Tests & Procedures - Reducing Anxiety & Distress

Key points about reducing anxiety and distress during cancer tests and procedures

• throughout treatment, your child will have tests and procedures to help the healthcare team
  diagnose and care for your child
• some of these tests will be quick and easy for your child, and some may produce anxiety or pain
• you can help prepare your child by giving simple, accurate information in a calm, non-emotional way
• talk to your child about coping methods that they can use on the day
• avoid giving your child long explanations about the procedure while it is happening

Being with your child during their procedure

It can help your child if you can be there during tests and medical procedures. If you can't be there, think about asking another person who your child is comfortable with. Because each child's experience is different, it is important to talk with your healthcare team about the best way to support your child.

Helping your child before their procedure

Talk with the nursing and healthcare staff to get a good understanding of why your child needs the procedure and what it will involve.

Keep it simple

Prepare your child by giving simple, accurate information in a calm, non-emotional way.

Use language your child can understand and answer any of their questions. Listen to your child's concerns about the procedure - they may be different from your own.

How much information you decide to give your child will depend on your child's age and how well you think they will cope. For a young or anxious child, talk about the procedure only a day or two beforehand so that you don't overwhelm them.

Discuss coping techniques

Talk to your child about coping methods that they can use on the day, such as distraction and breathing techniques.

They can use these to help manage any discomfort or anxiety about the procedure. Practice these techniques together. Talk to your child about when and how to use these techniques.

Provide choices

Where possible, give your child a choice. For example, your child can choose which finger for a finger-prick test.

They may also be able to choose a position, such as lying down or sitting on your lap, but check with the nurse or doctor first to see if this is possible. It is not helpful to offer your child a choice, such as when to start a procedure.

Helping your child during their procedure

Avoid giving your child long explanations about the procedure while it is happening.

Stay calm during the procedure. This will let you support your child as best you can. There are some techniques you can use to help during the procedure.

Maintain physical contact

Patting, rubbing, and stroking can be very soothing for your child.

Distraction

Encourage your child to focus on other things rather than on the procedure. Distraction could be blowing a windmill or party-blower, looking at a pop-up book or favourite book or counting objects around the room. It could also be telling a favourite story, recalling a happy event or watching a video or TV.

Imagery

Imagery involves imagining events – particularly sights, smells, sounds and tastes – as if the events were really happening. Ask your child to choose a favourite place or activity and focus on helping your child imagine that experience using all their senses.

Breathing and relaxation

Telling your child to "blow away the worry" can be very helpful before and during a procedure. Practise this with your child. It may help to imagine blowing out candles on a cake or letting air out of a tyre.

It's also a good idea to encourage your child to relax. For younger tamariki (children), you can suggest they "Go all floppy".

For older tamariki, teach them to breathe in comfortable feelings and breathe out tension. Encourage them to notice changes in their muscles and body.

Coping statements

It may help your child to use some coping statements before, during and after the procedure.

These statements can help your child to use their coping techniques and to praise themselves. Useful phrases include "I need to relax now", "soon it will be finished" and "this is helping me get better."

What you say to your child during a procedure and how you say it can affect how your child copes. Try to avoid talking about the procedure while it is happening. Talk about something else, like a past event, or coach your child to use a coping technique.

Avoid statements such as:

• "it'll be all right"
• "I'm sorry I have to do this"
• "I know it's hard"
• "stop being a baby"

Helping your child after their procedure

Praise and rewards

Praise your child and mention any attempt at using a coping technique. Rewards can be very helpful, but avoid bargaining with your child during a procedure, such as saying, "I'll buy you a PlayStation".

Reassure your child

If your child cries or is distressed because of pain, let your child know it is OK to feel upset. Keep using coping techniques even if they do not seem to be working at first.

Keep talking

Talk with your child and build on the parts that they found helpful. Talk to your child about how they are feeling about their illness and treatment. It is important to talk with your child and help them with any other worries they may have.

If you are concerned about your own or your child's level of distress, talk to a member of your healthcare team for help.

Professional support for my child with cancer

There are cancer centres for tamariki and young people in New Zealand. The cancer centres can offer support in coping with medical procedures. They can support tamariki diagnosed with cancer as well as their whānau (family). 

Play specialists and psychologists who specialise in child development work with tamariki and whānau to help build upon their existing strengths and coping strategies.

Nurses and support staff can also help with coping strategies to support tamariki who are having medical procedures. Staff can work with you to provide the support that your child needs.

Your healthcare team can give you information and practical suggestions to help your whānau adjust to hospital.