ผู้วิจัย/Authors: Prapaipun Jirunthorn
ชื่อเรื่อง/Title: THERAPEUTIC PLAY TO RELEASE MATERNAL SEPARATION ANXIETY IN HOSPITALIZED TODDLERS.
แหล่งที่มา/Source: Journal of The Psychiatric Association of Thailand, Vol. 26 No.4 Octoberr 1981.
รายละเอียด / Details:
In the study of Therapeutic Play to Release Maternal Separation Anxiety in Hospitalized Toddlers. ‘ two hypotheses were set as following:- One: Maternal separation reactions have occurred when the hospitalized toddlers are separated from their mothers. Two: Therapeutic play will release maternal separation reactions in hospitalized toddlers. Seperation anxiety as descirbed by Bowlby is ‘The manifestation of responses occurring in children between the ages of twelve months and four years when these children are removed from the mother figures to whom they are attached’. A child of one to three years old develops a strong relationship bond with his mother which is crucial to his survival and development. According to Erikson, during the toddler period, a child learns a sense of autonomy or self-dependence. He goes through a process of slowly in creasing detachment from the mother both at home and away from home. Hospitalization normally is a stressful situation for all people because of unfamiliar surroundings, changes of routine habits and painful experience. Hospitalization of children during the toddler period produces a severe psychological trauma because the child had to separate from his mother before a stable and secure dependency relationship has been established. The separation anxiety is found to be the most common experience for hospitalized children between the age of six months and four years as supported by studies of Godfrey(1) , Goerzen and Chinn (2) , Juenker(4) , Kennedy (5) , Pilliteri (6) , Solnit(8) It should be nurse’s role in helping these children to cope with their anxiety and regain their optimal health through this stage of developmental crisis. The purpose of this study is to evaluate the effectiveness of therapeutic play on the maternal separation anxiety. This study was conducted in the Pediatric ward of Ramathibodi Hospital during an eight-month period from January to August, 1979 . Twenty toddlers were selected by purposive sampling method and equally assigned into experimental and control groups. The trained nurse initiated nurse patient relationship with each child with his mother on the first day of admission until separation time. The child’s immediate reactions were observed five minutes and recorded in a check-list form of separation anxiety reaction by the researcher. Subjects in the experimental groups were then allowed to select either two or three combining techniques of therapeutic play and played with the trained nurse individually for thirty minutes. The researcher reassessed the child’s reactions after thirty minutes in all subjects. The same procedure was repeated for three days continuously in each child. Three techniques of therapeutic play were selected for treatment. The first one is therapeutic communication. It focuses on using verbal interaction to encourage a child to express the feeling of anxiety, hostility, fear, depression, etc. The second is playing a game ‘Peek-a-boo‘ or ‘nide and seek’. This game would help a child to enjoy the experience of appearance and disappearance of people. The last one is playing different types of toys which included a drum, crayons, a football, a picture book and medical equipment. These toys focus on therapeutic effects of physical expression of emotional tension, distraction from mother attention and entertainment. The results supported the first hypotheses that immediately after the mother’s departure, all toddlers in both groups demonstrated separation reactions in various degrees of severity in all three phases of adjustment process: The Protest, Despair and Denial phases . There were no significant different reactions between the two groups (P=.05). The hospitalized toddlers, who had separation anxiety displayed three phases of reactions (2,7) 1. Protest Phase: These reactions include loud crying, shaking the cot, throwing himself out and rejecting nurses attentions. 2. Despair Phase: The child was less active, withdrawn, apathetic and made no demand on the environment . He sought self-comfort, such as sucking his thumb. 3. Denial Phase: In this phase the child showed more interest in his surrounding, had a good appetite and did not frequently call for his mother. In figure 1, most children’s reactions in the protest phase were crying, listless and rejection behavior in severe degree struggle with anger in moderate degree
Keywords: anxiety, psychiatry, separation anxiety, maternal separation, childrenchild psychiatry, child, nurse’s role, therapeutic play, therapeutic communication, psychiatric nursing, nurse
Address: Nursing Department. Faculty of Medicine Ramathibodi Hospital Mahidol University , Ministry of University Affairs.
Country of publication: Thailand.
Category: Abstract Journal.