When kids anticipate "going to the doctor," many
become worried and apprehensive about the visit. Whether
they're going to see their primary care doctor or a specialist
- and whether for a routine exam, illness, or special problem -
kids are likely to have fears, and some may even feel guilty.
Some fears and guilty feelings surface easily, so that kids can
talk about them. Others are harbored secretly and remain unspoken.
You can help your child express these fears and overcome them.
Common Fears and Concerns About Medical Exams
Things that often top kids' lists of concerns about going to
the doctor include:
-
Separation.
Kids often fear that their parents may leave them in the exam
room and wait in another room. The fear of separation from the
parent during mysterious examinations is most common in kids
under 7 years old, but can be frightening to older kids through
ages 12 or 13.
-
Pain.
Kids may worry that a part of the exam or a medical procedure
will hurt. They especially fear they may need an injection,
particularly kids ages 6 through 12.
-
The doctor.
Some kids' concerns may be about the doctor's manner. A
kid may misinterpret qualities such as speed, efficiency, or a
detached attitude and view them as sternness, dislike, or
rejection.
-
The unknown.
Apprehensive about the unknown, kids also worry that their
problem may be much worse than their parents are telling them.
Some who have simple problems suspect they may need surgery or
hospitalization; some who are ill worry that they may die.
In addition, kids often harbor feelings of guilt: They may
believe that their illness or condition is punishment for something
they've done or neglected to do. Kids who feel guilty may also
believe that examinations and medical procedures are part of their
punishment.
How to Help
You can help by encouraging your kids to express their fears and
by addressing them in words that they understand and aren't
likely to misinterpret. Here are some practical ways to do
this:
Explain the Purpose of the Visit
If the upcoming appointment is for a regular health checkup,
explain that it's "a well-child visit. The doctor will
check on how you're
growing
and developing, and also ask questions and examine you to make sure
that your body is healthy. And you'll get a chance to ask any
questions you want to about your body and your health." Also,
stress that all healthy kids go to the doctor for such visits.
If the visit is to diagnose and treat an illness or other
condition, explain - in very nonthreatening language - that the
doctor "needs to examine you to find out how to fix this and
help you get better."
Address Any Guilty Feelings
A child who is going to the doctor because of an illness or
other condition might have unspoken feelings of guilt about it.
Discuss the illness or condition in neutral language and reassure
your child: "This isn't caused by anything you did or
forgot to do. Illnesses like this happen to many kids. Aren't
we lucky to have doctors who can find the causes and who know how
to help us get well?"
If you, your spouse, other relatives, or friends had (or have)
the same condition, share this information. Knowing that you and
many others have been through the same thing may help relieve your
child's guilt and fear.
If your child needs a doctor's attention because of a
condition that resulted in ridicule or rejection by other kids (or
even by adults), you'll need to double your efforts to relieve
shame and blame.
Head lice
, embarrassing scratching caused by
pinworm
, and involuntary daytime wetting or
bedwetting
are examples of conditions that are often misunderstood by others.
Even if you've been very supportive, you should reassure your
child again, before the visit to the doctor, that the condition is
not
his or her fault and that many kids have had it.
Of course, if your child has suffered an injury after
disregarding safety rules, it's wise to point out (as
matter-of-factly as possible) the cause-and-effect relationship
between the action and the injury. However, you should still try to
relieve guilt. You could say, "You probably didn't
understand the danger involved in doing that, but I'm sure you
understand now, and I know you won't do it that way
again."
If your child repeatedly disobeys rules and becomes injured,
speak to your doctor. This sort of worrisome behavior pattern needs
a closer look.
In any of these cases, though, be sure to explain, especially to
young kids, that going to the doctor for an examination is
not
a punishment. Be sure your kids understand that adults go to
doctors just like kids do and that the doctor's job is to help
people stay healthy and fix any problems.
Tell Kids What to Expect During a Routine Exam
You can use a doll or teddy bear to show a young child how the
nurse will measure height and weight. It also helps to show how the
doctor might:
- look in the mouth (and will need to hold the tongue down with
a special stick for just a few seconds to see the throat)
- look at the eyes and into the ears
- listen to his or her chest and back with a stethoscope
- tap or press on his or her tummy to listen to or feel
what's inside
- look quickly to see that the "private areas" are
healthy
- tap on the knees
- look at the feet
It's important for parents to let their kids know that what
they've taught them about the privacy of their bodies is still
true, but that doctors, nurses, and parents must sometimes examine
all parts of the body. Emphasize, though, that these people are the
only
exceptions.
Tell Kids What to Expect During Other Exams
If your child is going to the doctor because of an illness or
medical condition or is going to visit a specialist,
you
may not even know what to expect during the examination.
When you're calling to make the appointment, you can ask to
speak to the doctor or a nurse to find out, in a general way, what
will take place during the office visit and exam. Then you can
explain some of the procedures and their purpose in gentle
language, appropriate to your child's age level. Your child
will feel more secure understanding what's going to take place
and why it's necessary.
Be honest, but not brutally honest. Let your child know if a
procedure is going to be somewhat embarrassing, uncomfortable, or
even painful, but don't go into alarming detail.
Reassure your child that you'll be there and that the
procedure is truly necessary to fix - or find out how to fix - the
problem. (Adolescents may prefer to be examined without a parent or
with only a same-sex parent or same-sex chaperone present. That
preference should be honored.)
Kids can cope with discomfort or pain more easily if they're
forewarned, and they'll learn to trust you if you're honest
with them.
If you don't know much about the illness or condition, admit
that but reassure your child that you'll both be able to ask
the doctor questions about it. Write down your child's
questions.
If a blood sample will be taken during or after the examination,
be careful how you explain this. Some young kids worry that
"taking blood" means that
all
their blood will be taken. Let your child know that the body
contains a great deal of blood and that only a very little bit of
it (usually no more than 1 or 2 teaspoons [about 10 milliliters])
will be taken for testing.
Again, make certain that your child understands that the visit,
with its embarrassing or uncomfortable procedures, is
not
a punishment for any misbehavior or disobedience.
Involve Your Child in the Process
-
Gathering information for the doctor.
If the situation isn't an emergency, allow your child to
contribute to a list of symptoms that you create for the doctor.
Include all symptoms you've observed, no matter how unrelated
they may seem to the problem at hand. Also, before the visit,
prepare a history (in the form of a list) of your child's
previous illnesses and medical conditions and a history of
illnesses and medical conditions among close members of the
family (parents, siblings, grandparents, aunts, and uncles).
-
Writing down questions.
Ask your child to think of questions to ask the doctor. Write
them down and give them to the doctor. Or, if kids are old
enough, they can write down and ask the questions themselves. If
the problem has occurred before, list the things that have worked
and the things that haven't worked in previous treatment.
Kids will be reassured by your active role in their medical care
and will learn from your example. And you'll be prepared to
give the doctor information vital to making an informed
diagnosis.
Choose a Doctor Who Relates Well to Kids
Because your doctor is your best ally in helping your kids cope
with health examinations, it's important to carefully
select a doctor
. Of course, you want one who's knowledgeable and competent.
However, you also want a doctor who understands kids' needs and
fears and who communicates easily with them, in a friendly manner
and without talking down to them.
In the course of a physical exam, the doctor inspects, taps, and
probes various parts of the body - procedures that may be
embarrassing (or even physically uncomfortable) for kids. A good
rapport between doctor and patient can minimize these feelings.
If your child's doctor seems critical, uncommunicative,
disinterested, or unsympathetic, do
not
be afraid to change doctors. Ask for recommendations from other
parents in your area or from other doctors whose opinions you
trust.
If your child's illness or condition requires a specialist,
ask your doctor to recommend someone who's knowledgeable,
experienced, and friendly.
After all, adults want these characteristics in their own
physicians, so as a parent you should serve as your child's
advocate in seeking medical care.
Reviewed by:
Steven Dowshen, MD
Date reviewed: August 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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