Perioperative stress in children

Imagine that one morning, the people you live with wake you up, dress you, don't allow you to drink or eat anything and take you to a place you don't know. There, people who are strangers to you take you away from those with whom you feel familiar, limit your mobility and begin various interventions on your body, without having given you any information.

Depending on the age and development of the limbic system, all children experience a different degree of stress when they are about to be hospitalized for an operation.
In children, stress is magnified when the parent is also stressed.

According to studies, 75% of children and parents experience intense stress in front of an upcoming surgery. Here's why it's important that certain interventions happen at the right time:

• Upon highlighting the need to perform any operation, surgical or not, on a child, the health professional (doctor, etc) must provide the parent with all the information necessary so that, on the one hand, the parent is able to fully understand the problem and on the other hand, to give time to the acceptance of the problem.

• How is this going to be done? First we use language that is understandable to our interlocutor. We can't use academic terms to a person who graduated from elementary school, how will we be understood anyway? (see Bloom's taxonomy)

• We give the parent the opportunity to ask as many questions as they wish, without making ironic comments, simplifying the situation or even zeroing it out, so that it seems like a game. We must be completely honest, give the opportunity to discuss alternative solutions if there are any, and create the care plan for the child together. In the latter way, we show the parent how important his contribution to the healing of his child is, we allow him to continue to maintain the role of caregiver that nature has given him, and in general, there are benefits for the mental health of both the child and of the parent. Imagine a parent, whose child has been diagnosed with a malignancy, they have removed the child from the parent for examinations-hospitalizations-treatments, etc., in one case we have a child who experiences terror both because of the illness and the separation from the loved one, but also the parent is under stress - especially in the unfortunate case where the child passes away, the parent suffers horribly from feelings of remorse for not being as close to their child as they would have liked.

• Even if it is a routine act, the stress experienced by anyone, child or parent, should not be leveled by any health professional, with phrases like you are a strong child, don't cry so mom won't be sad, cry the men?, it's nothing! As with any emotion, fear is an emotion that should not be suffocated, but given space and time to be discussed and to assure the child or parent that we are there to help them, what they are experiencing is completely normal and with simple movements to show them that they can trust us.

• Note the following, it is no coincidence that a separation from the mother during the first days of an infant's life can have terrifying effects on his psyche throughout the rest of his life. Don't be fooled by the fact that not all children can express themselves in words, don't be fooled by a seemingly calm parent. The stress of separation, even for a short time, is terribly damaging for both parties. Pay attention to non-verbal communication as well.

• Finally, I'll close with what I keep running into. Parents should be honest with children. Tell them the truth. The doctor says that in order for you to be able to breathe better, we need to do an operation, to fix the problem with the meatballs you have inside the mussel. We will do some tests to see that everything is fine and the next day we will do the operation.You may be sore for a while, but then everything will be fine and you'll be able to sleep better! Make a story with all the truths, we don't need to go into details, but this way the child will have awareness, an opinion, will be able to cooperate better with the staff, will have a faster recovery, less need for painkillers, shorter stay in the hospital, best experience!

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