Introduction

Hospitalization occurs when symptoms of illness can no longer be tolerated in the individual's domestic environment, when technical investigations need to be performed or when treatments requiring specific equipment or 24-hour patient monitoring are to be undertaken. One might therefore expect that, at least for a substantial minority, hospitalization would be viewed as a source of relief or reassurance, or would hold out the possibility of offering a better understanding of symptoms or even resolution of symptoms. However, in the psychological literature, it is primarily conceptualized as a source of stress. Additionally, discharge from hospital is seen as a stressful time and Ley (1988) has reported high levels of depression in patients in the period following discharge.

This chapter discusses the stressors faced by hospitalized adults and emotional and cognitive responses to hospitalization. The role of health professionals in meeting the needs of hospitalized adults is considered and the impact of adult hospitalization on family members is examined.

Stressors

The Hospital Stress Rating Scale (Volicer & Bohannon, 1975) describes 49 ‘events’ associated with being in hospital which may be stressful. These events were ranked by 261 medical and surgical patients from the most to the least stressful. The most stressful, thinking you might lose your sight, relates to the threat of illness as does the fourth, knowing that you have a serious illness. Illness course was also identified as an area of concern in chronic bronchitis and emphysema patients by Small and Graydon (1993).