Coping strategies for hospital-related fears in pre-school-aged children


  • This study was supported by the Finnish Cultural Foundation.

Ms Marja Salmela, Metropolia University of Applied Sciences, PL 4030, 00079 Metropolia, Finland. Fax: +358 207835748; email:


Aim:  The aim of this study was to describe the child-reported coping strategies for hospital-related fears in 4–6-year-old children.

Method:  The data were collected by semi-structured interviews of 4–6-year-old volunteering children (n= 82) in Finland. Thirty-four children were interviewed in hospital, and 48 in kindergarten. The children were chosen through a purposive sampling method, in which volunteers were asked to take part in the study. The data were analysed with quantitative and qualitative methods.

Results:  The most frequent child-reported coping strategies were: the presence of parents and other family members (81/517, 15.7%), the help of the hospital personnel (58/517, 11.2%), positive images and humour (57/517, 11%), play (57/517, 11%) and the child's own safety toy (45/517, 8.7%). The children interviewed in hospital mentioned significantly more often play (P= 0.000) as their coping strategy than children interviewed in a kindergarten. Children interviewed in kindergarten expressed significantly more often the presence of parents (P= 0.032) and the help of the doctor (P= 0.012) as their coping strategy than the children interviewed in the hospital.

Conclusions:  The results showed that children have many coping strategies, especially ones in which the children themselves play an active role. Besides, the traditional methods for alleviating fear, children need possibilities to use coping methods in which they have an active role giving them a feeling of some control over the hospital environment and medical procedures.