Cancer treatment is very stressful experience that can overwhelm a preschooler’s natural ability to cope.
The emotional trauma preschoolers experience can delay healing and normal development. The negative effects on physical and mental health may last for years after treatment has ended.
Child life promotes effective coping for preschoolers.
Developmental Issues
- Fears the dark
- Learns best by doing
- Limited concept of time
- Fantasy and magical thinking
- Does not understand death as final
- Increased, yet limited language skills
- Egocentric (the world revolves around me)
- Views hospitalization and illness as a punishment
Hospital Stressors
- Separation from parent
- Feels unprotected and a sense of abandonment
- Unable to distinguish between fantasy and reality
- Misconceptions develop from lack of understanding
- Heightened fears (pain, strangers, medical equipment)
- Loss of competence and initiative in developmental tasks
Coping Behaviours
- Guilt
- Fantasy
- Temper tantrums
- Aggression and anger
- Regression to earlier behaviours
Interventions
- Encourage parent presence and participation in care
- Be realistic and truthful
- Correct misconceptions
- Offer choices when possible
- Encourage child participation in care
- Avoid words that provoke fantasies (cut, bleed)
- Allow expression of feelings through play and verbalization
- Reinforce that hospitalization, treatments and procedures are not punishment
- Let child explore equipment. Explain it in concrete terms (touch, smell, taste, sound, sight)
Pain Management / Comforting Techniques
- Videos
- Singing
- Bubbles
- Soft music
- Humour/Jokes
- Favourite object
- Comfort Positioning
- Encouraging statements
