HYANNIS – Are doctor’s visits the stuff of nightmares? For young children, they may be.
Parents said their child was afraid of going to the doctor at some or most visits (26 percent) or once in a while (24 percent), according to a recent national poll. A small number of parents said these feelings caused them to cancel or delay a doctor’s appointment.
“This is a very common fear,” said Dawnnica K. Eastman, MD, of Seaside Pediatrics in West Yarmouth. “There are a number of different reasons for children to react this way, from fear of vaccines or the physical exam, to just simply being scared about being in an unfamiliar environment.”
We asked Dr. Eastman to tell us more about this fear and what can be done to ease a child’s concerns.
What age range is most likely to be nervous or frightened?
I most commonly see the 15- to 18-month-old children who are fearful of physical exams. Older children are more aware of what is happening and become fearful of vaccines. Children of all ages can be fearful of the office.
What do you do to help kids feel at ease?
“I try to spend most of the beginning of the visit just talking with the parents and the children. If I see that they are especially nervous, I try to ask them questions unrelated to the visit to engage them in an age-appropriate way and have them see that I am interested in them as a person, but also to get their mind off of their anxieties.
“With toddlers, I will try to engage them with a book or drawing on paper. With school-aged children, I try to get them talking about something they are interested in, like sports or a hobby, which often does work to take their mind off the upcoming exam or vaccines.
“When younger children are fearful of the exam, I let them touch and hold my stethoscope to let them see that it is not scary, and nothing to be fearful of. I make sure to tell older children everything to expect with the physical exam and why I am doing it.”
What can parents do in advance, during the visit and after?
“Modeling good behavior is very important. If there are unexpected delays or long wait times, do not show the child that you are anxious or annoyed with the staff. This sends the wrong message and makes the children feel that the office is a ‘bad’ place to be. You should be calm and act happy to be at the office.
“Try to focus on the positive things at the visits. For well visits, you can make the child excited about seeing how much they have grown or telling the doctor how well school is going.
“You can encourage school-age children to be involved in the visits, by asking them ahead of time if they have any concerns about their health that they would like to discuss with us. This sets a positive tone and sends the message to them that we are interested in their health and that we are there to help them to stay healthy and/or feel better.”
Are kids especially nervous about vaccinations? If so, what can doctors and parents do?
“Yes, it is common for children to be fearful of vaccines. The most important thing to do is to not promise that a child isn’t going to get a vaccine. You cannot know what they are due for, and we sometimes like to use the opportunity of a child being in the office for a sick visit to get them caught up on required vaccines. If you make a promise and break it, trust is broken.
“Do not make jokes about the vaccines or use the vaccines as a ‘punishment,’ by saying, ‘If you don’t behave at the doctor’s, they will give you a shot.’ This sends the wrong message to the child.
“You can explain in a child friendly way what the vaccines are for and why they are important. We are giving vaccines because we care about your children, and we want them to stay well.
“We can give the vaccines early in the visit, even before you see the doctor. Often the anxiety about getting a shot is much worse than the shot itself. It is often just best to get it over with as early as possible, so we can focus on the rest of the visit.”
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