Psychological reaction by children of various ages to hospital care and invasive procedures

Hospital care and treatment by invasive procedures produce significant psyc hological effects on children. Urogenital surgery deserves particular study . The developmental aspects of different ages are highly relevant. A propos ed multidimensional model of contributing factors includes type of medical treatment, any previous surgery, the child's temperament, coping strategies of both child and parents and their psychological health, support from par ents and staff, information and psychological preparation and age of the ch ild. Up to now, then have been no clear recommendations as to the best age for elective surgical procedures in children according to psychological ris k. In general, older children adapt better psychologically after hospital c are. The literature, however, tends to advise elective surgery before 12 mo of age, based on apparent psychological adjustment in the very young after surgery and from a desire to shorten the period of living with the malform ation/disorder. However, increased follow-up surgery from early interventio ns gives a higher risk of psychological problems. More well-controlled stud ies are needed before final evaluation of the impact of surgical interventi ons on psyche-social symptoms according to age group. In this analysis a mu ltidimensional model is preferred.