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.

Pain

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

Email: Jillian@awch.com.au
AWCH Library

Who's got a normal family?

By Belinda Nowell and illustrated by Miša Alexander
Little Steps Publishing, Glebe 2016.  ISBN 9781925117752.


“I read the book three times… it makes people feel okay about the type of family they have”, said one primary school reader

Who’s got a normal family?
‘Who’s got a normal family?’ a delegate at the recent ACWA* conference read out loud.  “Well whose family is normal?” she asked, laughing. It’s not hard to see why this recent Australian book caught the interest of many who came by our ACWA resource booth.

With two hats on, one friendly delegate working with children in out-of-home care, had also recently become a foster parent. She said how helpful this book would be for a sibling adjusting to a new family member.

Welcome to a new foster child
The story is about Alex, an easy going boy. It is news time at school, Alex is greeted with classroom cheers when he tells the children his new baby foster sister has arrived. That is all except one boy, Jimmy Martin, who has a “stomp in his step and upside-down smile”. He yells “babies are boring” and “she’s not your real sister”.

Alex is sad and asks his mum about “normal families” when he gets home from school. She pulls out his class photo and they talk about the families at school. Alex’s mum is a supportive adult presence who helps sort through Alex’s difficult emotions.

Different but unique 
This picture book entices readers with its character-filled illustrations. Each school child is introduced with their family. Alex is a foster child, Alir came to Australia for safety with his large family, Eva has a daddy but not a mummy, Henry has two dads, etc. With an upbeat tone, Alex chats about what makes each child and family unique. There’s a sense of fun and acceptance which makes this book enjoyable to read.

Something to share
Alex finds a way, with the help of his mum, to connect with Jimmy. He realises Jimmy is sad because his daddy doesn’t live with him anymore. Alex shares what he has just learned about “normal families” with Jimmy, as well as showing him his hidden blue-tongue lizard family and all ends well.
Who might like this book?

Families with infant school children, the book is aimed at children 5-7 years. Younger children and older independent readers may also find this book engaging and helpful.

More resources

• Dhiiyaan is a beautiful reading App written and illustrated by Elaine Russell, for grandparent kinship carers to share with their kids.
• Healthcare professionals may want to look at Out of homecare and healthcare pathways, by NSW Health.

You are like you and The Internet is like a puddle A Big Hug Book Series, recent Australian resources displayed at our ACWA* conference booth.

Have you found a children’s resource promoting child wellbeing to recommend? If so, please let us know.

 * Association of Children's Welfare Agencies (ACWA) is the NSW non-government peak body representing the voice of community organisations working with vulnerable children, young people and their families.

Jillian Rattray

AWCH librarian

http://Library.awch.org.au

September 2016