PSYC 450 Week 1 DB Forum 1 Example

Discussion Board Forum 1: Thread and Two Replies

PSYC 450 Children in Healthcare, Discussion Board Forum 1 (thread and two replies)

Thread by [Student Name]

The prompt, the child described and the classmates' posts are composites standing in for the course's own forum; the textbook and the journal article are real and described from their published sources; the requirements follow Liberty's public course guide for PSYC 450.

Thread

Six-year-old Maddie sits on a stretcher in a curtained preoperative bay, holding a stuffed rabbit and refusing to put on a hospital gown. She has asked her mother four times whether the doctor will "cut her throat open." Her tonsillectomy is routine for the surgical team, but nothing about it is routine for her. She has never slept away from home except at her grandmother's.

Rollins et al. (2018) describe how illness and hospitalization can threaten children's sense of control, separate them from familiar people and routines and expose them to procedures they do not understand. Young children may interpret medical events through magical thinking, imagining that a procedure is punishment or that a body part will be lost. Their reactions, from clinging to tantrums, are often reasonable responses to a frightening situation that no one has explained in terms they can grasp.

Research suggests these reactions matter beyond the moment. Kain et al. (2006) studied 241 children aged 5 to 12 having outpatient tonsillectomy and adenoidectomy, measuring their anxiety before surgery and following their recovery in the hospital and at home for two weeks. Children who were highly anxious before surgery experienced significantly more pain both in the hospital and during the first three days at home, and they consumed more codeine and acetaminophen during recovery. They also had a higher incidence of emergence delirium, 9.7% compared with 1.5%, and more anxiety and sleep problems after surgery.

The practical lesson, and the one I will carry into my site visit, is that the emotional care Maddie receives before her operation is part of her medical care. Age-appropriate preparation, a chance to handle a mask or see the recovery room and help for her mother in staying calm could reduce not only her distress today but her pain and sleep problems next week. A few minutes of explanation using words like "a special sleep" rather than "cut" might change how she remembers the whole experience.

Classmates: do you remember a medical experience from childhood, and what made it better or worse?

Reply to Hailey

Hailey, you noted that Maddie's mother looked as anxious as Maddie. That matters, because Kain et al. (2006) assessed parents' anxiety along with children's, and children take emotional cues from the adults around them. Rollins et al. (2018) emphasize family-centered care, which treats parents as partners who also need preparation and support. A brief explanation for the mother, perhaps showing her where she can wait and when she will see Maddie again, could help both of them, since a calmer parent gives a child one less reason to panic.

Reply to Jonah

Jonah, your idea of using the waiting time for preparation fits the research well. For a six-year-old, a child life specialist might use a doll with a small mask and gown to show each step and let Maddie practice breathing into the mask herself. Rollins et al. (2018) describe play as a natural way for young children to master frightening experiences. Given the outcomes Kain et al. (2006) found, those minutes could pay off well after discharge.

References

Kain, Z. N., Mayes, L. C., Caldwell-Andrews, A. A., Karas, D. E., & McClain, B. C. (2006). Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery. Pediatrics, 118(2), 651-658. https://doi.org/10.1542/peds.2005-2920

Rollins, J. H., Bolig, R., & Mahan, C. C. (Eds.). (2018). Meeting children's psychosocial needs across the health-care continuum (2nd ed.). PRO-ED.