M2: Conversations with Parents and Children

Question 1

a skill we all need to learn and develop

Answer 1

Communication

Question 2

The most likely sources of difficult conversations are occasions that may be…..

Answer 2

uncomfortable, disagreeable, problematic, emotionally-charged or stressful situations

Question 3

8 OCCASSIONS THAT MAY BE PROBLEMATIC, EMOTIVE, OR STRESSFUL (G2K)

Answer 3

1. Prior to surgical or medical intervention
2. Dealing with serious or acute illness
3. Dealing with disability
4. Following the death of someone close
5. When family and medical team disagree on the best interest of the child
6. Information and involvement in treatment
7. Appropriate medical treatment
8. This may involve sex, sexual orientation, or sexual
   abuse.

Question 4

To protect the child from distressing news/burden of

knowing: loss of innocence, hopelessness and despair

Answer 4

Involvement in Treatment discussions or decisions

Question 5

This is most especially seen when outcome of the treatment is uncertain.

Answer 5

Disagreements

Question 6

3 PREPARING TO ENGAGE IN A DIFFICULT SITUATION

Answer 6

1. KNOW what to say
2. SET the scene
3. ESTABLISH the objectives

Question 7

restate what you just heard using “I” statements. This allows you to clarify what the other person is actually saying, not what you think

Answer 7

Reiterate

Question 8

Count to 10 before saying anything. (Compose how you respond and think) of possible consequences as a result of what you are going to do.

Answer 8

Contemplate

Question 9

Take a (deep breath) to check in, settle your thoughts, emotions and give yourself some time to compose yourself.

Answer 9

Respire

Question 10

(Speak with compassion and thoughtfulness). Assume the good intentions of your conversation partner or partners and seek to educate rather than defend your point of view.

Answer 10

Communicate

Question 11

Two important ways in communicating complex

information to children are as follows

Answer 11

1. Make it simple

2. Explain complex procedures easily

Question 12

is based in predictions and probabilities rather than absolute certainties

Answer 12

Prognosis

Question 13

What will a 3 to 5 year old most likely ask if it is the first time that the patient will encounter this feeling or illness

Answer 13

What is happening to

me?”

Question 14

What will a 6 to 8 year old most likely ask?

Answer 14

“Why do I have a fever?”;

Question 15

What will a 9 to12 year old most likely ask?

Answer 15

“What sort of illness do I have?”

Question 16

Before a child undergoes amputation, allow the child to ______. This is to make the child less anxious about the
procedure.

Answer 16

play with their doll/toy or ask her what happened with the doll

Question 17

most important skill in communicating

effectively

Answer 17

Listening

Question 18

Principles in communicating with children and adolescents are as follows

Answer 18

1. Listen with full attention
2. Hold off giving advice as this deprives children of the experience of finding their own solutions
3. Children have to come to terms with their problems
   in their own individual ways.
4. No one can make a decision about a problem for a child.
5. ## Giving distressing information is not a single event
6. Listen attentively
7. Hold off advice
8. Children have to come to terms on their own
9. Don’t make decision for child
10. Don’t give distressing info at one go

Question 19

Children’s communication abilities vary with their age and experience

Answer 19

(master SIFU)

1. Subtle nonverbal communication
2. Idiosyncratic use of language
3. Frame of reference
4. Unfamiliar experience

Question 20

15 GIVING EMOTIVE AND SENSITIVE INFORMATION (G2K)

Answer 20

1. Introduce yourself.
2. One person needs to be designated to lead in giving
   information otherwise, the child will be overwhelmed.
3. Find out what the child likes to be called. Be as
   thoughtful as you can.
4. Be aware of levels and stages of development.
5. Avoid rushing the child, and allow them time to get to know you.
6. Let them dictate the pace.
7. Firmly establish what the child’s understanding is of the issue in question.
8. Respond to the child as an individual, and do not
   assume that all children are the same.
9. Talk to children normally. Comfortably audible.
10. Try to keep speech clear and sentences short.
11. Do not try to copy children’s slang or adopt their
    mannerisms.
12. Be aware of what might for the child, constitute a
    threat.
13. Believe. Trust must be the basis of any relationship and is particularly important among children.
14. Children exist as an integral part of a family system, so try to work in partnership with the parents.
15. It is not advisable to just challenge or override the
    parents, especially in front of the child.

Question 21

METHODS COMMONLY USED BY ADULTS TO GET

CHILDREN AND ADOLESCENTS TO COOPERATE (G2K)

Answer 21

1. Blaming and accusing
2. Name-calling
3. Threats
4. Commands
5. Lecturing and moralizing
6. Warnings
7. Martyrdom statements
8. Comparisons
9. Sarcasm
10. Prophecy

Question 22

The rights of children include

Answer 22

1. Right to information
2. Right to express
3. Right of expression to influence.
4. Right to decision making

Question 23

The following are necessary things to do when parents do not want to inform or involve their children in medical discussions:

Answer 23

(UREA)

1. Understand
2. Respect .
3. Educate.
4. Allow sufficient time.

Question 24

How to Discuss the options and strategies to parents

Answer 24

(2 Whos and 2 Whats)

1. Who tells child.
2. Who should be present.
3. What is given after
4. What is the best way of presenting information.

Question 25

Emphasize to parents that giving information to children is not an all-or-nothing event but a process hence _____

Answer 25

It must be planned

Question 26

Results of disagreements about treatment include

Answer 26

1. Process involves multidisciplinary team second opinion courts.
2. Medical team needs to be clear about what they feel is in the child’s best interest
   - —————————————————————–
3. Second opinion courts
4. Best interest of the child

Question 27

Who will be involved, where will you meet, how will you manage the conversation? is an example of

Answer 27

Setting the scene

Question 28

Explaining slowly that based on studies in the past, the prognosis is 6 months to 1 year, but also indicate that it is of no guarantee that that will also happen to the patient.

Is an example of

Answer 28

Prognosis

Question 29

To relay the bad news to a child ask them following 5 first

Answer 29

A. What happened?
B. What does he/she knows?
C. What did he/she expect?
D. What are his/her thoughts?
E. What do you remember?

Question 30

(Ouchy, booboo) are examples of

Answer 30

Idiosyncratic use of language

Question 31

A child may call his/her

grandmother as “Nanay” or his/her aunt as “Mama” is an example of

Answer 31

Idiosyncratic use of language

Question 32

mother raises an eyebrow which

would indicate something which is an example of

Answer 32

Subtle nonverbal communication

Question 33

Using 1-10 as a pain scale is an example of using a Child’s….

Answer 33

frame of reference

Question 34

Children act differently when either the

physician is around or not is an example of

Answer 34

Children’s interpersonal responses on the context of a situation