Analyzing the resilience of hospitalized children and its relationship between state and trait anxiety: a hospital school approach

Purpose The study aimed to examine whether resilience skills upon hospital admission and its changes throughout the hospital school experience improve the state and trait anxiety of hospitalized children. Design The study examined data from a prospective one-group pretest–posttest study. The State and Trait Anxiety Scale (STAIC) and the School Resilience Scale (SRS) for children were assessed upon admission to and before discharge from the hospital school (HS). A visual Likert scale was used to evaluate the acceptance of curriculum-based activities. Complementary variables related to children's diseases were included. Results Sixty children, aged 9–14 years, who attended the HS were included (36 girls and 24 boys). Upon admission to the HS, students were in the 53rd and 31st percentile for state and trait anxiety and in the 50th percentile for resilience. Before their discharge, a decrease was observed in both state and trait anxiety ( P = 0.001 and p = 0.007, respectively) along with a significant improvement in overall resilience ( P = 0.022). Multivariate analysis showed that the only independent factor that negatively moderated the evolution of state anxiety was previous admissions ( p = 0.002). However, the time spent at the HS ( p = 0.035), as well as the resilience dimensions related to children's identity ( p = 0.009), their environment ( p = 0.031), and external resources ( p = 0.048) were factors that reduced trait anxiety during hospitalization. Conclusions Whereas the state anxiety evolution in hospitalized children was fundamentally conditioned by previous hospitalization experiences, in terms of moderating trait anxiety, both individual resilience capacities and those provided by the socio-family environment contributed significantly to reinforcing the positive management of children's emotions throughout the Hospital School experience.