- Reassuring kids before a painful medical procedure makes them more fearful.
- Facial expressions and tone of voice are every bit as important as what you say.
- The best tactics for calming fears is to distract or not be present.
Although parents might mean well, trying to soothe a child distressed by a painful medical procedure, such as a vaccination, could cause the young patient to worry even more. Click to enlarge this image.
Hemera
It turns out that most parents are freaking kids out when children are about to undergo a painful medical procedure.
A new study has started to crack the mystery behind why saying, "Don't worry," to kids causes them to be more anxious than ever, while children whose parents just talk about something else cope better.
"It seems counterintuitive that reassurance can hurt," said Meghan McMurty of the Departments of Psychology, Pediatrics and Psychiatry at Dalhousie University in Halifax, Nova Scotia. But it's a well established fact that when parents try to soothe kids facing a needle, it nearly always backfires.
To find out just what aspects of reassurance were heightening the fear in children, McMurty and her colleagues recruited 100 children between ages 5 and 10 and their parents. All the children were having blood drawn for tests in an outpatient blood lab.
By videotaping the parents' behaviors and playing them back to children before they left the clinic, along with video vignettes by actors recreating the same behaviors, the researchers hoped to separate out the effects of whether the parents reassured them, their facial expressions as well as the tones of parents' voices. The children rated what they saw in the videos.
"It's unfortunately not an easy picture," said McMurty who is the lead author on a paper regarding the study in the July issue of the journal Pain. "Childrens' perceptions depended on all three factors."
They found that during reassuring behavior, facial expressions conveying fear and talking in a rising tone caused more fear in the children. Interestingly, when the actor did distracting behaviors rather than reassuring -- but still wore a fearful facial expression -- children also rated it as quite worrisome. This was exacerbated when the actor's voice had a falling tone.
In other words, reassuring parents can convey worry, and worried facial expressions play a powerful role, the authors suggest.
That's not to say that simply smiling will solve the problem, of course.
"Are you supposed to have a happy expression on your face (when your child is in pain)?" McMurty asked. "That's not natural either."
Other pain researchers are impressed with the study.
"A particularly impressive feature of the (experiment's) design was... the 'real time' assessment of distraction and reassurance," commented Kenneth Prkachin of the Department of Psychology at the University of Northern British Columbia.
Although the study is just a start, McMurty says there are still some good strategies for parents.
"The best thing to do is distract," said McMurty. Do something that is age appropriate, like blowing bubbles or talk about other things that interest them.
Another approach, when practical, is to consider not being present for the procedure. It's common knowledge in pediatric dentists' offices, for instance, that children handle procedures better when the parents stay in the waiting room. But even that plan can fall through if the health care professionals break the rules, said McMurty.
"It's also very tempting for health care professionals to reassure," McMurty said. "Historically health care professionals' training in pain management is not very good."
McMurty said she hopes that eventually she can create a research-based tip sheet to help parents and professionals lower children's anxiety about medical procedures.
comments ( )