Children's responses to emergency department care

Children's responses in, and to, the emergency department (ED) were investigated. Data collected in 1975 by Resnick and Hergenroeder at the Pediatric Trauma Center of the Johns Hopkins Hospital were reanalyzed. One coder recorded all patient information, scored the Behavioral Rating List (BRL) designed for the study, and kept an anecdotal record of the responses and activities of patients and parents while in the ED. Principal components analysis of the items of the BRL found two types of response--protest and withdrawal. Of all the personal variables, only the child's age was found to be related significantly to the type of stress response exhibited. The verbalization categories of fears, curiosity, and concern about the immediate future were also found to be significant with respect to stress response. For the situational variables, the degree of injury or amount of time spent in the facility did not predict the patient's stress response. Parents' presence or proximity did not affect the child's response significantly. Parental responses of quieting and personal guilt were related significantly to child's protest score; parents of boys quieted their children significantly more often than did parents of girls; and with age, parental responses of quieting, personal guilt, and affection decreased significantly, while responses of guilt/punishment and anger increased significantly.