Helping Children Cope with Medical Tests and Interventions.
Helping Children Cope with Medical Tests and Interventions.
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DOI：
10.1016/j.jradnu.2016.11.005
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发表时间：
2017-03
影响因子：
--
通讯作者：
Geert-Jan van G
中科院分区：
文献类型：
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作者：
Lang EV;Viegas J;Bleeker C;Bruhn J;Geert-Jan van G
当焦虑和疼痛使患者难以合作或在需要时保持静止时，医疗程序和测试成为一项挑战。幸运的是，在手术开始时用催眠语言进行短暂的干预，可以使疼痛和焦虑的处理方式发生积极而持续的变化。虽然麻醉似乎是消除疼痛的简单解决方案，但麻醉前焦虑对术后行为和恢复的不良影响往往没有得到充分认识。本文讨论了自我催眠放松的选择，适用于与儿童的互动。儿童的高度可接受性使他们相对容易地参与到虚构的场景中。避免消极的建议是避免反安慰剂效应的关键，这种效应以后可能很难克服。一旦孩子沉浸在他或她喜欢的场景或爱好/选择的活动中，环境和程序刺激就可以很容易地整合到图像中。与力量、自信或韧性特征相联系的自我强化隐喻尤其具有增强能力的作用。即使儿童完全处于全身麻醉状态，他们仍然可能记得房间里说了什么，因此应保持谨慎的措辞。
Medical procedures and tests become a challenge when anxiety and pain make it difficult for the patient to cooperate or remain still when needed. Fortunately a short intervention with hypnoidal language at the onset of a procedure induces a positive and sustained change in the way pain and anxiety are processed. While anesthesia may appear to be a simple solution to eliminate pain, the adverse effects of pre-anesthesia anxiety on postoperative behavior and recovery are often not fully appreciated. This paper discusses options for self-hypnotic relaxation that are applicable to interactions with children. The high suggestibility of children makes it relatively easy to engage them in make-believe scenarios. Avoidance of negative suggestions is key in avoiding nocebo effects that may be difficult to overcome later. Once a child is immersed in his or her preferred scenario or hobby/activity of choice, environmental and procedural stimuli can be easily integrated in the imagery. Ego-strengthening metaphors that tie in features of strength, confidence, or resilience are particularly empowering. Even when children are fully under general anesthesia they may still have recall of what is said in the room and therefore caution in word choice should be maintained.