Unaccompanied Hospitalized Children: An Integrative Review

Abstract

Problem: A child's hospitalization is often associated with stress that is exacerbated when the child is left unaccompanied by parents/caregivers. Parental presence, as part of a family-centered approach to care, is a strategy to mitigate the stressors and negative effects of hospitalization. However, due to a variety of circumstances, some children continue to remain unaccompanied in the hospital. This integrative review explored the phenomenon of unaccompanied hospitalized children.

Eligibility criteria: Relevant articles available in full-text and written in English were identified through electronic searches of CINAHL, PubMed, and PsycINFO and through hand searches of reference lists.

Sample: Eleven studies were included, analyzed, and synthesized into themes. Study quality was assessed using Bowling and Pearson's appraisal checklists.

Results: Distress of hospitalized children is evident when children are unaccompanied in the hospital and left to experience the stressors of hospitalization alone. The compounding effects of hospitalization and separation can cause distress and psychological trauma during and after the hospitalization period. Pediatric nurses strive to provide care to unaccompanied children that lessens these negative effects.

Conclusions: Unaccompanied hospitalized children represent a vulnerable population. While the literature provides some insight into the experiences, research does not adequately explore the unaccompanied hospitalized child's experience.

Implications: Pediatric nurses hold a position that enable them to support the physical and psychosocial needs of unaccompanied hospitalized children. By recognizing and addressing the stressors and distress unaccompanied children experience, nurses can help alleviate the subsequent effects resulting from separation and hospitalization.

Keywords: Hospitalization experience; Integrative review; Parental absence; Pediatric nursing; Unaccompanied hospitalized children.