Ten questions: Developmentally appropriate support for pediatric testing in young children—How you can help

Abstract

a w i t t p Introduction Jorian is a 4-year-old child with corrected transposition of great arteries with ventricular septal defect repair and a single-chamber pacemaker programmed VVIR. History of hospitalization includes numerous tests and procedures since birth, ventricular septal defect device closure at age 18 months, and a pacemaker placed at age 3 years. Jorian is being seen at his local hospital for syncope due to the distance from his pediatric center. A pacemaker check and electrocardiogram were ordered, Jorian presents in the waiting room as very distressed, crying, and hiding behind his mother’s leg when approached by hospital staff. The following 10 questions will address proper assessment of Jorian’s history, provision of a child-friendly environment, and ideas to build trust and rapport by using a developmentally appropriate approach. Regardless of how much experience the health care professional has in working with children, there are key proactive steps that can be taken to reduce fear, stress, and anxiety during hospital visits. 1. What are typical hospital-related fears of a preschool aged child? Children aged 2–7 years (preschool age) are in the preoperational stage, classified by Jean Piaget’s cognitive development theory. Children at this age rely on direct exerience to understand information given to them. For example, if a young child has never been to the hospital before, he or she would not understand the phrase “you will ride on a stretcher to the OR.” A more concrete explanation would be, “you will ride on a bed with wheels to the room where the doctors will fix your heart.”