Play interventions to reduce anxiety and negative emotions in hospitalized children

Abstract

BackgroundHospitalization is a stressful and threatening experience, which can be emotionally devastating to children. Hospital play interventions have been widely used to prepare children for invasive medical procedures and hospitalization. Nevertheless, there is an imperative need for rigorous empirical scrutiny of the effectiveness of hospital play interventions, in particular, using play activities to ease the psychological burden of hospitalized children. This study tested the effectiveness of play interventions to reduce anxiety and negative emotions in hospitalized children.MethodsA non-equivalent control group pre-test and post-test, between subjects design was conducted in the two largest acute-care public hospitals in Hong Kong. A total of 304 Chinese children (ages 3-12) admitted for treatments in these two hospitals were invited to participate in the study. Of the 304 paediatric patients, 154 received hospital play interventions and 150 received usual care.ResultsChildren who received the hospital play interventions exhibited fewer negative emotions and experienced lower levels of anxiety than those children who received usual care.ConclusionThis study addressed a gap in the literature by providing empirical evidence to support the effectiveness of play interventions in reducing anxiety and negative emotions in hospitalized children. Findings from this study emphasize the significance of incorporating hospital play interventions to provide holistic and quality care to ease the psychological burden of hospitalized children.Trial registrationClinicalTrials.gov NCT02665403. Registered 22 January 2016.

O Brincar na Percepção de Enfermeiros em um Hospital Pediátrico do Maranhão

“…O uso de fantasias ajuda no aprendizado da criança sobre ela mesma e na sua visão de mundo. As brincadeiras com fantasias propiciam a criança uma sensação de poder e domínio que não são possíveis na vida real e isso possibilita um aumento na habilidade de regular o próprio afeto, na redução da agressão e na elaboração de sentimentos positivos 9 . Dessa forma, as brincadeiras poderão ser utilizadas como instrumento essencial na assistência de enfermagem à criança, um recurso terapêutico que propicia expressão de sentimentos, redução de estresse e interação criança-família-profissional, reduzindo significantemente o impacto emocional gerado pela internação hospitalar 1 .…”

Influence of Therapeutic Play on the anxiety of hospitalized school-age children: Clinical trial

“…The CD: H anxiety score was obtained using the Child Drawing: Hospital (CD: H) instrument, and was obtained after analysis of one drawing by each child (10,13) .…”

“…However, the fact that the instrument is validated in Brazil may limit understanding of the instructions for its application due to the absence of a translation into Portuguese. Two researchers were trained in the use of Child Drawing: Hospital (CD: H) (10,13) and how to approach children and their families to participate in the research. The data were collected in the two institutions.…”

“…The Child Drawing: Hospital (CD: H) instrument, which assesses the degree of anxiety of hospitalized school-age children, was used to verify the effect of the DTP session (10,13) . Although CD: H has not been validated in Brazil, we adopted this, since neither written nor verbal language is involved in the evaluation and interpretation of the drawing, and thus should not interfere in the results.…”

“…Play is a safe way to externalize concerns, fears and feelings, as it is a projective activity in which a child, who has not yet fully acquired the cognitive and verbal communication skills, can express himself freely (8,10) . Moreover, since DTP has a cathartic function, it can directly influence the emotional state of the child, suffering from hospitalization, releasing tensions and emotions that may not otherwise be socially accepted, such as anger and aggression (5,8,(10)(11)(12)(13) .…”