Adolescent test or procedure preparation

Answer 1

Definition

Proper preparations for a test or procedure can reduce an adolescent's anxiety, encourage cooperation, and help the adolescent develop coping skills.

Alternative Names

Test/procedure preparation - adolescent; Preparing adolescent for test/procedure

Information

There are a number of ways to help an adolescent prepare for a medical test or procedure.

First, provide detailed information and explain reasons for the procedure. Let your adolescent participate in making as many decisions as possible.

PREPARING BEFORE THE PROCEDURE

Explain the procedure in correct medical terms, and tell your adolescent why the test is being done. (Ask your provider to explain if you are not sure.) Understanding the need for the procedure may reduce your adolescent's anxiety.

To the best of your ability, describe how the test will feel. Allow your adolescent to practice the positions or movements that will be required for the particular test, such as the fetal position for a lumbar puncture.

Be honest about discomfort that may be felt, but don't dwell on the topic. It may help to stress the benefits of the procedure, and that you will have more information when the results are in. Talk about things that the adolescent may find pleasurable after the test, such as feeling better or going home. Rewards, such as shopping trips or movies, may be helpful if the adolescent is able to enjoy them.

To the best of your ability, tell your adolescent how the equipment works in literal terms. If the procedure takes place in an unfamiliar location, your adolescent may benefit from a tour of the facility beforehand.

Suggest ways for the adolescent to stay calm:

• Counting
• Creating an environment with low sensory stimulation
• Blowing bubbles
• Deep breathing
• Guided imagery
• Hand-held Video Games
• Holding the hand of a calm parent (or someone else) during the procedure
• Relaxation (thinking pleasant thoughts)
• Other distractions

When possible, let your adolescent make some decisions, such as the time of day or the date the procedure is performed. The more control a person feels over a procedure, the less painful and anxiety-producing it is likely to be.

Allow your adolescent to participate in simple tasks. Encourage participation during the procedure, such as holding an instrument, if allowed.

Discuss potential risks. Adolescents commonly have elevated concerns about risks, particularly about any effects on appearance, mental function, and sexuality. Address these fears honestly and openly if at all possible. Provide information about any appearance changes or other possible side effects that may result from the test.

Older adolescents may benefit from videos that demonstrate adolescents of the same age explaining and undergoing the procedure. Ask your health care provider if such films are available for your adolescent's viewing. It may also be helpful for your adolescent to discuss any concerns with peers who have successfully managed similar stressful situations. Ask your health care provider if they know any teens who are interested in peer counseling or if they can recommend a local support group.

DURING THE PROCEDURE

If the procedure is done at the hospital or your health care provider's office, ask if you can stay with your adolescent. However, if your adolescent does not want you to be there, it is best to honor this wish. Out of respect for your adolescent's growing need for privacy and independence, do not allow peers or siblings to view the procedure unless the adolescent asks them to be present.

Avoid showing your anxiety. This will make your adolescent more upset and anxious. Research has suggested that children are more cooperative if their parents have taken measures (such as anxiety reducing acupuncture) to reduce their own anxiety.

Other considerations:

• Ask your health care provider to limit the number of strangers entering and leaving the room during the procedure, because this can raise anxiety.
• Ask that the provider who has spent the most time with your adolescent be present during the procedure, if possible.
• Your adolescent may have difficulty with a new authority figure entering the situation. This complication can be reduced if someone he or she knows performs the test. Otherwise, your adolescent may show some resistance. Prepare the adolescent in advance for the possibility that the test will be done by someone unfamiliar.
• Ask that anesthesia be used (as appropriate) to reduce any discomfort for your adolescent.
• Assure your adolescent that his or her reactions are normal.

References

Khan KA, Weisman SJ. Nonpharmacologic pain management strategies in the pediatric emergency department. Clin Ped Emerg Med. 2007;8(4):240-247.

LeRoy S, Elixson EM, O'Brien P, et al. Recommendations for preparing children and adolescents for invasive cardiac procedures: a statement from the American Heart Association Pediatric Nursing Subcommittee of the Council on Cardiovascular Nursing in collaboration with the Council on Cardiovascular Diseases of the Young. Circulation. 2003;108(20):2550-2564.

Yip P, Middleton P, Cyna AM, Carlyle AV. Non-pharmacological interventions for assisting the induction of anaesthesia in children. Department of Paediatric Anaesthesia, Starship Children's Hospital, Auckland, New Zealand. Cochrane Database Syst Rev. 2009 Jul 8:(3):CD006447.

Reviewed By

Review Date: 04/19/2010

Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.