PEDIATRICS Vol. 26 No. 3 September 1960, pp. 482-490
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Knudson, A. G.
Right arrow Articles by Natterson, J. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Knudson, A. G., Jr.
Right arrow Articles by Natterson, J. M.

PRACTICE OF PEDIATRICS

PARTICIPATION OF PARENTS IN THE HOSPITAL CARE OF FATALLY ILL CHILDREN

Alfred G. Knudson Jr. M.D., Ph.D.1 and Joseph M. Natterson M.D.1

1 Department of Pediatrics, City of Hope Medical Center, Duarte, California

A program for the participation of parents in the hospital care of fatally ill children is described. Such a program is practical and, in fact, serves useful purposes for patients, parents and staff.

The ill children are spared to a large extent from the great difficulty of separation from the parents. This has a maximally beneficial effect upon children less than 6 years of age. For the child 6 to 10 years of age, fear of procedures and of bodily harm seem to take precedence over separation fear, so that parent participation is less helpful. Parent participation is least helpful for the children over 10 years of age, where fear of death itself is the primary problem. There is apparently a maturation of death fear, whereby it evolves from separation fear and mutilation fear.

Parents, particularly mothers, are enabled to cope with their own separation anxiety and guilt feelings by participating in the hospital care of the child. This is especially important initially in the course of the child's illness, when the mother's reactions are conspicuously characterized by denial, guilt and hysterical emotionality. Later, when the mother's behavior becomes more rational, her desire to participate is balanced against her desire to support the rest of the family. There is apparently a phasic response in the mother, with an initial emotional and denying reaction and a later more rationally adaptive reaction.

Staff personnel, particularly nurses, are largely relieved of the burden of assuming a role of psychologic parentage. An opportunity to identify with a research program is afforded, thus providing constructive purpose. Compensation is also provided by the gratitude of parents who have come to know the staff and to appreciate their efforts and by the satisfaction of aiding in the psychologic rehabilitation of parents.