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Psychological stress, ego defenses, and cortisol production in children hospitalized for elective surgery
Insights
Children
Area of Science:
- Pediatric Psychology
- Child Psychology
- Medical Psychology
Background:
- Hospitalization and surgery are significant stressors for children.
- Understanding children's coping mechanisms is crucial for managing distress.
Purpose of the Study:
- To investigate the link between coping mechanism effectiveness and physiological distress indicators in children.
- To explore the relationship between defense mechanisms and stress response during hospitalization.
Main Methods:
- Studied 25 children (ages 7-11) before and during hospitalization.
- Assessed defense effectiveness via clinical interview and Rorschach test.
- Measured cortisol production rates from 24-hour urine samples.
- Evaluated ward adjustment using a questionnaire.
Main Results:
- No correlation between defense effectiveness and cortisol in out-patient settings.
- Inverse relationship found between cortisol levels and defense effectiveness during hospitalization.
- Defense style correlated with coping abilities under stress.
- Identified four distinct child reaction patterns to hospitalization.
Conclusions:
- Defense effectiveness and style play a role in how children cope with hospitalization stress.
- Physiological stress responses (cortisol) are influenced by coping mechanisms in a hospital environment.
- Children exhibit varied responses to the hospital experience, highlighting the need for tailored support.
Abstract:
This study was designed to investigate the relationship between the effectiveness of coping mechanisms and physiological indicators of distress in children faced with the experience of hospitalization and surgery. Twenty-five children between the ages of 7 and 11 were studied in the out-patient department, 2 weeks before surgery, and again during their hospital stay. Effectiveness of defenses and defense style was measured by a clinical interview and by the Rorschach test. Cortisol production rates were measured by the analysis of 24-hour urine collections at home and again in the hospital. Ward adjustment was also rated by a ward questionnaire. The results indicated no relationship between defense effectiveness and cortisol production rates in the out-patient department and an inverse relationship between cortisol production and defense effectiveness under the stress of hospitalization. Defense style was found to correlate with coping under stress. Four different groups of children emerged, suggesting four different types of reaction to the hospital experience.