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

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 child participate in making as many decisions as possible.

PREPARING BEFORE THE PROCEDURE

Explain the procedure in correct medical terms, and tell your child 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 child's anxiety.

To the best of your ability, describe how the test will feel. Allow your child 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 child 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 child is able to enjoy them.

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

Suggest ways for the child to stay calm:

• Counting
• Blowing bubbles
• Deep breathing
• Guided imagery
• Holding the hand of the parent (or someone else) during the procedure
• Relaxation (thinking pleasant thoughts)
• Other distractions

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

Allow your child to participate in simple tasks. Encourage participation during the procedure, such as holding an instrument, if allowed. Let your child hold your hand (or the hand of someone else in the room) for comfort, as it can actually reduce pain by reducing anxiety and providing distraction.

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 children may benefit from videos that demonstrate children of the same age explaining and undergoing the procedure. Ask your health care provider if such films are available for your child's viewing. It may also be helpful for your child to discuss their concerns with peers who have successfully managed similar stressful situations. Ask your health care provider if they know any teens 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 child. However, if your child does not want you to be there, it is best to honor this wish. Out of respect for your child's growing need for privacy and independence, do not allow peers or siblings to view the procedure unless the child asks them to be present.

Avoid showing your anxiety. This will make your child more upset and anxious.

Other considerations:

• Ask your health care provider to limit the number of strangers entering and leaving the room during the procedure, since this can raise anxiety.
• Ask that the provider who has spent the most time with your child be present during the procedure, if possible.
• Your child 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 child may show some resistance. Prepare the child 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 child.
• Assure your child that his or her reactions are normal.

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.