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University Microfilms INFORMATION TO USERS This dissertation was produced from a microfilm copy of the original document. While the most advanced technological means to photograph and reproduce this document have been used, the quality is heavily dependent upon the quality of the original submitted. The following explanation of techniques is provided to help you understand markings or patterns which may appear on this reproduction. 1. The sign or "target" for pages apparently lacking from the document photographed is "Missing Page(s)". If it was possible to obtain the missing page(s) or section, they are spliced into the film along with adjacent pages. This may have necessitated cutting thru an image and duplicating adjacent pages to insure you complete continuity. 2. When an image on the film is obliterated with a large round black mark, it is an indication that the photographer suspected that the copy may have moved during exposure and thus cause a blurred image. You will find a good image of the page in the adjacent frame. 3. When a map, drawing or chart, etc., was part of the material being photographed the photographer followed a definite method in "sectioning" the material. It is customary to begin photoing at the upper left hand corner of a large sheet and to continue photoing from left to right in equal sections with a small overlap. If necessary, sectioning is continued again — beginning below the first row and continuing on until complete. 4. The majority of users indicate that the textual content is of greatest value, however, a somewhat higher quality reproduction could be made from "photographs" if essential to the understanding of the dissertation. Silver prints of "photographs" may be ordered at additional charge by writing the Order Department, giving the catalog number, title, author and specific pages you wish reproduced. University Microfilms 300 North Zeeb Road Ann Arbor, Michigan 48106 A Xerox Education Company I I 73-2070 MENKE, Edna Mae, 1941- FACTORS RELATED TO CHILDREN'S PERCEPTION OF STRESS IN THE HOSPITAL. The Ohio State University, Ph.D., 1972 Education, guidance and counseling University Microfilms, A XEROX Company, Ann Arbor, Michigan ©Copyright by Edna Mae Menke 1972 THIS DISSERTATION HAS BEEN MICROFILMED EXACTLY AS RECEIVED. FACTORS RELATED TO CHILDREN'S PERCEPTION OF STRESS IN THE HOSPITAL DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate Sehool of the Ohio State University By Edna Mae Menke, B.S., M.S. * * * * * The Ohio State University 1972 Approved by Adviser College of Education PLEASE NOTE: Some pages may have indistinct print. Filmed as received. University Microfilms, A Xerox Education Company ACKNOWLEDGEMENTS I wish to express my sincere appreciation to my major adviser, Dr. Herman J. Peters, for his guidanee, encouragement, support, and time throughout my doctoral program. Also I want to thank Mrs. Annabelle Peters for her enoouragement during my studies, I would like to thank the other members of my committee for their assistance during my doctoral program. These include Dr. Donald J. Tosi, Dr. James V, Wigtil, and Dr. Robert J. Wherry. I would like to express ny appreciation to Dr, Lillian Pierce who encouraged me to pursue doctoral work, I would like to express my gratitude to the children and their parents who made this study possible. Also a word of thanks to the staff at Children's Hospital and at Riverside Methodist Hospital. I would also like to express my gratitude to ray friends for their invaluable support and encouragement during my doctoral program. Especially those who shared with me during the "high" and "low" points in my studies. Above all, I am especially grateful to my parents, for their encouragement, moral support, and financial support, which they provided throughout my studies. ii Recognition is due for the financial support that the National Institutes of Health provided for my doctoral studies. My studies were possible from a special nurse research fellowship (5FX)4-NU-27,237-03). iii VITA September 26, 1941 Born — Cincinnati, Ohio 1963 B.S.N., University of Cincinnati, Cincinnati, Ohio 1963-1964 Assistant Evening Supervisor, St, Luke Hospital, Fort Thomas, Kentucky 1964-1966 Instructor, St, Elisabeth School of Nursing, Covington, Kentucky 1966-1967 Instructor, James Ward Thorne School of Nursing, Chicago, Illinois 1968 M.S., The Ohio State University, Columbus, Ohio 1969 Instructor, School of Nursing, The Ohio State University, Columbus, Ohio 1969-1972 National Institutes of Health Fellow, The Ohio State University, Columbus, Ohio FIELDS OF STUDY Major Field» Counseling and Guidance Studies in Counseling and Guidance. Professors Herman J, Peters and James V. Wigtil Studies in Quantitative Psychology, Professor Robert J. Wherry iv TABLE OF CONTENTS Page ACKNOWLEDGEMENTS .......................................... 11 VITA ...................................................... lv LIST OF TA B L E S ............................................ vii CHAPTER I. INTRODUCTION.................................... 1 The Problem Statement of the Problem Research Hypotheses Definitions Organization of the Study II. THEORETICAL FRAMEWORK............................ 13 Perception Stress Hospitalizationi A Stressful Experience for a Child Model for Studying Children's Perception of Stressful Stimuli in the Hospital III, METHODOLOGY ............................... 80 Research Design Sample Measurement of Stress Statistical Analysis of the Data v Page IV. ANALYSIS OF THE D A T A ............................. 103 Identification of Stressful Stimuli Test of the Research Hypotheses Summary of Results Discussion of the Results V. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS........ l6l Summary Conclusions Recommendations for Future Studies APPENDIXES A. STIMULI IN THE G A M E ........................... 178 B. INTERVIEW S C H E D U L E ........................... 198 C. CONTINGENCY TABLES FOR NON-SIGNIFICANT STIMULI 202 BIBLIOGRAPHY .............................................. 256 ▼i LIST OF TABLES Table Page 1. Description of the sample 86 2. Judges* rating of the stimuli 94 3. Subjects' responses to each stimuli in the game 104 4. Frequency distribution of subjects' responses 105 to what they dislike in the hospital 5. Frequency distribution of subjects' responses 107 to what bothers them the most about being in the hospital 6 . Frequency distribution of subjects' responses 109 to whom they miss the most 7. Frequency distribution of number of intraper­ 110 sonal stressors identified by each subject 8 . Frequency distribution of number of interper­ 111 sonal stressors identified by each subject 9. Frequency distribution of the number of 112 environmental stressors identified by each subject 10, Frequency distribution of the total number 113 of stressors identified by each subject 11, Summary of phi coefficients and ohi-squares 115 for subject's age and stimuli 12, Contingency table for the stimulus, girl, and 116 the subject's age vll Table Page 13. Contingency table for the stimulus, dog, and 117 the subject's age 14. Summary of phi coefficients and chi-squares for 120 subject's sex and stimuli 15. Contingency table for the stimulus, dog, and 121 subject's sex 16. Contingency table for the stimulus, nurse, 122 and the subject's sex 17. Summary of phi coefficients and chi-squares 126 for subject's diagnosis and stimuli 18. Contingency table for the stimulus, dog, and 127 the subject's diagnosis 19. Contingency table for the stimulus, medications, 128 and the subject's diagnosis 20. Summary of phi coefficients and chi-squares for 131 subject's length of hospitalisation and stimuli 21. Contingency table for the stimulus, girl, and 132 the subject's length of hospitalization 22. Contingency table for the stimulus, dog, and 133 the subject's length of hospitalization 23. Contingency table for the stimulus, nurse, and 134 the subject's length of hospitalization 24. Contingency table for the total number of 135 stressful stimuli and the subject's length of hospitalization 25. Summary of phi coefficients and chi-squares for 139 subject's preparation and stimuli 26. Contingency table for the stimulus, nurse, and 140 the subject's preparation 27. Contingency table for the stimulus, house, and 141 the subject's preparation viii Table Page 28. Contingency table for the total number of 142 stressful stimuli and the subject's preparation 29. Summary of phi coefficients and chi-squares for 146 subject's experience with separation and stimuli 30. Contingency table for the stimulus, hospital room, 147 and the subject's experience with separation 31. Contingency table for the stimulus, stethoscope, 148 and the subject's experience with separation 32. Canonical weights and canonical factors for the 151 two sets of variables 33. Canonical weights for the first canonical factor 153 34. Contingency table for the stimulus, boy, and the 203 subject's age 35. Contingency table for the stimulus, mother, and 203 the subject's age 36. Contingency table for the stimulus, father, and 204 the subject's age 37. Contingency table for the stimulus, baby, and 204 the subject's age 38. Contingency table for the stimulus, eat, and the 205 subject's age 39. Contingency table for the stimulus, nurse, and 205 the subject's age 40. Contingency table for the stimulus, doctor, and 206 the subject's age 41. Contingency table for the stimulus, hospital 206 gown, and the subject's age 42. Contingency table for the stimulus, hospital 207 room, and the subject's age 43. Contingency
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