Play interventions to reduce anxiety and negative emotions in hospitalized children

William H C Li, Joyce Oi Kwan Chung, Ka Yan Ho, Blondi Ming Chau Kwok, William H C Li, Joyce Oi Kwan Chung, Ka Yan Ho, Blondi Ming Chau Kwok

Abstract

Background: Hospitalization 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.

Methods: A 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.

Results: Children who received the hospital play interventions exhibited fewer negative emotions and experienced lower levels of anxiety than those children who received usual care.

Conclusion: This 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 registration: ClinicalTrials.gov NCT02665403 . Registered 22 January 2016.

Keywords: Anxiety; Children; Emotions; Hospitalization; Paediatrics; Play interventions.

References

    1. Francischinelli AGB, Almeida FA, Fernandes DMSO. Routine use of therapeutic play in the care of hospitalized children: nurses’ perceptions. Acta Paulista de Enfermagem. 2012;25:18–23. doi: 10.1590/S0103-21002012000100004.
    1. Fernandes SC, Arriaga P. The effects of clown intervention on worries and emotional responses in children undergoing surgery. J Health Psychol. 2010;15:405–415. doi: 10.1177/1359105309350231.
    1. Li HCW, Lopez V, Lee TLI. Effects of preoperative therapeutic play on outcomes of school-age children undergoing day surgery. Res Nurs Health. 2007;30:320–332. doi: 10.1002/nur.20172.
    1. Lohaus A, Klein-Hessling J, Ball J, Wild M. The prediction of health-related in behavior in elementary school. J Health Psychol. 2004;9:375–379. doi: 10.1177/1359105304042347.
    1. Erikson E. Childhood and society. 2. New York: W. W. Norton & Company; 1963.
    1. Piaget J. The origins of intelligence in children. New York: Norton; 1963.
    1. LeVieux-Anglin L, Sawyer EH. Incorporating play interventions into nursing care. Pediatr Nurs. 1993;19:459–463.
    1. Norris AE, Aroian KJ, Warren S, Wirth J. Interactive performance and focus groups with adolescents: The power of play. Res Nurs Health. 2012;35:671–679. doi: 10.1002/nur.21509.
    1. Frauman A, Gilman C. Creating a therapeutic environment in a pediatric renal unit. ANNA J. 1989;16:20–22.
    1. Erickson F. Reactions of children to hospital experience. Nurs Outlook. 1958;6:501–504.
    1. Wolfer JA, Visintainer MA. Pediatric surgical patients’ and parents’ stress responses and adjustments. Nurs Res. 1975;24:244–255. doi: 10.1097/00006199-197507000-00002.
    1. He HG, Zhu L, Li HCW, Wang W, Vehviläinen-Julkunen K, Chan SW. A randomized controlled trial of the effectiveness of a therapeutic play intervention on outcomes of children undergoing inpatient elective surgery: study protocol. J Adv Nurs. 2014;70:431–442. doi: 10.1111/jan.12234.
    1. Zahr LK. Therapeutic play for hospitalized preschoolers in Lebanon. Pediatr Nurs. 1998;24:449–454.
    1. Carroll J. Evaluation of therapeutic play: a challenge for research. Child Fam Soc Work. 2000;5:11–22. doi: 10.1046/j.1365-2206.2000.00136.x.
    1. Chan EA, Cheung K, Mok E, Cheung S, Tong E. A narrative inquiry into the Hong Kong Chinese adults’ concepts of health through their cultural stories. Int J Nurs Stud. 2006;43:301–309. doi: 10.1016/j.ijnurstu.2005.06.001.
    1. Li WHC. The importance of incorporating cultural issues into nursing interventions for Chinese populations. In: Chien WT, editor. Strategies in evaluation of complex health care interventions for people with physical or mental health issues. New York: Nova Biomedical Book; 2009. pp. 127–137.
    1. Nisbett R. The Geography of Thought: How Asians and Westerners Think Different--and Why. New York: Free Press; 2003.
    1. Li HCW, Chung OKJ, Ho KY, Chiu YS. Effectiveness and Feasibility of using the Computerized Interactive Virtual Space in Reducing Depressive Symptoms of Hong Kong Chinese Children Hospitalized with Cancer. J Spec Pediatr Nurs. 2011;16:190–198. doi: 10.1111/j.1744-6155.2011.00288.x.
    1. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
    1. Dempster M, McCorry NK, Brennan E, Donnelly M, Murray LJ, Johnston BT. Do changes in illness perceptions predict changes in psychological distress among oesophageal cancer survivors? J Health Psychol. 2011;16:500–509. doi: 10.1177/1359105310386633.
    1. Polit DF, Beck CT. Nursing research: Principles and methods. 8. Philadelphia: Lippincott Williams & Wilkins; 2012.
    1. Lara-Muñoz C, Ponce De Leon S, Feinstein AR, Puente A, Wells CK. Comparison of three rating scales for measuring subjective phenomena in clinical research. I. use of experimentally controlled auditory stimuli. Arch Med Res. 2004;35:43–48. doi: 10.1016/j.arcmed.2003.07.007.
    1. Li HCW, Mak YW, Chan SCS, Chu AK, Lee EY, Lam TH. Effectiveness of a play-integrated primary one preparatory programme to enhance a smooth transition for children. J Health Psychol. 2013;18:10–25. doi: 10.1177/1359105311434052.
    1. Davey HM, Barratt AL, Butow PN, Deeks JJ. A one-item question with a Likert or Visual Analog Scale adequately measured current anxiety. J Clin Epidemiol. 2007;60:356–360. doi: 10.1016/j.jclinepi.2006.07.015.
    1. Li HCW, Chung OKJ, Ho KY. Effectiveness of an adventure-based training programme in promoting the psychological well-being of primary schoolchildren. J Health Psychol. 2013;18:1478–1492. doi: 10.1177/1359105312465102.
    1. Li HCW, Lopez V. Development and validation of a short form of the Chinese version of the State Anxiety Scale for Children. Int J Nurs Stud. 2007;44:566–573. doi: 10.1016/j.ijnurstu.2005.12.004.
    1. Li HCW, Wong EML, Lopez V. Factorial structure of the Chinese version of the State Anxiety Scale for Children (short form) J Clin Nurs. 2008;17:1762–1770. doi: 10.1111/j.1365-2702.2008.02284.x.
    1. Li HCW, Lopez V. Children’s Emotional Manifestation Scale: Development and testing. J Clin Nurs. 2005;14:223–229. doi: 10.1111/j.1365-2702.2004.01031.x.
    1. Cohen J. A power primer. Psychol Bull. 1992;112:155–159. doi: 10.1037/0033-2909.112.1.155.
    1. Landreth GL. Play therapy [electronic resource]: the art of the relationship. 3. New York: Brunner-Routledge; 2012.

Source: PubMed

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