Home' Trinidad and Tobago Guardian : December 23rd 2013 Contents B20
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Nurses understandably want to reassure kids
during a medical procedure. But a new Scottish
study looking at dental care suggests that placating
words might only increase a child s anxiety.
Reassurances given at the beginning of a routine
dental task were tied to more child distress compared
to encouraging words offered near the end of the
Children who were not anxious at the start of the
visit and who heard reassurances about 15 seconds
into the event had a 2 in 3 chance of getting more
stressed by reassurances. For kids who were anxious
at the 15-second mark, the chances jumped to nearly
"For children who are very anxious, the reassurance
can have even more negative effects," said Yuefang
Zhou and her colleague, Gerry Michael Humphris,
both of the University of St Andrews in Scotland,
conducted the study.
Since the late 1980s, researchers have known that
phrases intended to soothe - "Don t worry. It won t
hurt," for example - might only add to kids stress
levels during painful and major events like surgery
or cancer treatment.
The current study published in the Annals of
Behavioral Medicine confirms the same relationship
found in past research on more serious procedures,
said Keith Allen.
"In that sense, this study does offer a small con-
tribution," he said.
Allen, a professor of psychology at the University
of Nebraska Medical Center, was not involved in the
For the study, Zhou and Humphris videotaped 270
boys and girls between ages 3 and 5 in local nursery
schools and their interactions with a female dental
nurse while she applied varnish to their teeth. The
varnish - not to be confused with sealant - is painted
on kids teeth and forms a protective film against
Researchers coded behaviours, such as whether a
child appeared stressed out or whether the nurse
offered verbal reassurance.
All of the data was analysed using specific software
that allowed researchers to insert a "time stamp" at
the moment a behaviour occurred.
The time stamps provided a new twist in analysing
the relationship between reassurance and child anxiety,
"But, that element, I think, is an artifact," he said.
"The fact is that towards the end of a procedure,
kids tend to get better anyway, because usually the
doctor or nurse is doing less invasive things."
Zhou and Humphris also point to the fact that a
child s distress does not provide a straightforward
link with reassurance.
Allen agreed. "It s possible that when kids have
disruptive behaviour, the nurse may say more reas-
suring things," he said.
"So we don t know if the comments caused the
distress, or, if the distress caused the nurses to give
reassuring comments," Allen said.
Tooth decay is the most common chronic childhood
disease and five times more common than asthma,
according to the American Academy of Paediatric
The good news is that alternatives exist.
"One alternative to reassurance is to offer praise,"
Zhou said. "But it is important to use specific praise."
"So if a child opens his or her mouth wide, then
the nurse can say, Well done for opening your mouth
wide! " she said.
Parents and nurses could consider engaging the
child in an activity, like singing his or her favourite
song, said Humphris.
When nurses or parents say things like "It s not
going to last much longer," or "It s going to be okay,"
said Allen, they are putting the focus on the negative
aspects of the experience.
"We found that question-oriented or permission-
seeking instructions do not work very well for patients
at these young ages," Zhou said.
"If a nurse says, Would you please open your
mouth? then the child can refuse," she said.
"So it is best to give them instructions in a firm
way," Zhou said, adding: "Don t fool them." (Reuters)
YOUR DAILY HEALTH
News and Advice
Study: Nurses' soothing words
may not help kids' stress
New Scottish study looking at dental care suggests that placating words might
only increase a child's anxiety.
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