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Preparation of children for emergency medical care: a primary prevention approach
1Department of Psychology, University of Kansas, Lawrence 66045-2160.
Insights
A hospital program reduced medical fears and increased knowledge in children before emergency room visits. The intervention showed greater benefits for Black children and improved knowledge even after an actual ER visit.
Area of Science:
- Pediatric Emergency Medicine
- Child Psychology
- Health Education
Background:
- Rising pediatric emergency room (ER) visits necessitate understanding children's psychological responses to ER care.
- There is a need for effective interventions to mitigate fear and enhance knowledge in children facing ER visits.
Purpose of the Study:
- To evaluate the efficacy of a multicomponent hospital program designed to prepare children for ER visits.
- To assess the program's impact on children's medical fears and knowledge.
- To examine differential effects based on race and the impact of subsequent ER exposure.
Main Methods:
- Phase 1: 148 kindergarteners assessed for medical fears and knowledge pre- and post-intervention, with a 4-week follow-up.
- Phase 2: 51 high-fear children from Phase 1 randomly assigned to undergo an ER medical examination.
- Measures included self-report fear/knowledge scales, observational distress, and physiological arousal.
Main Results:
- Program attendees showed significantly reduced medical fears and increased medical knowledge compared to controls at posttest and follow-up.
- The program was more effective for Black children than White children.
- While the program did not reduce distress during an actual ER visit, it significantly increased medical knowledge post-visit.
Conclusions:
- A multicomponent hospital preparation program can effectively reduce medical fears and enhance knowledge in children anticipating ER visits.
- The program demonstrates potential for targeted application, particularly benefiting Black children.
- Further research is needed to address distress during actual ER encounters despite improved knowledge.
Abstract:
Increased emergency room use and the resulting rise in pediatric visits have prompted interest in psychological aspects of pediatric emergency care. This study evaluated the efficacy of a multicomponent hospital program designed to prepare children for emergency room visits. In Phase 1, 148 kindergarteners completed measures of medical fears and knowledge at pretreatment, posttreatment, and a 4-week follow-up. Program attenders had significantly fewer medical fears and higher medical knowledge at posttest and follow-up than control children. The program was more effective for black than white children. In Phase 2, 51 high-fear children from Phase 1 were selected randomly to attend a medical examination in an emergency room. No effects for program emerged on the observational distress measures or physiological arousal. Phase 2 children showed significantly increased medical knowledge at follow-up compared to children who did not receive the medical exam.