**5. Importance of interdisciplinary care in pediatric surgery**

Over 13 years of work (1998-2011) improvements has been observed, with the procedures that were adopted, both for pre-operative preparation and for the treatment of chronic patients.

For out-patient follow-ups and in the infirmary, the improvements were in the affective development of emotional conflicts, fears, illusions, prejudices against the disease; facilitation of desensitization to procedures and to the hospital setting; lower levels of anxiety in both patients and parents, who demonstrated awareness and comfortableness regarding the procedures; hospitalizations with fewer complications and faster recoveries.

This data shows the importance of the performance of an interdisciplinary staff in the treatment of a pediatric surgery patient and his/her family.

The importance of intervention procedures aimed at the pre-operative preparation of children and their families is increasingly recognized. We should stress the need for this process to be carried out by a specialist in psychology who does not only stop to provide information about clinical procedures.

It is necessary that intervention programs provide conditions in which the parents and children can express their fears and anxieties about the situation that they are experiencing so that they can understand it more effectively.

Psychological Intervention, performed by a professional who is qualified to identify the emotional characteristics of parents and children in a systematic manner and with interdisciplinary support, can reduce the harmful effects to the child-family-professional bonds and can also reduce the undesirable aspects of hospitalization and surgery and consequently support the healthy development of the child.

The presence of a psychology professional together with the surgical team is fundamental when attempting to provide effective treatment to pediatric patients and their families, providing them with an effective understanding of procedures, better interaction with the staff, greater adherence to treatment, and consequently fewer risks to the emotional development of the child as a result of hospitalization.

This team believes that the interdisciplinary treatment in pediatric surgery is of utmost importance, because surgery is a time of crisis for parents and children, during which they are frightened and concerned about the necessity of a surgical intervention.

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While the child is afraid of the unknown, of pain and of separation from their loved ones, the adults, in turn, fear the inherent risks of the invasive procedures, illness, and the possible poor prognosis and the treatments to which the child may be submitted.

Therefore, we believe that a staff trained in the care of both children and caregivers, and able to deal with the children's and adults' fears and illusions about their reality, is very important for the proper development of the measures taken and actions necessary in each case.

Our experience supports the national and international published literature that is very rich in articles about the importance of humanizing clinical care with a child and family during illness, especially with those that require hospitalization and who are submitted to invasive procedures, aimed specifically at the preparation of these patients for the procedures they will be undergoing. Here can be mentioned the studies of desensitization to invasive procedures, child-parent coping strategies, treatment and prognosis, as well as interdisciplinary interaction.

From these considerations the importance of guidance and counseling programs for children, when subjected to surgery, as well as for parents, can be emphasized, for both the literature and the real experience reported here show that these interventions are effective in the reduction of anxiety in mothers and children, providing better conditions for confronting stressful situations, and lower rates of behavioral changes in children after surgical procedures.

#### **6. References**


While the child is afraid of the unknown, of pain and of separation from their loved ones, the adults, in turn, fear the inherent risks of the invasive procedures, illness, and the

Therefore, we believe that a staff trained in the care of both children and caregivers, and able to deal with the children's and adults' fears and illusions about their reality, is very important

Our experience supports the national and international published literature that is very rich in articles about the importance of humanizing clinical care with a child and family during illness, especially with those that require hospitalization and who are submitted to invasive procedures, aimed specifically at the preparation of these patients for the procedures they will be undergoing. Here can be mentioned the studies of desensitization to invasive procedures, child-parent coping strategies, treatment and prognosis, as well as

From these considerations the importance of guidance and counseling programs for children, when subjected to surgery, as well as for parents, can be emphasized, for both the literature and the real experience reported here show that these interventions are effective in the reduction of anxiety in mothers and children, providing better conditions for confronting stressful situations, and lower rates of behavioral changes in children after

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**6. References** 


**Part 4** 

**Psychosocial Issues**

