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How the pediatrician should inform the child


Pediatricians often forget that our patients need a reasonable understanding of what is happening to them, just like adults.

Children with a disease ask themselves questions such as: What is wrong with me? Is what happens to me normal? Have I done something wrong to be like this? Why do I have cold hands? Why don't I feel like eating? Why am I bleeding? Why don't you give me anything to eat? How long will I be admitted? How many times will I have to go to the hospital? Will any of the tests they send me hurt me?

As a guide, we propose the following informative decalogue, specially designed for our little patients:

1. Closeness. First of all, we will look him in the face and be close. Let us also introduce ourselves to them. It is good that they know what our name is.

2. Discouragement. We will try to break the ice, and we will go on to tell him with a certain ease (but without falling into the comic) what happens to him. For example, if we speak to a celiac: 'There are children who cannot eat fried eggs; you can eat them, and dip the yolk with bread, but you have to do it with a slightly different bread than normal. That special bread is gluten-free, which is what makes you sick. '

3. Optimism. Try to convey positivity with your phrases: 'Now you have a stain on your lung that makes you breathe regularly, but as soon as it passes you will be able to go to the field for a very long walk'.

4. Alternatives. 'Indeed, you will miss Alberto's birthday, but another day you can invite Alberto and all your friends to play at home. You're going to have a great time. '

5. Drawings. When they feel bad, young children think that 'their whole body is bad'. We can use a very sketchy drawing and point out exactly what is wrong.

6. Comprehension. Children under the age of two don't understand what it's like to be sick, but they worry about being separated from their parents. For this reason, we will tell them that their father or mother will always be in the hospital with them. Between the ages of 2 and 6, children are aware that they are sick, and what is happening to them must be explained simply. To avoid feelings of guilt, do not forget to tell them that what happens to them is not a consequence of their behavior. Above 6 years, the level of understanding is higher, and it is necessary to adapt to it when reporting.

7. Don't lie. If the child asks us if an analysis is going to be done, we should not say 'but it will not hurt'. It is better to say that 'it may bother you a little, but if you blow, it will go away immediately'. Or 'they are going to spray you so that it bothers you very little'.

8. Leave the door open. The information will be constant, day by day. We will recommend that the child and the parents write down on a piece of paper all the questions the little one asks himself.

9. They listen to us. Although it may not seem like it, while doctors talk to their parents, children listen to us.

10, Empathize. If the illness is long and the recovery is tedious, speak to him in understandable terms such as 'this is a bit of a bummer, it is normal that one day you will be a little down'. 'Don't feel bad if you are angry.'

And finally: we have to make it clear that they are not the only ones who have been through this. It is convenient to clarify that 'not only have they had mesenteric adenitis, many others like him have already been cured', 'pneumonia is frequent, they tend to go very well and do not generate sequelae'. Let them be actively involved in treatment decisions: 'what better relieves your pain, paracetamol or metamizole?'

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