What part about surgery is most stressful for a school-aged child?

If your school-aged child is facing surgery, it can be helpful to plan ahead if possible. Explain what your child can expect. It's most helpful to do this about a week or two before the surgery. Preparing too far in advance can cause more anxiety. Recognizing what is stressful to your school-aged child while in the hospital can guide you in getting him or her ready for the surgical experience. Common stressors and fears in the hospital may include:

• Being away from family, familiar surroundings, pets, school, and friends

• Thinking he or she is in the hospital because he or she is bad or is being punished

• Having a part of the body destroyed or injured

• Loss of control

• Pain (or the possibility of pain)

• Needles and shots

• Dying during surgery

How do I prepare my school-aged child for surgery?

• Tour the facility with your child before surgery. This lets your child see the sights, sounds, and events he or she will experience the day of surgery. It can help your child learn about the hospital, and gives him or her time to talk about concerns and questions. Ask a child life specialist to explain what will happen, and why, in terms your child can understand.

• Check that your child knows why he or she is having surgery in words he or she can understand. School-aged children may not ask questions about something they think they are supposed to know about. This can lead a parent to think the child understands what surgery and a hospital stay involve.

• Have your child explain back to you what is going to happen in the hospital. School-aged children sometimes will listen carefully, but not understand all that was said. This can help you to learn if your child understands of what lies ahead.

• Read books about the hospital or surgery with your whole family.

• Give as many choices as possible to increase your child's sense of control. For example, let your child choose what clothes, music, or movies to bring to the hospital.

• Emphasize that your child has not done anything wrong and that surgery is not a punishment.

• Don't use doctors, nurses, needles, and procedures as sources of punishment. For example, "If you don't do as the doctor says, he will give you a shot." Portray the healthcare providers as caring, helpful people.

• Explain the benefits of the surgery in terms your child can understand. For example, "After your knee has healed, you will be able to play soccer again."

• Encourage your child's friends to visit the hospital, or to keep in touch with your child by telephone, email, texts, or with letters and cards.

• Young children can practice with a doctor's kit on a stuffed animal, such as listening to their heart. This can make them more comfortable with medical care.

• Learn as much as you can about your child's surgery. Children can tell when their parents are worried. The more you know, the better you will be able to help explain things to your child.

• A family member should stay with your child as much as possible. Always tell your child when you are leaving, why, and when you will be back. If your child will stay in the hospital for several days, ask family and friends to call and visit often, depending on your child's condition.

• Let your child know that it is OK to be afraid and to cry. Encourage him or her to ask questions of the doctors and nurses.

• When your child is stressed, he or she may regress or display new fears, such as being afraid of the dark. Give many compliments and hugs. Parents should always hold their child's hand (not restrain him or her—let healthcare professionals do that if it is needed) during tests or procedures.

Helpful books for you and your child

Claire Ciliotta and Carole Livingston. 1992. Why Am I Going to the Hospital? Lyle Stuart. (Ages 5 to 12)

James Howe. 1994. The Hospital Book. Morrow Junior Books. S. B. Stein. 1985. A Hospital Story. New York: Walter and Co.

Lisa Ann Marsoli. 1984. Things To Know Before You Go To The Hospital. Silver Burdett Co.

Debbie Duncan, Nina Ollikainen (Illustrator). 1995. When Molly Was In The Hospital: A Book for Brothers and Sisters of Hospitalized Children. Rayve Productions, Incorporated. (Ages 4 to 7)

Virginia Dooley and Miriam Katin. 1996. Tubes in My Ears: My Trip to the Hospital. Mondo Publishing. (Ages 5 to 7)

Paulette Bourgeois, Brenda Clark (Illustrator). 2000. Franklin Goes to the Hospital (volume 25). Scholastic, Inc. (Ages 5 to 7)

Deborah Hautzig. 1985. A Visit to the Sesame Street Hospital. Random House/Children's Television Workshop. (Ages 4 to 7)

Marianne Johnston and Erin Mckenna. August, 1997. Let's Talk About Going To The Hospital. The Rosen Publishing Group, Incorporated. (Ages 8 to 9)

Francine Paschal. 1991. Twins Go To The Hospital: Sweet Valley Kids Series #20. Bantam Books. (Ages 6 to 8)

Juliana Lee Hatkoff, Craig Hatkoff, Marilyn Mets (Illustrator). 2001. Good-Bye Tonsils!. Penguin Putnam Books for Young Readers. (Ages 4 to 8)

Norman Bridwell. 2000. Clifford Visits the Hospital. ( Clifford the Big Red Dog ). Scholastic Inc. (Ages 4 to 8)

H.A. Ray. 1999. Curious George Goes to the Hospital. Rebound my Sagebrush. (Ages 4 to 8)

Barbara Taylor Cork. 2002. Katie Goes to the Hospital. Peter Bedrick; 1 edition. (Ages 4 to 8)

Joanna Cole and Bruce Degar. 1989. The Magic School Bus: Inside the Human Body. Scholastic, Incorporated. (Ages 6 to 9)

Anne Civardi and Michelle Bates. 2002. Going to the Hospital. Sagebrush Education Resource. (Ages 4 to 8)