and methodological considerations are discussed, and recommendations made for future research that can further support inpatient children and their families.
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