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Published in: BMC Pediatrics 1/2016

Open Access 01-12-2016 | Research article

Play interventions to reduce anxiety and negative emotions in hospitalized children

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

Published in: BMC Pediatrics | Issue 1/2016

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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.
Literature
1.
go back to reference 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.CrossRef 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.CrossRef
2.
go back to reference Fernandes SC, Arriaga P. The effects of clown intervention on worries and emotional responses in children undergoing surgery. J Health Psychol. 2010;15:405–15.CrossRefPubMed Fernandes SC, Arriaga P. The effects of clown intervention on worries and emotional responses in children undergoing surgery. J Health Psychol. 2010;15:405–15.CrossRefPubMed
3.
go back to reference Li HCW, Lopez V, Lee TLI. Effects of preoperative therapeutic play on outcomes of school-age children undergoing day surgery. Res Nurs Health. 2007;30:320–32.CrossRef Li HCW, Lopez V, Lee TLI. Effects of preoperative therapeutic play on outcomes of school-age children undergoing day surgery. Res Nurs Health. 2007;30:320–32.CrossRef
4.
go back to reference Lohaus A, Klein-Hessling J, Ball J, Wild M. The prediction of health-related in behavior in elementary school. J Health Psychol. 2004;9:375–9.CrossRefPubMed Lohaus A, Klein-Hessling J, Ball J, Wild M. The prediction of health-related in behavior in elementary school. J Health Psychol. 2004;9:375–9.CrossRefPubMed
5.
go back to reference Erikson E. Childhood and society. 2nd ed. New York: W. W. Norton & Company; 1963. Erikson E. Childhood and society. 2nd ed. New York: W. W. Norton & Company; 1963.
6.
go back to reference Piaget J. The origins of intelligence in children. New York: Norton; 1963. Piaget J. The origins of intelligence in children. New York: Norton; 1963.
7.
go back to reference LeVieux-Anglin L, Sawyer EH. Incorporating play interventions into nursing care. Pediatr Nurs. 1993;19:459–63.PubMed LeVieux-Anglin L, Sawyer EH. Incorporating play interventions into nursing care. Pediatr Nurs. 1993;19:459–63.PubMed
9.
go back to reference Frauman A, Gilman C. Creating a therapeutic environment in a pediatric renal unit. ANNA J. 1989;16:20–2.PubMed Frauman A, Gilman C. Creating a therapeutic environment in a pediatric renal unit. ANNA J. 1989;16:20–2.PubMed
10.
go back to reference Erickson F. Reactions of children to hospital experience. Nurs Outlook. 1958;6:501–4.PubMed Erickson F. Reactions of children to hospital experience. Nurs Outlook. 1958;6:501–4.PubMed
11.
go back to reference Wolfer JA, Visintainer MA. Pediatric surgical patients’ and parents’ stress responses and adjustments. Nurs Res. 1975;24:244–55.CrossRefPubMed Wolfer JA, Visintainer MA. Pediatric surgical patients’ and parents’ stress responses and adjustments. Nurs Res. 1975;24:244–55.CrossRefPubMed
12.
go back to reference 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;70:431–42.CrossRefPubMed 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;70:431–42.CrossRefPubMed
13.
go back to reference Zahr LK. Therapeutic play for hospitalized preschoolers in Lebanon. Pediatr Nurs. 1998;24:449–54.PubMed Zahr LK. Therapeutic play for hospitalized preschoolers in Lebanon. Pediatr Nurs. 1998;24:449–54.PubMed
14.
go back to reference Carroll J. Evaluation of therapeutic play: a challenge for research. Child Fam Soc Work. 2000;5:11–22.CrossRef Carroll J. Evaluation of therapeutic play: a challenge for research. Child Fam Soc Work. 2000;5:11–22.CrossRef
15.
go back to reference 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;43:301–9.CrossRefPubMed 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;43:301–9.CrossRefPubMed
16.
go back to reference 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. p. 127–37. 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. p. 127–37.
17.
go back to reference Nisbett R. The Geography of Thought: How Asians and Westerners Think Different--and Why. New York: Free Press; 2003. Nisbett R. The Geography of Thought: How Asians and Westerners Think Different--and Why. New York: Free Press; 2003.
18.
go back to reference 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;16:190–8.CrossRefPubMed 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;16:190–8.CrossRefPubMed
19.
go back to reference Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
20.
go back to reference 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;16:500–9.CrossRefPubMed 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;16:500–9.CrossRefPubMed
21.
go back to reference Polit DF, Beck CT. Nursing research: Principles and methods. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. Polit DF, Beck CT. Nursing research: Principles and methods. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
22.
go back to reference 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;35:43–8.CrossRefPubMed 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;35:43–8.CrossRefPubMed
23.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
24.
go back to reference 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;60:356–60.CrossRefPubMed 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;60:356–60.CrossRefPubMed
25.
go back to reference 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;18:1478–92.CrossRefPubMed 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;18:1478–92.CrossRefPubMed
26.
go back to reference 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;44:566–73.CrossRefPubMed 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;44:566–73.CrossRefPubMed
27.
go back to reference 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;17:1762–70.CrossRefPubMed 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;17:1762–70.CrossRefPubMed
28.
go back to reference Li HCW, Lopez V. Children’s Emotional Manifestation Scale: Development and testing. J Clin Nurs. 2005;14:223–9.CrossRefPubMed Li HCW, Lopez V. Children’s Emotional Manifestation Scale: Development and testing. J Clin Nurs. 2005;14:223–9.CrossRefPubMed
30.
go back to reference Landreth GL. Play therapy [electronic resource]: the art of the relationship. 3rd ed. New York: Brunner-Routledge; 2012. Landreth GL. Play therapy [electronic resource]: the art of the relationship. 3rd ed. New York: Brunner-Routledge; 2012.
Metadata
Title
Play interventions to reduce anxiety and negative emotions in hospitalized children
Authors
William H. C. Li
Joyce Oi Kwan Chung
Ka Yan Ho
Blondi Ming Chau Kwok
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2016
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-016-0570-5

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