by Lauren Mednick, PhD
Effective preparation of children for medical procedures can have both short and long-term benefits. Children who have accurate expectations of what they will experience are likely to cope more effectively, experience less anxiety, and be more cooperative. Further, decreased anxiety before a procedure may decrease the child’s report of pain, analgesic consumptions, emergence of delirium, and sleep problems. Finally, positive medical experience as a child may influence future anxiety, pain, and coping with medical encounters. Despite these potential benefits, preparation for medical interventions is typically aimed at the child’s caregivers through informed consent discussions. Although all children need to be informed about what to expect both before and after a medical procedure, what details to tell a child and when require thoughtful consideration. Here are some tips for including children in these important discussions:
Tip 1: Explain What Sensations They will Experience
Children want to know what they will feel, see, hear, smell, and taste both before and after the procedure. If the child will be asleep during the procedure, they do not need to hear details about what will happen during this time.
Tip 2: Be Honest
If children are given information that turns out not to be true, they are likely to develop a distrustful relationship with their parents and/or the medical team that may negatively affect future interactions.
Tip 3: Use Simple, Non-Threatening Language
For example, instead of saying “the doctor will give you some dye in your IV”, you might say “the doctor will give you some medicine in the tube in your arm that will help her be able to see your ____ more clearly.”
Tip 4: Be Certain to Include Details about What Equipment the Child May Wake Up With
For example, if the child will wake up with an IV (“tube in your hand”) or foley (“tube in your penis”). Also, provide information about when these things are likely to be removed.
Tip 5: Tell the Child How They Might Feel Immediately after the Procedure and Throughout Recovery
Be sure to provide choices and soften language (e.g., don’t say hurt or pain). You can say for example, “Some kids say their leg feels sore and some say it feels funny. Others say the medicine helps them not feel much at all. You can tell me how it feels for you.”
Tip 6: Include What the Procedure Site Might Look Like
Include details such as if there will be swelling, bandages, blood, or color change.
Tip 7: Timing
In general, younger children do best when told 1-2 days before the procedure, school-age children do best with having these conversations about a week before the procedure, and adolescents do best when involved in treatment planning as it occurs.
Lauren Mednick, PhD is a clinical psychologist in the Department of Psychiatry at Boston Children’s Hospital and an Assistant Professor in the Department of Psychiatry at Harvard Medical School. She is the clinical director of the Outpatient Psychiatry Service, as well as the director of the Medical Coping Clinic. Her clinical time is devoted to helping patients and families learn skills to promote healthy coping with medical conditions. Prior to becoming a psychologist, Lauren worked as a certified child life specialist. Thus, she is most passionate about helping prepare children for medical procedures, as well as teaching clinicians about this topic.