4. Separation Anxiety / Anaclitic
Depression
The major stress from middle infancy
throughout the preschooler years,
especially for children ages 6-30
months.
John bowlby describes 3 stages of
separation anxiety as:-
1. Stage of protest
2. Stage of despair
3. Stage of detachment
5.
6. Infant
Separation anxiety disturbance in the development
of basic trust
4-8month – depression and withdrawal
Interference of growth and delayed development
8-12 month– limited tolerance to separation
Evidenced by excessive cry and over dependence on
mother
7. Toddler
Protest
Frequent crying,
Shaking crib,
Rejecting nurses attention,
Urgent desire to find mother
Showing sign of distrust with
anger and tears.
Despair
Helpless
Apathetic
Anorectic
Looks sad cry continuously
Use comfort measures-thump
sucking
Tightly clenching the toys
8. Preschooler
Demonstrate separation anxiety by
refusing to eat, experiencing difficulty in
sleeping, crying quietly for their parents,
asking about parents.
Express anger by breaking toys.
9. Scholar
Concerned with fear, worry, fantasies, modesty
and privacy
Defense mechanism used is Regression,
separation anxiety, negativism Depression,
Suppression denial, phobia- unrealistic fear
10. Adolescent
Concerned with problem of privacy
Separation from peers, family, and school
Interference with body image and independency or self
concept or sexuality
Anger and uncooperative behavior
Defense mechanism used are denial or withdrawal
rejection and depression
17. Parental anxiety
Factors affecting anxiety:-
Seriousness of the disease
Previous experience of illness
Medical procedures
Available support system
Cultural and religious belief
Communication pattern
18. Sibling anxiety
Being cared by outsiders like relatives,
neighbors
Receiving little information about ill sibling
Lack of parental affection
Separation anxiety
Fear of loosing love from parents
25. Role of nurse
1 • Flexible visiting hours to reduce the separation anxiety
2 • Family centered care to make the child feel secure
3 • During the separation, nurse provide support by physical presence
4 • Provide favorable environment to reduce anxiety
5 • Encourage rooming-in
6 • Try to continue home routine of the ill child
7 • Provide warmth and support