ABSTRACT
Despite encouraging advances in the treatment of childhood cancer, death remains the long-term prognosis for some children with cancer. Hospitals have traditionally been the setting for the treatment of children with cancer. Hospitalization is, however, particularly frightening and upsetting to children. For children under five years old, the greatest fear is caused by separation from their mothers, in addition to separation from other family members, the home, and their playthings. Hospitalization forces separation from the mother at the same time that it introduces the child to new people and places and, frequently, to painful routines. In addition to their fear of separation, children over five are preoccupied with threats to their bodily integrity and functioning (Spinetta, Rigler, and Karon, 1973). Children’s need for their parents increases markedly during serious illness, but hospitalization has traditionally reduced their access to them. Currently, pediatric oncologists often attempt to administer cancer treatment protocols to children on an outpatient basis. However, when these treatment protocols have been exhausted and their cancer is still out of control, children are generally hospitalized for the final days of their lives.
