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Fear of Surgery is Eased by Parental Support

When children were surveyed about their greatest fears, they ranked "having an operation" as number seven, noted Barry Newman, M.D., chief of pediatric surgery at the Ronald McDonald® Children's Hospital of Loyola University Medical Center (RMCH of LUMC). "Parents can make the experience far less scary with honest discussion and emotional support," Newman said.

"Educating children about surgery lets them feel as if they are more in control and gives them a sense of mastery," said Kathleen Wallensack, child life coordinator, RMCH of LUMC. "They can walk away feeling stronger, better educated and more confident."

Wallensack and Newman shared their expertise on how parents can best prepare their children for surgery:

Age appropriate information  

• Why they need an operation
• What will happen at the hospital
• Whether it will be uncomfortable
• Whether they will notice any physical change like a scar, a bruise or loss of mobility
• When their parents will be with them
• When they will go home

For young children, the discussion should begin as close to the day of surgery as possible - only two or three days in advance. Children as young as 2 will benefit from some advance preparation. By ages 3 and 4 - when long-term memory begins - discussion is very effective in helping them overcome their fears. It is important to tell the child, particularly those in the 4 to 6 age range, that it is not their fault that surgery is needed. Playing "operating room" may help young children deal with their fears.

The level of detail and the child's involvement will gradually increase with age. By the teenage years, children can be actively involved in asking the doctor questions and helping make decisions. They may even appreciate a diagram of what will be done during surgery.

Getting to know the hospital

To familiarize children with the hospital setting, the Ronald McDonald® Children's Hospital of Loyola University Medical Center offers a pre-operative tour that gives children an opportunity to see a hospital room, the play room and the school room and meet some of the hospital staff. Siblings also are invited since they may be curious or frightened about the operation. Patient families may schedule tours by calling (708) 216-1086.

What to expect on surgery day

Children will take comfort in knowing what will happen at different points throughout their day in the hospital. Young children can be
prepared for one portion of the day at a time.

Coping mechanisms

During uncomfortable procedures, parents can help their children practice coping skills. For example, simple games can distract them from pain, such as counting people walking by or holes in the ceiling or saying the alphabet. Since the body relaxes on each exhalation, blowing a pinwheel or making noises while blowing through lips or teeth may
be helpful.

Having some control and involvement helps children cope. Parents can ask: "Would you like to watch TV or watch the nurse?" "Would you like to lie down or sit on my lap?" or "Would you like to hold the bandage until we need it."

Words make a difference

Vivid descriptions, incorporating all five senses (sight, hearing, touch, smell, taste) are good preparation. For example, "The machine will sound like a vacuum" or "It will feel cold." Time references also are helpful such as "It will sting for as long as a television commercial."

Parents should avoid emotionally charged words such as "cut" or "hurt." They can use more neutral language instead, such as "the doctor will make an opening," or "you might be a bit sore."

The most important support parents can give is to be honest but frame things in a positive way to give the child the feeling that he or she can cope. Use a calm, low voice and continually reassure the child that he or she is doing a good job, no matter how they appear to be doing.

To find a pediatric surgical sub-specialist at the Ronald McDonald® Children's Hospital of Loyola University Medical Center, call 1-877-216-KIDS.

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