Preschooler test/procedure preparation
Alternative names:
preparing preschoolers for test/procedure; test/procedure preparation - preschooler
Information:
Definition:
Proper preparation for a test or procedure that can reduce your child's anxiety, encourage cooperation, and help develop coping skills.
Research has shown that preparatory interventions are effective in reducing some signs of distress in children such as crying or resisting the procedure; this led to other findings suggesting that with preparation children report less pain and exhibit physiologic signs showing less distress.
Before the test, know that your child probably will cry, and restraints may be used. You can try the use of play in demonstrating what will happen during the test and in discovering your child's concerns. Explaining the procedure will also be of value in reducing your child's anxiety. Make sure your child understands that the procedure is not a punishment, and focus on the pleasurable things that will happen after the test. But the most important way you can help your child through this procedure is by being there, and showing you care.
PRE-PROCEDURE PREPARATION:
Limit your explanations about the procedure to 10 or 15 minutes, because preschoolers have a limited attention span. Any preparation should take place directly before the test or procedure.
Here are some general guidelines for preparing your child for a test or procedure:
- Explain the procedure in language your child understands, and use concrete terms, avoiding abstract terminology.
- Make sure your child understands the exact body part to be involved and that the procedure will be limited to that area.
- If the procedure affects part of the body that serves a noticeable function (such as speech, hearing, or urination), explain how the procedure will affect or not affect the function.
- While talking about the procedure with your child, avoid words that have more than one meaning.
- Give your child permission to yell, cry, or otherwise express any pain verbally.
- If you think your child has not understood something you are explaining, ask if he or she understands, and be certain that you define all new terms in simple language.
- To the best of your ability, describe how the test will feel.
- Allow your child to practice different positions or movements that will be required for the particular test or procedure, such as the fetal position for a lumbar puncture.
- Save topics or subjects that you think will cause your child the most stress for last.
- Be honest with your child about discomfort that may be felt, but don't dwell on the topic, since this could instill undue concern in your child.
- Stress the benefits of the procedure and anything that the child may find pleasurable afterwards, such as feeling better, or going home.
- Explain that the procedure is not a punishment.
PLAY PREPARATION:
Play and third-person communication can be wonderful and revealing ways of demonstrating the procedure for your child, and identifying his or her concerns. This technique needs to be individualized for each child, and most health care facilities that are oriented toward children, such as a children's hospital, use this same technique to prepare your child. Given the age of your child, this type of interaction may not increase his or her level of understanding, but each child is unique in abilities. This type of communication can take some practice.
Children asked direct questions about their feelings often are avoidant and elusive. Of course, some children are more than happy to share their feelings with you, but as anxiety and fear increase it is not uncommon for a child to withdraw.
Most young children have an object of importance they keep close to them. This object or toy can be a tool for a type of interaction called third-party communication. It is less threatening for your child to communicate concerns through the toy or object than to express them directly. For example, take a 4-year old girl who is clearly afraid, has a doll named Becky, and is going to have her blood drawn. You could look at the girl and tell her that Becky looks like she might feel afraid. Your child may or may not share those feelings at this point, and additional questioning along this line may be necessary.
The same object or doll can be a productive tool for explaining the procedure. Children of this age are very concrete thinkers. Concrete thinking involves taking everything literally, and an inability to make deductions or generalizations. For example, if you say you feel fine to a concrete thinker, he or she may interpret that by thinking your feeling or touch sensation is intact. For younger children who have a limited vocabulary, concrete thinking means they need visual examples, and it is helpful if they can experiment themselves.
Once you are familiar with the procedure through information obtained from your health care provider and this software, briefly demonstrate on the toy or object what your child will experience during the procedure. For example, show positioning, bandages, stethoscopes, cleaning the skin, how incisions are made, injections are given, or IV's are inserted. Medical toys are available, or you can ask whether your health care provider can share some of the noninvasive items you need for the demonstration and play period. After your demonstration, allow your child to play with some of the noninvasive items. The way he or she plays can also give you clues regarding concerns and fears.
Regardless of the test or procedure performed, your child will probably cry. This is a normal response to the strange environment, unfamiliar people, restraints, and separation from you. Your child will cry more for these reasons than because the test or procedure is uncomfortable. Knowing this from the onset may help relieve some of your anxiety about what to expect. Having specific information about the test may further reduce your anxiety. For more information please see the appropriate test.
WHY RESTRAINTS?
Your child may be restrained by hand or with physical devices. Children of this age may be unwilling or unable to follow the necessary requests of your health care provider, so restraints may be used to ensure your child's safety.
Most tests and procedures require extreme accuracy to obtain the desired outcome, whether that be correct placement of an IV, or accurate test results, and in some cases, to avoid injuring the child.
For example, if your child needs an X-ray, clear test results require there be no movement. Furthermore, in radiological and nuclear studies while the films are taken, all staff temporarily leave the room. In these situations, restraints are used for your child's safety. If a venipuncture is performed to obtain a blood sample or start an IV, restraints are important in preventing injury to your child. If your child moves while the needle is being inserted, trauma could damage the venous system, bone, tissue, or nerves.
Most tests and procedures require extreme accuracy to obtain the desired outcome, whether to place an IV correctly, ensure accurate test results, or to avoid injuring the child.
Your health care provider will use every means to ensure the safety and comfort of your baby. Besides restraints, other measures include medications, observation, and monitors.
DURING THE PROCEDURE:
Your presence helps your child during the procedure, especially if the procedure allows you to maintain physical contact. If the procedure is performed at the hospital or your health care provider's office, you will most likely be given the opportunity to be present.
If you are not asked to be by your child's side and would like to be, ask your health care provider if this is possible. If you think you may become ill or anxious, consider keeping your distance but remaining in your child's line of vision. If you are not able to be present, leaving a familiar object with your child may be comforting.
Other considerations:- Ask your health care provider to limit the number of strangers entering and leaving the room during the procedure, since this can raise anxiety.
- Ask that the care provider who has spent the most time with your child perform the procedure.
- Ask that anesthetics be used where appropriate to reduce the level of discomfort your child will feel.
- Ask that painful procedures not be performed in the hospital bed, so that the child does not come to associate pain with the hospital room.
- Imitate the behavior you or your health care provider need the child to do, such as opening the mouth.
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The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2000 adam.com, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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