A 10-year-old child is hospitalized for a sports injury requiring surgery. The nurse notices the patient frequently uses their tablet and seems withdrawn when family visits. Which nursing intervention is most appropriate to promote psychological well-being during hospitalization?

Adolescents rely heavily on peer relationships for psychological well-being, so encouraging supervised peer contact via phone/video chats reduces distress and supports developmental needs. Other options may increase isolation (limiting devices), are less effective (extended family visits), or do not address social needs (educational materials).

Correct Answer: 1

In-Depth Rationale

This question addresses the psychosocial needs of a school-age child during hospitalization, a critical component of the NCLEX-RN "Psychosocial Integrity" and "Health Promotion and Maintenance" categories. The child's withdrawn behavior and frequent tablet use are key clinical cues. While the tablet might appear to be a distraction, it can also represent a self-initiated coping mechanism to maintain a sense of normalcy and connection. The most therapeutic nursing intervention is one that leverages this behavior to address the core issue of social isolation, which is a significant stressor for hospitalized children.

A recent scoping review on psychosocial supports for hospitalized children with chronic conditions identified social support as a fundamental domain of intervention ^[2]. The review emphasizes that facilitating connections with peers is a vital strategy to mitigate feelings of loneliness and isolation during admission. For a 10-year-old child, who is in Erikson's stage of Industry vs. Inferiority, peer relationships are paramount for self-esteem and psychological well-being. Encouraging peer contact through supervised phone calls and video chats directly applies this evidence. This intervention validates the child's developmental need for social interaction, utilizes a familiar and acceptable medium (the tablet), and does so within a safe, monitored framework that respects hospital policies.

The other options are less appropriate or potentially counter-therapeutic based on the provided evidence and developmental principles:
- Option 2: Restricting electronic device usage removes the child's primary tool for connection and distraction, which could increase anxiety and a sense of powerlessness. The evidence points toward leveraging technology for psychosocial benefit, not restricting it [1,2].
- Option 3: While family support is crucial, the child is already withdrawing during family visits. This signals that simply increasing the quantity of family time does not address the underlying issue, which may be a longing for normal peer interaction. The scoping review categorizes family support and peer support as distinct psychosocial needs, and the child's behavior specifically points to an unmet social need with their own age group ^[2].
- Option 4: Providing educational materials addresses the informational support domain, which is important for reducing fear of the unknown [1,2]. However, the immediate cues of withdrawal and solitary tablet use point more directly to a deficit in social support. While education is valuable, it does not directly target the presenting problem of social isolation. The reviewed literature indicates that psychosocial interventions are most effective when they are tailored to the specific domain of need, which in this scenario is social, not informational .

Therefore, the most appropriate and evidence-informed intervention is to facilitate safe, structured peer interaction, directly addressing the social isolation that is likely contributing to the child's withdrawn behavior.