The Importance of Prep: Preparing Children and Teens for Medical Procedures

There are few things more difficult for a parent or caregiver than watching a loved one in a heightened state of anxiety or worse, in pain. For many parents, this is a rare occurrence—perhaps a fall off a bike led to a broken arm or a burst appendix led to an emergency surgery.

For parents of children with chronic and/or rare diseases, however, the reality is a more common occurrence.

Often, parents and caregivers may feel helpless and unprepared for the wide range of reactions their child may have in response to medical procedures.  Over time, these feelings of helplessness on the part of the parent or caregiver can lead them to develop their own levels of anticipatory anxiety—the parent becomes wary of even going to their child’s appointment to have a procedure.

Unfortunately, children are very perceptive of their parents’ moods and will often “feed off” any anxiety or hesitancy that a parent may have. This can set off a negative feedback loop of even more intense behavioral reactions on the part of the child which, in turn, makes the parents more anxious and reactive (Mahoney et al., (2010).

When the reactions and tensions become too intense on the part of both the child and parent, avoidance behaviors can occur, leading to delays in procedures.  For children with chronic diseases, the long-term consequences of the unstable avoidance patterns established early in life may follow them well into their adulthood(Bray et al., (2019).

While this negative feedback loop represents a dysfunctional cycle of parent-child interactions, there are things that parents can do to reduce the anxieties and tensions on the part of the child which, in turn, will likely decrease their own anxieties as a parent.

Evidence-based practices exist that have shown to be effective in reducing some of the anxieties and fears related to medical procedures(Mechtel and Stoeckle , 2017).

In looking at some key parts of these practices that exist, experts suggest that the most important thing to do with a child is to PREPARE them.

Helpful Hints

  1. Provide age/developmentally appropriate information
    If your child is younger, they may benefit from having you read a book to them that discusses medical procedures. Not only does this allow for an introduction to their upcoming procedure or visit, but it also further establishes trust and bonding between the child and parent or caregiver. The American Psychological Association(APA) has a companion website called Magination Press. It contains many award-winning books that deal specifically with child and teen mental health topics like stress management, depression, and anxiety. It has several books about doctor visits and procedures.
  2. Allow for open communication and emotional expression
    It’s ok for a child to be scared, anxious, or even angry about an upcoming medical procedure or doctor’s visit. Very few adults would report that they enjoy getting blood drawn or being poked and prodded. Listening to a child’s fears is much more beneficial than dismissing them. After you’ve provided age/developmentally appropriate information, encourage children to ask questions and voice any emotions they may have. Once a child identifies an emotion, coping mechanisms and strategies can be taught to decrease much of the anxieties and stressors.
  3. Engage the healthcare team
    If a child is experiencing a great deal of anticipatory anxiety about an upcoming procedure or visit, let your physician’s office know. In many cases, making the staff aware that your child has concerns will allow them to proactively modify their strategies and techniques before the visit begins. If your child will be undergoing a procedure in a hospital, check to see if the hospital has a Child Life Specialist on staff. Even if they do not have this specific role the office, hospital, or clinical trial may have a member of staff who is there to support children and/or their families to approach the interventions in the most positive way. When in doubt, ask around?

Although every child and situation is different, proactively following these steps towards preparation can help to reduce anxieties and stress for both the parent and the child.

References

Bray, L., Appleton, V., & Sharpe, A., (2019). ‘If I knew what was going to happen, it wouldn’t
worry me so much’: Children’s, parent’s and healthcare professionals’ perspectives on
information for children undergoing a procedure. Journal of Child Healthcare, 23 (4)

Mahoney, L., Ayers, S., & Seddon, P., (2010). The association between parent’s and healthcare
professional’s behavior and children’s coping and distress during venipuncture. Journal of
Pediatric Psychology, 35(9), 985-995. https: doi:10.1093/jpepsy/jsq009

Mechtel, M., & Stoeckle, A., (2017). Pyschosocial care of the pediatric oncology patient
undergoing surgical treatment. Seminars in Oncology Nursing, 33(1), 87-97. https:
dx.doi.org/10.1016/j.soncn.2016.11.009

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