Fostering Resilience in Hospitalized Children

Jordan Clemens


Pediatr Nurs. 2020;46(4):204-206. 

In This Article

Abstract and Introduction


Hospitalization presents a variety of medical, psychological, and emotional challenges for children. With these challenges also come disruptions in daily life, routines, and family systems for those requiring an inpatient admission. To optimize outcomes for patients and their families during times of disequilibrium engendered by the stress of hospitalization or diagnosis, it is important to prioritize interventions that cultivate the resilience needed for optimal coping. In line with the lifespan developmental perspective, being diagnosed with a chronic illness or enduring a hospitalization is a non-normative event with the potential to disrupt long-term development, if not buffered with effective coping skills that foster resilience.

Although several definitions of resilience have been posed, a very common theme that presents itself across the research literature is adaptation. Adaptation to stressful circumstances or life events has been identified as a key indicator of resilience. Resilience then involves patterns of positive functioning that have resulted from effective adaption to stressful circumstances. Resilience not only promotes optimal coping, but also provides protection to the brain and biological systems that are adversely affected by continual exposure to stress (National Scientific Council on the Developing Child, 2015). Resilience, therefore, helps to optimize outcomes both mentally and physically by turning potentially toxic stress, through adaptive skills, into tolerable and productive stress. Resilience can be viewed as a seesaw, in which resilience is achieved when positive outcomes outweigh negative outcomes, tipping the seesaw in the direction of positive outcomes. For example, within the hospital setting, helping a child with a chronic illness learn and master coping skills for frequent invasive procedures (such as daily insulin injections) could help foster resilience, making the stress of the procedure more manageable for the developing child and their family.

Resilience can be strengthened across the lifespan because it is not a fixed trait, but rather, a modifiable one. Harvard University – Center on the Developing Child (n.d.) outlines four key factors that have demonstrated evidence in the fostering of resilience: "supportive adult-child relationships, building a sense of self-efficacy and perceived control, providing opportunities to strengthen adaptive skills and self-regulatory behavior, and mobilizing sources of faith, hope, and cultural traditions." There are many opportunities for interprofessional teams in hospital settings to attend to these four factors, thus helping children attain, develop, and strengthen a sense of resilience.