An NHS doctor who has developed an app to help reduce anxiety in children undergoing healthcare procedures has raised £1.5m from NPIF – Mercia Equity...
Preparing and informing children for hospital
Visiting hospital is anxiety-provoking for both children and their families. 50-75% of children are affected by significant anxiety before healthcare procedures.
Preparing and informing children for hospital.
Uncertainty fuels anxiety:
Coming to hospital is anxiety-provoking for both children and their families. Entering an unfamiliar place, filled with unknown people and strange equipment, leads to children feeling frightened, scared and out of control [1,2]. A lack of knowledge and understanding exacerbates these feelings. Fear of the unknown, concerns about being separated from a parent, and anticipated pain all serve to raise anxiety levels [3,4,5], resulting in poor patient experiences and worse health outcomes .
Preparation reduces anxiety:
There is much evidence to demonstrate the benefits of effectively preparing children before their hospital visit ; timely preparation helps to reduce anxiety and improve patient experiences. When children have an understanding of what will happen, they have lower levels of anxiety and are able to cope better - for example, they are less likely to be upset or need to be physically restrained or held [8,9,10].
Children do not currently receive effective pre-procedural preparation:
Children have a recognised right to receive information to facilitate them in understanding and partaking in decisions of relevance to them (United Nations). Despite this, children continue to be poorly prepared and ill-informed prior to healthcare encounters [11,12]. Healthcare professionals, constrained by time, often have limited or no opportunity to deliver effective pre-procedural preparation and information face-to-face. In most circumstances parents or caregivers are relied upon to relay information between healthcare providers and their child .
Parents as “information gate-keepers”:
Caregivers routinely act as “information gate-keepers” – taking on the responsibility of providing information and preparing their child for hospital. For myriad reasons this is often suboptimal for children, families and healthcare organisations. Adults with little or no previous healthcare knowledge or experience may be unsure themselves what will happen making it difficult to explain it to their child. They may struggle with how to present complex information to young children or worry about “information overload” causing their child to be more anxious . For caregivers, shouldering the burden of responsibility creates extra stress during an emotionally-laden time; for healthcare organisations the result is ill-prepared children who are more resource-intensive (e.g. requiring premedication or physical restraint) and at risk of poorer outcomes.
What can we do to improve this situation?
Children are not receiving the information they want or need prior to hospital visits and caregivers are struggling to plug this “information hole” . Provision of face-to-face preparation from healthcare professionals is the gold standard of care, but this is resource-intense and beset by the negative impacts of health inequalities on access to care (e.g. prohibitive travel costs). We believe that innovations in digital health technology are the next step to addressing this issue. The Little Journey app, delivering information articles, virtual tours and coping skills development techniques, empowers families through knowledge. By providing children and families with the tools to effectively prepare for hospital at a time and location convenient to them, we believe that we can support all children, all across the world, to better health.
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- Bray L, Appleton V, Sharpe A. (2022) ‘We should have been told what would happen': Children's and parents' procedural knowledge levels and information-seeking behaviours when coming to hospital for a planned procedure. J Child Health Care. 2022 Mar;26(1):96-109.