Top tips for engaging children and young people of different ages
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1 Top tips for engaging children and young people of different ages Dr Zoe
2 Outline Benefits of involving children and young people in developing patient information Methods of involving children and young people
3 Benefits of involving children and young people Increasing emphasis placed on giving children and parents more: information power choice over the treatment they receive and involving them more actively in planning their care
4 Benefits of involving children and young people To the service itself To the young people taking part For those developing information
5 Benefits Involving children and young people can: aid prioritisation of topic areas for information result in greater understanding of children and young people s perspectives learn new skills to facilitate communication ensure child-centred materials are developed
6 How do we involve children in research? 1. Generation of topics for patient information resources 2. Design of patient information resources 3. Evaluation of patient information resources
7 How do we involve children in research? 1. Generation of topics for patient information resources 2. Design of patient information resources 3. Evaluation of patient information resources
8 GUIDE FOR YOUNG PEOPLE
9 Development of guide for young people with dental anxiety Step-by-step process
10 Development of guide for young people with dental anxiety Step-by-step process Development guided by Five Areas model of Cognitive Behavioural Therapy Used child-centred approach The team
11 Phase 1. Explore with young people their own experiences of dental anxiety Face-to-face semi-structured interviews were conducted with 13 dentally anxious children, aged 9-16 years and their parent/s Topic guide informed by the Five Areas Model (Williams and Garland, 2002) Data analysed using framework analysis Interviews with 19 dental team members
12 CBT: Five Areas Model (Williams and Garland, 2002) Situational factors Unhelpful thoughts Altered physical symptoms Altered feelings Unhelpful behaviours
13 Situational factors Communication and information-sharing Well tell me like exactly what they would do, cause I don t like surprises. (Claire, 14 years) To be told what was going to happen during a dental visit Information explained in an age-appropriate and nonpatronising manner Conflicting views about how much detailed information should be provided Intolerant to changes once a plan had been agreed
14 Situational factors Communication and information-sharing Noises Other children crying, dental equipment, and dental extractions Sights Dental instruments and distress in others Sensations Instruments in the mouth Potential threatening stimuli within the clinical environment And it s like it stings, it doesn t hurt, it stings. It stings really badly like 10,000 bees stinging you inside your mouth. (Michael, 13 years)
15 Unhelpful thoughts Negative predictions (catastrophising) Negative social judgements Reliving traumatic experiences I bet she loves me coming because she s got to do lots of stuff on me, and she can experiment on me like a doll. (Emily, 14 years)
16 What if they do something wrong? They slip, and then I swallow something and it chokes and I die. (Michael, 13 years) Unhelpful thoughts Negative predictions (catastrophising) Negative social judgements Reliving traumatic experiences I bet she loves me coming because she s got to do lots of stuff on me, and she can experiment on me like a doll. (Emily, 14 years)
17 Altered feelings Before/during treatment Fear/anxiety words terrified, petrified Angry...because Physical they didn t listen. discomfort They lied. I wanted to shout words at them. (Danielle, 11 trapped years old) Meltdown Angry Feel a bit proud. I ve done it. I ve faced my fears. (Chloe, 11 years old) Embarrassed After dental treatment Exhausted Drained Proud
18 Unhelpful behaviours Avoidance Aggression Deceive their parents/carers Downplay symptoms Negotiate with the dental team Delay dental treatment e.g. refuse to open their mouths They can t force your mouth open or anything, so I thought to myself, Well if I keep it shut they can t really do anything. (Sophie, 12 years old)
19 Autonomic hyperarousal sweating and shaking, clammy palms, having butterflies, stomachaches, feeling sick and becoming pale Situational factors Unhelpful thoughts Altered physical symptoms Altered feelings Unhelpful behaviours
20 Phase 2. To develop a guide with input from children, parents and professionals Dentally anxious children 9-16 years, parents and dental professionals all involved Participants shown drafts of guide and modifications made based on feedback Accompanying resources developed for patients and dental team members
21 Key features of the child guides 1) Challenge unhelpful thoughts Normalises dental anxiety Provide information 2) Enhance control Message to the Dentist Stop signal contract 3) Reflect and plan reward
22 Normalises anxiety
23 Challenges unhelpful thoughts Images reproduced from Living Life the to Full
24 Provides information
25 Enhances control
26 Enhances control
27 Letter to the dentist
28 Message to the dentist
29 Message to the dentist Assess severity
30 Message to the dentist Assess severity Identify specific situation factors for the patient
31 Message to the dentist Assess severity Identify specific situation factors for the patient Choose tools (relaxation, distraction, and coping)
32 Message to the dentist Assess severity Choose tools (relaxation, distraction, and coping) Identify specific situation factors for the patient Enhance control
33 Reflect and reward Rewards: Lunch out Going to the ice skating rink Baking Fish and chips Trip to the cinema
34 Resources for parents
35 Resources for the dental team
36 Formats Available: Paper Online at Online shop ibook
37 Summary of top tips Involving children and young people in developing patient information is not a oneoff process it takes time Build in choice and control Use their own words where possible Children more sensory in their information needs Be honest Consider needs of parents and clinicians too Be guided by their preferences for media don t presume its an app or web resource
38 Thank you for listening
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