Fingerprint ABCs - Anxiety

Fear of illness, needles, pain or surgery occurs quite often. It can be caused by unpleasant experiences from the past, but also by imagining how treatment might go. Some children and adolescents tend to see future events in black colors. That's why it's a good idea to find out in advance how treatments or meetings with doctors will go, in order to support your child in dealing with anxiety.

Although from an adult's perspective what happens to a child is trivial and inconspicuous, in a young person it can cause a lot of anxiety and fear. It is worth bearing in mind that many adults, despite their years still fear medical interventions or visits to the dentist. Perhaps if someone had taken care of their fears when they were younger and taken their fears seriously, they wouldn't have had to face their anxiety when drawing blood or drilling a tooth until now.

Anxiety can take many forms. Some children talk about what is happening to them and what they are feeling, while others show anxiety through behavioral changes such as body trembling, shallow and rapid breathing, cessation of speech or crying. Above all, however, anxiety manifests itself through muscle tensing. Do you remember situations in which your child hit his leg or arm or injured himself to the point of blood, but didn't even notice it because he was in the middle of fascinating play? This happened, among other things, because the child's attention was focused on the play, and he himself felt safe, relaxed and calm. In an agitated state, on the other hand, when a child feels intense anxiety, such as during a blood draw or vaccination, he tenses his muscles so much that this intensifies the sensation of pain.

Light or moderate anxiety that disappears as quickly as it appeared is not a bad thing. It lets us know that something important is happening that is worth looking into and taking some action on. What can be worrisome, however, is anxiety that persists for a long time, which does not diminish, and which takes on a very intense form. It may be accompanied by a change in appetite, a constant feeling of tightness in the stomach, a sense of emptiness in the head and sleep problems. Long-term severe anxiety can slow wound healing and prolong recovery. When the body can't relax and unwind, all unpleasant sensations are felt more strongly.

Children report that their greatest fears are of the medical staff, separation from their parents and loss of a sense of control and security. They also fear pain, death, as well as the unfavorable outcome of the operation, which will be a disappointment to them. That's a lot of worry for a little person. It is difficult to carry such a burden alone, so parents and medical staff play an important role in taming the fear. Explain to the child what is going to happen, talk to him about his hopes and fears about the treatment. Don't promise that everything will be fine, as no one can predict this with certainty. Also remember to let the child experience emotions, even if they seem inadequate to you. In moments of intense emotion, no one wants to hear that he or she is overreacting and should calm down immediately. A better strategy is to reassure the child that you are beside him and will find a solution together.

Effective ways to reduce anxiety about surgery are to occupy oneself with pleasurable activities, such as playing. The child has the opportunity not only to have a pleasant time, but also to relieve his tensions and work through his fears.

Studies report that playing immediately before a surgical procedure significantly reduces anxiety in the child, thereby improving the well-being of their caregivers. This is an important point, because as often as in children, anxiety occurs in their caregivers. This is completely natural. The stressful and new situation of treating a child and carrying his emotions can be very taxing on even the most resilient person. Lack of control over events, the feeling that nothing is under one's control, and fear of the child's pain or anxiety about whether the medical team is taking proper care of the child are situations that can trigger a great deal of anxiety.

Additionally, it intensifies immediately before surgical procedures, after surgery - when the child may feel pain - as well as during periods of fundraising for treatment. Usually then, however, caregivers are perfectly capable of handling their emotions and the sensations in their bodies. Difficulties can arise when the child returns home or after treatment is completed. Then, instead of the desired rest and relaxation, severe anxiety or even depression can set in. Then the parent finally doesn't have to mobilize all his or her resources for action, and the chronic fatigue that has been with him or her for the last time comes to the fore. As a result, the body and mind say STOP. An important role in preventing such conditions is played by a support group that will accompany the child and his caregivers throughout the treatment process.

To reduce children's and parents' anxiety prior to surgery, premedication is standard, that is, the administration of agents that have a calming and sedative effect, thereby reducing the tension associated with the operation. At Paley European Institute, we also make sure that entertainers and a psychologist come to the children to entertain them and make their time waiting for surgery easier. We also know how important it is for a child to feel safe, which is why a parent accompanies the child to the operating theater. During the operation, the caregiver receives information about the procedure, which makes it easier to cope with the waiting and reduces the feeling of helplessness.

At every stage of treatment, our team remains at your disposal - precisely so that you have all the information you need and are not left alone with your anxieties. A calm parent is a calm child.

Sources of knowledge and inspiration that led to this article:

Fortiera,M.A., Kaina Z.N. (2015), Treating Perioperative Anxiety and Pain in Children: A Tailored and Innovative Approach, Paediatric Anaesthesia

Ghabeli F., Moheb N., Nasab S.D. (2014), Effect of Toys and Preoperative Visit on Reducing Children's Anxiety and their Parents before Surgery and Satisfaction with the Treatment Process, Journal of Caring Sciences

Melettia D.P. et al.(2019), Psychological preparation reduces preoperative anxiety in children. Randomized and double-blind trial, Jornal de Pediatria