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Psychological Preparation

Kira is a 5-year-old who is admitted to the ER following a fall from her bunk bed. The primary health care provider has ordered a X-ray. Kira is worried and keeps asking, “When can I go home? What are you going to do to me? Don’t hurt me.” What can you, as a CCLS, do to help alleviate Kira’s stress and to teach her about the X-ray?

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First response:

New! Psychological Preparation

Alissa Dodge (Aug 8, 2016 1:46 PM) - Read by: 3Mark as ReadReply to This MessageReply
 

 

"The general guidance has been that younger children benefit form preparation closer to the event, while older children fair better when preparation is initiated earlier" (Thompson, 2009, p. 169). Since Kira is a younger child, it would be more beneficial to her to explain the steps of the X-ray closer to when the X-ray is scheduled. Since the X-ray can be a scary time for Kira, it is important for the CCLS to focus on both explaining the procedure and ways to cope with her anxiety. When providing Kira with information, it is important that it is accurate and relevant to what she will be going through. "Plans that are appropriate to the event, to the child and family, and to the staff involved can be made based on the information that has been gathered" (Thompson, 2009, p. 174). By gathering pertinent information about Kira and her case, the CCLS will be able to help calm Kira down. For example, when Kira asks when she will be able to go home, you do not want to give her false hope of going home after the X-ray is done, but the CCLS should find out from the doctor what her care of plan is and explain to Kira that she will be able to go home as soon as possible instead of giving her an exact time frame that could get her hopes up or make her more anxious."Imagine you had the job of redesigning light to make it a bit more powerful—so you could see through bodies, buildings, and anything else you fancied. You might come up with something a bit like X rays." (Explain that Stuff). Even though this description of an X-ray is a little easier to understand, it would still be too complex for Kira. The CCLS can explain to Kira that the x-ray machine is just like a big camera. Just like cameras take pictures of people, the X-ray machine is going to take pictures of different parts of her body so the doctor can see her bones better. The CCLS can explain to Kira that she will be laying on a table just as if she were laying in bed. The X-ray tech may move different parts of her body to get a closer look, but since Kira is concerned about being hurt, the CCLS can ask Kira if she is hurting anywhere so the x-ray tech is more careful with the specific area. Using simple words and comparing the X-ray to something she is familiar with will help Kira stay calm about the procedure. To help calm Kira's anxiety, the CCLS could give her some bubbles to blow to help with her breathing, or use medical play therapy so she can see the medical tools she may be introduced to during the X-ray so she has a more positive opinion of the tools.

References:

Woodford, Chris (2009). Xrays. Explainthatstuff. Retrieved from http://www.explainthatstuff.com/xrays.html

Thompson, R.H (2009). The handbook of child life: a guide for pediatric psychosocial care. Springfield, IL: Charles C.      Thomas Publisher Ltd.

 

Second Response:

New! Week 6 / Forum 6: Psychological Preparation

Brittany Nanney (Aug 9, 2016 10:00 AM) - Read by: 2Mark as ReadReply to This MessageReply
 

 

Kira, a young five year old girl is experiencing worry and is scared over her upcoming X-ray. We as future certified child life specialists can help alleviate her stress and teach her about this X-ray. First, I would explain it to her in simple terms and on eye level with her. Describing at how it is like taking a good picture and it shows the doctors amazing things. Preparing her mental and emotional state is just as important as prepping her physically for the X-ray. We want "to ease a child's fear and anxiety with therapeutic and recreational play activities." (Child Life Council 2010). By incorporating easy games and activities that are appropriate for Kira's age and developmental level, we can calm and relax her prior, during, and post X-ray. Letting her "roll play" taking a photograph herself would allow her to feel less discomfort and see that it will not hurt after all. Using creative sound features and artistic objects can help alleviate some apprehensions about the X-ray. We want to ensure that we are building trust and opening lines of communication with Kira so she can ask about the X-ray and feel more laid back. Since she is frightened, I might even ask her about her "favorites". For example, singing her favorite song quietly and softy might help. Letting her use her imagination through play can be helpful as well. A doll she loves, a stuffed animal that she sleeps with each night, etc. could be beneficial. These toys and games will allow her to enjoy symbolic and fantasy play, which is ideal for her age range (Thompson 2009).

On a personal note, when I was in first grade, I broke my wrist and had to have an X-ray. I remember how much I loved roll playing at that age so demonstrating the entire technique of what an X-ray entails would be of great assistance to Kira. Making her feel like a small part of the procedure itself would show her that it will be fast and easy.  It's a great way to allow her to see what the X-ray and involves so she can better understand.

My References

Child Life Council. (2010). Empowering Children and Families to Child Life: Cope with Life's Challenges. Rockville, MD: Child Life Council, Inc.

Thompson, R.H. (2009). The Handbook of Child Life: A Guide For Pediatric Psychosocial Care. Springfield, IL: Charles C. Thomas Publisher Ltd.

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