Best Approach to Decrease Anxiety in a 10-Year-Old Girl Undergoing Surgery
Use a heart model to show her how the surgery will go (Option A) is the best approach for a 10-year-old child, as this age group is in the concrete operational stage and learns optimally through hands-on, visual demonstrations with tangible medical equipment that allows them to see, touch, and understand the procedure. 1
Developmental Rationale for This Age Group
A 10-year-old child is in the concrete operational period (7-11 years) of cognitive development, characterized by:
- Logical thinking abilities with rudimentary understanding of cause and effect 1
- Ability to understand internal body parts and body functions (e.g., can comprehend that the heart is a pump) 1
- Learning through concrete, experiential methods rather than abstract verbal explanations alone 1
- Fear of loss of body parts, disability, and loss of control - making visual demonstration particularly important to address these specific anxieties 1
Why Option A (Heart Model) is Superior
Hands-on demonstration with medical equipment is the gold standard for school-age children because:
- School-age children benefit from play sessions with trained healthcare providers that offer simple explanations while allowing the child to see and handle medical equipment 1
- This approach provides sensory information about what they will experience, which is critical for reducing anxiety 1
- Children can process information and become familiar with equipment through tactile engagement 1
- The concrete, visual nature addresses their developmental stage where learning is primarily experiential 1
Why Other Options Are Less Effective
Option B (Verbal Explanation Only)
- Verbal information alone is insufficient for this age group 1
- While simple, realistic language is important, it must be combined with visual/tactile demonstrations 1
- Information processing is affected by anxiety, requiring ongoing validation of understanding through interactive methods 1
Option C (Book 2 Weeks Prior)
- Timing is suboptimal: School-age children respond best when information is presented approximately 1 week before surgery, not 2 weeks 1
- Written materials alone are less effective than hands-on demonstrations for this developmental stage 1
- Books are useful as adjuncts but not primary interventions for concrete operational thinkers 1
Option D (Parents Talking About Importance)
- This approach focuses on rationale rather than preparation, which doesn't address the child's anxiety 1
- While parental involvement is crucial, parents should be coached on how to support the child rather than simply explaining importance 1
- Parental anxiety can actually increase child stress if not properly managed 1
Optimal Implementation Strategy
The nurse should:
- Schedule the demonstration approximately 1 week before surgery (optimal timing for this age) 1
- Use the heart model with simple, child-sensitive language avoiding threatening medical terminology 1
- Allow the child to handle the model and ask questions to validate understanding 1
- Provide sensory information about what they will see, hear, and feel during the procedure 1
- Include parents in the session so they can reinforce information and provide emotional support 1
Critical Pitfalls to Avoid
- Don't rely solely on verbal explanations - this age requires concrete, hands-on learning 1
- Avoid medical jargon that can be threatening or misinterpreted 1
- Don't provide information too early (>2 weeks) or too late (day of surgery) 1
- Never dismiss the child's fears or tell them how they "ought to feel" 2
- Recognize that excessive parental reassurance can paradoxically increase child anxiety 1