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The Long-stay Paediatric Inpatient and Consultation-liaison Psychiatry

Dr Zanda Jaquire
MBChB FCPsych Senior Registrar Child Psychiatry Dept. Child Psychiatry, UCT & Red Cross Hospital

What is a Long-stay Patient?

Definition: 6 days or more = long stay

Every hospitalised child: psychological reaction Degree varies - developmental level - pre-morbid emotional - chronic / serious condition - reaction of the family

Models of Interaction with Paediatrics

Emergency response Anticipatory Case finding Continuous care and collaboration

Education and support

Risk-factors for Emotional Problems:

younger age pre-morbid emotionally vulnerable sudden / unprepared admission prolonged hospitalisation chronic / more severe conditions invasive / painful procedure immobilisation, disfigurement

Physical factors

Parents emotions (understanding, expectations, guilt)

marital stress / disruption financial drain

Why you become concerned:

Depression Behaviour problems Parent

Psychiatry Assessment:

Time and flexibility Knowledge of normal development Emotional defence or regression Child as an individual in current context Relationships: parent-staff-outside Knowledge of medical illness and potential role of neuro-active medication

Abigail and Guillian-Barr S.

Physically extremely ill, urban ? clinically depressed Regular assessment impossible Focus on support structure identity autonomy Input from everyone associated Medication