The psychosocial stressors and interventions chart demonstrates hospital stressors for children at different ages and intervention strategies to combat them. The chart also utilizes theory to support all areas.

1. Psychosocial Stressors and Interventions Chart
Age Group
Erik Erikson’s
Psychosocial theory
(Berk, L., 2022)
Jean Piaget’s
Cognitive
development theory
(Berk, L., 2022)
Freud (Berk, L.,
2022)
Hospitalization Stressors Psychosocial Interventions
Infancy
(0 to 1)
Trust versus mistrust
is characterized by
the need for infants
to gain a sense of
trust in the world
around them. If they
are neglected they
may begin to feel
mistrust.
Sensorimotor is
defined by kids using
their eyes, ears, hands
and mouth to solve
everyday problems.
An example of this is
pushing a button that
will then play music.
Oral stage is
characterized by
children navigating the
world primarily using
their mouth i.e feeding
and putting objects in
their mouth.
The hospitalization stressors that
infants face in this developmental
stage are separation anxiety, a
change in their typical routine and
environment, and response to
pain. They may struggle to be
away from their caregivers when
it is time for them to undergo
procedures. During these
procedures they also struggle to
deal with the pain as they are
most reactive to pain during this
age. They may also struggle with
the fact that they are
overstimulated by their
environment while facing changes
to their eating and sleeping
patterns due to specific operation
and medication times. (Whitten,
2023)
An intervention for
separation anxiety is to
utilize developmentally
appropiate distractions. They
could engage the infant with
a toy while the parent leaves
the room for procedures so
they are distracted.
An intervention for a change
of their routine and
environment is to have the
caregiver feed during
procedures because it will
help them balance the
interruption procedures
place on routines. One
intervention for managing
pain is the use of a comfort
object because studies show
that distraction is proven to
help cope with pain. This is
effective especially if it is an
object they are familiar with.
(Whitten, 2023)
Toddlerhood
(1 to 3)
Autonomy vs shame
and doubt is
characterized by
toddlers wanting to
make decisions for
Preoperational is
defined by children
starting to use
symbolism to
characterize their
Anal stage is
characterized by the
fact that children enjoy
holding and releasing
feces and if there are
Three hospitalization stressors
that this age range faces are fear
of bodily injury, loss of routine,
and forced regression. Because
children are coming out of a stage
One psychological
intervention for fear of
bodily injury is to facilitate
medical play. If children are
able to engage in medical

2. themself and they
can also feel a sense
of shame for making
the wrong decision.
sensorimotor skills.
They also begin to
utilize make believe
play.
issues with potty
training they can
manifest later such as
issues with extreme
orderliness.
where they are still very receptive
to pain they may fear medical
procedures that they know will
cause pain. Since children are
also starting to have a sense of
making decisions for themself
and creating their own routine
like waking up and brushing their
teeth, hospitalization may create a
loss of routine. Because they are
also experiencing many
developmental advancements like
walking and other motor skills,
hospitalization may force them to
regress developmentally when
they can be forced to be imobile.
(Whitten, 2023)
play and have a certain level
of preparation and
familiarity with medical
objects that will be used they
will exhibit less fear. An
intervention for loss of
routine is to provide
structure and replication in
their schedule when
possible. For example they
can make sure that the child
eats the same thing for
breakfast each time even if
the time for breakfast shifts
due to procedures. An
intervention for forced
regression is engaging in
activities that promote
movement. A child may be
more confined to their bed
due to medical procedures so
it is important to promote
movement that will help
facilitate developmentally
appropriate milestones such
as walking. (Whitten, 2023)

3. Preschool
(3 to 5)
Initiative versus guilt
is characterized by
children in this age
beginning to engage
in make believe play
and starting to gain
insight into the
person they are. If
too much is
demanded from them
they may begin to
feel guilt.
Along with utilizing
make believe play and
symbolism
preoperational is also
characterized in this
age range by children
lacking a certain
amount of logic when
it comes to problem
solving and thought.
The phallic stage is
characterized by
children adopting their
same sex caretaker’s
characteristics and
values in order to avoid
punishment.
Three hospital stressors may be a
loss of control, separation
anxiety, and fear of bodily
mutation. Children in this age
group are just now starting to gain
a sense of independence as they
typically are fully mobile on their
own and capable of socializing so
hospitalization can limit this and
make them feel as though they
aren't in control. Children
experience separation anxiety
because they may be away from
their caregivers an extensive
amount even though they have an
established relationship and
routine. They experience fear of
bodily mutation because they
have a new sound sense of
identity and their increase in
imaginative play can make them
think the worst about the
procedures they are facing.
(Whitten, 2023)
An intervention for loss of
control is to give choices
when possible. For example
if the practitioner needs to
take the child’s blood
pressure they can ask which
arm they want it to be on.
An intervention for
separation anxiety is
parental involvement. The
parent can ensure to have
conversations with the child
beforehand about how much
time they will be spending
apart. This preparation from
the parent beforehand allows
the child more time to
process everything.An
intervention for fear of
bodily mutation is to provide
coping mechanisms and
distractions such as a
buzzing bee. (Whitten,
2023)
School Age
(6 to 12)
Industry versus
inferiority is
characterized by
children beginning to
learn to work with
others but they may
feel a sense of
inferiority if they
have negative
experiences with this.
Formal operations are
defined by more
abstract and
systematic thinking.
They also begin to
rethink the logic of
statements.
The latency stage is
characterized by sexual
instincts dying down
and children begin to
adopt values and
characteristics from
same sex individuals
that are not their
caretakers.
Three stressors in this stage are
fear of loss of mastery, fear of
bodily injury and pain, and fear of
illness itslef. Fear of loss of
mastery is a stressor because
children are beginning to master
certain skills and hobbies like
sports and hospitalization could
potentially take that away from
them. Since children are very
aware of how pain effects their
An intervention for fear of
loss of mastery is to promote
therapeutic play that
includes freedom within
limits. Children can engage
in play that can relate to
something they were already
interested in so they still feel
that sense of mastery. An
example could be coloring in
a sports picture if they enjoy

4. body there is more anticipation to
how certain procedures will hurt.
At this stage children are now
able to have a bit more complex
thinking so they can fear the
illness itself and how it will effect
their life long term.(Rollins et al.,
2018)
sports. An intervention for
fear of bodily injury and
pain is to provide medical
information. It is important
that children understand
what they are going through
especially when they have
questions about it. This can
help reduce anxieties
especially knowing what
parts of procedures are
happening so they aren't
surprised. An intervention
for fear of illness itself is to
promote parental
involvement and provide
information. It is important
parents know about the
illness so they can also help
ease their child’s anxieties as
a trusted adult. (Rollins et
al., 2018)
Adolescence
(12 to 18)
Identity versus role
confusion is
characterized by kids
in this group
exploring their
personal and career
goals and gaining a
sense of identity
from it.
Formal operations are
also defined by
complex thinking
patterns where they
solve problems by
creating a hypothesis
and deducting
information. They
also utilize their own
experience much
more.
The genital stage is
characterized by the
biological changes of
puberty and sexual
impulses start to
reappear. Successful
development during
earlier stages results in
healthy mature
sexuality and related
areas.
Three hospital stressors are
separation from family and peers,
fear of loss of identity, and body
image and sexuality. In this age
adolescents are well accustomed
to being around their family and
peers so hospitalizations presents
a big shift as they are away from
them. In this age adolescents are
starting to solidify their identity
and peer acceptance is very
important so they begin to fear
that they will only be known for
whatever medical issue or illness
An intervention for
separation from family ans
peers is encourage peer
group activities. This gives
the adolescents a space
where they can relate to
other people that may be
going to similar things as
them. An interventio for fear
of loss of identity is to
encouraged self expression.
It is important for
adolescents to feel like they
have control of their identity

5. they are going through.
Adolescents are still going
through body changes in this time
and with peer acceptance being so
important they start to fear that
their peers will notice any
changes in their body from
hospitalization.(Rollins et al.,
2018)
and self expression can help
facilitate that control and
create a new identity for
them that they are confident
in. An intervention for body
image issues is to provide
privacy when necessary.
Adolescents need to know
that their privacy is
respected and need that
particular time alone to feel
comfortable in their body
especially as it is changing
for various reasons. (Rollins
et al., 2018)