PSYC 450 Week 3 DB Forum 3 Example

Discussion Board Forum 3: Thread and Two Replies

PSYC 450 Children in Healthcare, Discussion Board Forum 3 (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 review are real and described from their published sources; the requirements follow Liberty's public course guide for PSYC 450.

Thread

Eight-year-old Tyrese needs monthly blood draws to monitor a kidney condition. Since a frightening emergency room visit two years ago, every draw has ended with four adults holding him down while he screams. His mother now dreads the appointments as much as he does, and Tyrese has started complaining of stomachaches the night before.

Rollins et al. (2018) describe procedures as moments when children feel especially powerless, and they emphasize giving children an active role, honest information and choices wherever choices are real. A child who can decide which arm, whether to watch and what to hold has some control in a situation that otherwise has little.

Psychological strategies have been tested in many trials. Birnie et al. (2018) updated a Cochrane review of randomized controlled trials involving children and adolescents aged 2 to 19 years undergoing needle-related procedures such as injections, blood draws and IV insertion. Their review supported distraction and hypnosis as effective for reducing children's self-reported pain and distress, although the authors rated their confidence in many of those findings as limited because the trials were small or open to bias. Distraction ranged from simple toys and bubbles to videos and virtual reality. The review also examined other approaches, including breathing exercises and combined cognitive and behavioral strategies.

For Tyrese, a plan might include three changes. First, a child life specialist could meet him before the next draw to explain each step and let him practice on a doll. Second, instead of lying flat, he could sit upright on his mother's lap in a comfort hold, with one arm extended. Third, he could choose his distraction, perhaps a game on a tablet, and use a short breathing script he practiced with the specialist. The goal is not only a calmer draw next month but a better experience to replace the memory he carries now. Each success can be named afterward, so Tyrese hears that he helped make it go well.

Classmates: when, if ever, is holding a child down the right choice?

Reply to Brielle

Brielle, you argued that restraint is sometimes necessary for safety, and I agree that a needle cannot go into a moving arm. Still, there is a difference between brief, gentle holding and four adults pinning a child. Rollins et al. (2018) note that procedures experienced as overpowering can make future ones harder. Comfort positioning keeps the arm still while leaving the child supported rather than overpowered, and it lets a parent stay close instead of standing back while strangers hold the child.

Reply to Noah

Noah, your point about fourteen-year-old Ava, who wanted to watch her IV being placed, is important. Birnie et al. (2018) reviewed several strategies, and distraction is only one of them. Some adolescents cope by gaining information and control. For Ava, the nurse could narrate each step, let her count down before the needle and offer breathing as an option, so she watches on her own terms. Offering the choice again at every visit matters too, since a teenager who wants to watch one month may prefer a game the next.

References

Birnie, K. A., Noel, M., Chambers, C. T., Uman, L. S., & Parker, J. A. (2018). Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database of Systematic Reviews, 2018(10), Article CD005179. https://doi.org/10.1002/14651858.CD005179.pub4

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