Voorbereiding van die pre-primêre kind op hospitalisasie: ‘n Spelterapeutiese benadering (Afrikaans)

Abstract

A hospitalisation experience is serious for every toddler, and implies physical and emotional trauma of one kind or another. The reaction of the toddler in terms of this trauma in effect is a normal reaction to an unnatural situation, through which he tries to be in control of himself and his unknown environment. His lack of experience, incomplete cognitive reasoning, and lack of insight cause anxiety and stress for the toddler. Misbehaviour because of account of his anxiety and fear which the form part of the toddlers attempts to control and get hold of this unknown situation. The research is primarily aimed at how the therapist, parents and hospital personnel can prepare, assess and support the toddler, in terms of handling the hospitalisation process. Seeing that there is normally no one to blame for the toddlers admission to hospital, the child directs his anger and anxiety at himself, resulting in inner conflict and intense feelings of guilt. The research project aims to focus on preparation of the pre-primary toddler for hospitalisation, by using playtherapeutic intervention, in order to lessen the fear and anxiety of the experience. This goal was achieved by a literature study, an empirical study with the aid of application of a preparatory intervention program, as well as an assessment and an evaluation of the program, in order to make recommendations, regarding the research. Optimal care, and preparation of sick toddlers for admission in hospital, includes more than satisfying the child’s physical needs. It also asks for gratification of the toddler’s psychosocial needs. Support and preparation of both the child and his/her parents form an integral component of the sanitary care process. Therapeutic activities with the child that is going to hospital, can, according to the goals of the research study, be instrumental in reducing fear, promote self-esteem, become acquainted with the medical setting and procedures, as well as providing in the toddlers physical, emotional, psychological and psychosocial needs. A complete and refined play therapeutic preparation program was developed and evaluated through the findings of the empirical and literature study. The process of intervention research was followed in the empirical study, where data was obtained with the aid of a purposive sample, of 20 hospitalised toddler respondents. Creswell’s dominant-less-dominant model was utilised. A dominant quantitative approach was being followed, through witch data was assembled by a self developed structured observation instrument, as a post-test for both the experimental as well as the comparative group. The less dominant, but equally important qualitative approach, that consisted of 9 playtherapeutic sessions with experimental group, field notes and interviews with parents, enrich and verified the quantitative data. According to the integration of the quantitative and qualitative findings, the conclusion can be made that the preparatory playtherapeutic program had a positive impact on the way fear and the toddlers handled anxiety during hospitalisation, with less misbehaviour. The findings show that the developed preparatory playtherapeutic program can be implemented with great success and confidence, with toddlers that are going to be hospitalised. It is recommended that further research can be done on development and evaluation of preparation programmes for toddlers from less fortunate communities. Seeing that individual sessions may due to financial difficulties be less tenable, group sessions and community work can be recommended to reach larger groups of children, as well as creating community awareness for the needs of toddlers, related to hospitalisation.