Procedural anxiety

This page has been written to help you and your child prepare for the procedure. The information will give you some practical advice and tips, which should help to reduce distress. 

This page has been written to help you and your child prepare for the procedure. The information will give you some practical advice and tips, which should help to reduce distress. 

There may be a time when you have to take your child to the doctor or hospital for a medical procedure. Procedures can make children feel scared and anxious. 

Before the procedure 

Talk to the medical team – listen and ask questions 

Find out what needs to be done and why. Also listen to how it might feel for your child during and afterwards. The more understanding you have of this, the better you will be able to help your child. Don’t be afraid to ask questions if there is anything that you do not understand about the procedure. 

Talk to your child 

Explain to your child what is going to happen before the procedure. Use play to show younger children. Be honest; for example, do not tell your child it will not hurt if it will. Instead, tell your child that it might hurt but it will be over quickly and that they will then be okay. This will mean that your child will trust the information you give them and be more willing to follow your advice. Some children like to be re-told the information regularly and so it would be helpful for you to do this if your child asks. 

Allow your child the opportunity to ask questions and express any concerns. If you cannot answer any of your child’s questions, then it is okay to ring your child’s medical team to ask for further advice. If your child is older, you may want to encourage them to ask the doctors or nurses any questions they may have. 

Think about timing when telling your child exactly when they will be having the procedure. Waiting for a procedure can sometimes make children feel more worried. When you decide to tell your child may depend on their age and understanding.

Preparations with the medical team 

Talk about previous experiences of procedures. Tell the medical team how you usually help your child manage their worries and if there is anything that you have found helpful or unhelpful. Ask the team for alternative suggestions if you need them. The team will have lots of experience in this. 

Ask what choices are available for your child. There may not be a choice over whether they have the procedure or not but they may be able to have control over some parts of the procedure. For example, your child may be able to choose whether to look or not look, say ‘go’ for when the procedure can begin, etc. Having some control over the procedure can have a positive effect on your child’s coping. 

During the procedure 

Pain relief 

Pain relief is offered to children and young people having an injection or having their blood taken. This can be a local anaesthetic cream, or a spray. These work by numbing the surface of the skin. It is useful to talk to your medical team about this beforehand, as the cream takes up to an hour to numb the skin. 

Distraction 

Any activity that takes a child’s mind away from what is happening is worth trying. Talk to your child and encourage them to think of activities they could do to take their mind off things. Some examples include: 

• Providing a physical distraction through touch e.g. patting, massaging, playing with child’s hair, etc. 

• Bringing some music to listen to on a personal music player. 

• Bringing a hand held computer or laptop. 

• Bringing their favourite book, toy or game. 

• Playing memory or counting games. 

• Thinking of fun or interesting topics you can discuss. 

There will be some resources available if you speak to your medical team. 

Relaxation 

Relaxation helps to gain some control over the physical feelings of anxiety. Encourage your child to practice breathing slowly and deeply to help them feel calm. Learning to relax muscles can be helpful. An example is to teach your child to tense a muscle and then relax it so it goes floppy like a rag doll. There is more information about relaxation in a separate leaflet produced by the department of Psychology in Healthcare. 

Holding and positioning 

It may help to hold your child’s hand or hold your child in a position that is comfortable and appropriate for the procedure. Your child might like being close to you and it could help them to feel less worried. 

Coping talk   

Try to use coping talk whilst your child is having the procedure, encouraging them throughout and trying to take their mind off what is happening. Try to get them to focus on the procedure being over rather than any discomfort that they may be experiencing. 

Setting a calm example 

Children often pick up how their parents and carers are feeling. If you are feeling anxious they may pick this up. Try to be calm and relaxed, this will help your child see that you can manage anxiety, and it is less likely to be a problem for them. 

Some parents and carers find it difficult to remain calm during their child’s procedure. If this is the case, you may prefer to stay out of the room where your child is having the procedure. If you need to do this, you should not feel guilty. Perhaps you could bring another member of the family or a friend to help support you and your child and have this as an agreed plan prior to the procedure. 

Maintaining a calm environment 

This is a teaching hospital and you might be asked if a student may observe the procedure. When a child or young person is showing signs of distress it can sometimes be challenging if the room is over-crowded. Parents and carers have the right to request that only people essential to the procedure are present. This will not affect your child’s care. 

After the procedure 

Praise and rewards 

Praise your child for what they have done. Even if the procedure fails, still praise your child for doing their best. You may also agree beforehand that your child will get a reward following the procedure, for example: 

• Stickers. 

• Small gifts. 

• Trips out e.g. to the park or swimming. 

• Visiting friends. 

• Favourite snack or drink. 

Talk about the procedure 

Think about what went well, what didn’t go well and what helped your child manage. Also consider if there is anything that could be done differently another time. 

Summary 

If your child is anxious about medical procedures, it can be helpful to prepare them in advance using some of the strategies in this leaflet. Please talk to the medical team about this.