Wednesday, 28 June 2017

Children in hospital: a guide for family and carers

Children in hospital: a guide for family and carers by Richard Lansdown
Oxford University Press (Oxford Medical Press) (1996) ISBN: 0-19-262357-5

"Matching the intervention to the child"...

Children in hospital: a guide for family and carers is an information-packed book combining research and personal experience. Written by Richard Lansdown, formerly consultant Psychologist at Great Ormond St Hospital London, one of the world’s leading children’s hospitals.

Although the book is over 20 years old, families, healthcare professionals, early childhood educators and students will find a useful overview supporting children in hospital and healthcare. Researchers continue to read this book today.

Child rights

Have we come to expect child-friendly services? Lansdown writes about early hospitals and emotional aspects such as separation and the battle of early visitors, this gives a significant background. Development of child rights in hospital, saw the emergence of advocacy organisations and the Charter for children in hospitals, NAWCH 1984.

In Australia, AWCH promoted child rights and better healthcare with Health care policy relating to children and their families published 1974, revised 1999 and Charter on the rights of children and young people in healthcare services, 2010. Understanding child rights in healthcare is essential. An 11 year old girl on a children’s ward in the UK asks “aren’t we kids supposed to have a bill of rights when we are in hospital?", Children's hospital charter revisited.

Fear and coping

Children and families going to hospital or healthcare appointments may be fearful, Lansdown approaches the topic from a child’s perspective without being simplistic. You will find practical information about children’s understanding of health, illness and treatment. Play in hospital and play specialists (also known as child life therapists or specialists) guide children towards meeting their emotional needs.


Parents and carers can be supportive when a child is in pain and often know what techniques are likely to distract their child during medical procedures such as injections. Children turn to their parents or carers to see if it is safe and to know what to do.

The chapter on pain gives an understanding of its impact on children. Information and support are based on the child’s developmental stage and what works for them. Supportive strategies for children facing painful procedures include active distraction. This may involve reading books, toys, songs, stories, video games, mobile apps and new technologies such as video goggles. Other supportive strategies are participation, desensitization and modelling, watching a film that shows other children and mastery coping or coping models (initial anxiety then coping). Being noisy (counting out loud), guided imagery, relaxation and breathing techniques are some more options to consider.

A combination of distraction strategies might be used such as bubble blowing and guided imagery. For example, a child is asked to visualize the colour of the pain and places it on a bubble as though it was an imaginary cloud floating away. As the pain moves off, the bubble changes to the child’s favourite colour, blowing away pain and fear (p 116).

Talking with children

Summaries of pain assessment tools show how children rate their pain. Why ask children about pain? Adults usually explain how important a procedure is but there could be a gap in the child’s thinking. For example, a finger prick/injection to take blood may leave some children wanting information about why it is being done and what will happen next with the blood.

Children in hospital: a guide for family and carers reviews literature and includes bibliographical references providing a quick source of information for healthcare professionals and students. Families will find it is easy to dip into relevant sections. This book gives a valuable overview on the wellbeing of children in healthcare and also shows glimpses of what a good children's healthcare service should look like.

More information

For more information about supporting children through medical procedures, see Needles and Needle-Related Medical Procedures links.

AWCH also holds a copy of Needles: helping to take away the fear, a booklet for parents based on information provided by Dr Richard Lansdown produced by Action for Sick Children, 1994.

Jillian Rattray
AWCH librarian
AWCH Library

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