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Research on children's behavior after hospitalization: a review and synthesis
1Child Life Program, Wheelock College, Boston, Massachusetts 02215.
Insights
Childhood hospitalization can lead to increased negative behaviors after discharge, but this effect typically resolves within two weeks. The duration of the hospital stay, not age or condition, influenced the severity of behavioral distress.
Area of Science:
- Child Psychology
- Pediatric Health Outcomes
- Behavioral Science
Background:
- Extensive research exists on mitigating distress during childhood hospitalization.
- Limited studies have investigated the long-term behavioral impact on children post-discharge.
Purpose of the Study:
- To determine if childhood hospitalization causes negative behavioral changes after discharge.
- To assess the duration of these behavioral reactions.
- To identify factors influencing the intensity of post-hospitalization behavioral changes.
Main Methods:
- A meta-analysis was performed on existing studies.
- The Posthospital Behavior Questionnaire was the primary assessment tool.
- Analysis focused on effect size, duration, and influencing factors.
Main Results:
- A significant increase in negative behaviors was observed post-discharge (effect size +.29).
- This behavioral response diminished over time, largely resolving within two weeks.
- Hospitalization duration of 2-3 days was associated with greater behavioral distress compared to shorter or longer stays.
Conclusions:
- Childhood hospitalization can result in transient negative behavioral changes.
- Interventions may not be necessary as the effect diminishes naturally.
- The length of hospital stay is a critical factor, more so than patient age or medical condition.
Abstract:
Despite the presence of considerable research on techniques for reducing distress associated with childhood hospitalization, few studies have examined the more basic issue of whether the event negatively affects children after discharge. A meta-analysis was conducted of studies using the Posthospital Behavior Questionnaire (the most commonly used method of examining posthospital behavior) to determine whether hospitalization results in negative behavioral change, the duration of this reaction, if detected, and factors potentially related to its strength. The mean weighted effect size was +.29 (Confidence interval .95 = +/- .07). Thus, in the absence of interventions, negative behavior tends to increase significantly after discharge (z = +3.99; p < .00006). However, this response diminishes with time and has largely disappeared after 2 weeks. Contrary to expectations, neither age of subjects nor their medical condition was related to their degree of upset. Subjects hospitalized for periods of 2 to 3 days exhibited more behavioral distress than did those hospitalized for either shorter or longer periods.