Play Intervention Applied to Hospitalized Children: Effects on Anxiety and Medical Fear
Keywords:
State anxiety, Trait anxiety, medical fear, intravenous cannulation, blood sampleAbstract
OBJECTIVE: To ease the anxiety and medical fear before intravenous cannulation or blood collection procedures among hospitalized children.
METHODOLOGY: This study employed a pre-test, post-test quasi-experimental design during June to August 2023 from the hospital paediatric medicine ward. Sixty school-aged children (aged 6-12) were chosen through purposive sampling. The control group's data was collected first, followed by a play intervention for the experimental group. Both groups were similar in size. Baseline data on children and parents was gathered using the State-Trait Anxiety Inventory and the Children's Fear Scale.
RESULTS: The children participating in the intervention had a mean age of 9.23±1.65. Notably, a significant portion of both groups experienced respiratory illnesses, with a higher prevalence observed in the control group (33.3%) compared to the intervention group (26.6%). A three-day play intervention significantly improved outcomes for hospitalized children (p<0.001). It helped them manage anxiety both in the general sense (trait anxiety) and specifically related to medical procedures (p<0.001) such as inserting intravenous catheters (IVs) or drawing blood. The study also found a strong correlation between a child's overall anxiety level and their anxiety around medical procedures (r 0.49, p=0.000).
CONCLUSION: Play intervention had a positive impact on state anxiety, trait anxiety and fear about intravenous cannulation or blood collection procedures. Pediatric nurses and parents working together to incorporate play is one of the most important aspects of a child's hospitalization. This approach focuses on improving health outcomes by making play a part in the healing process.
References
William Li HC, Lopez V, Lee TL. Effects of preoperative therapeutic play on outcomes of school-age children undergoing day surgery. Res Nurs Health. 2007; 30(3): 320-32. doi: 10.1002/nur.20191.
Dehghan Z, Reyhani T, Mohammadpour V, Aemmi SZ, Shojaeian R, Nekah SMA. The effectiveness of dramatic puppet and therapeutic play in anxiety reduction in children undergoing surgery: a randomized clinical trial. Iran Red Crescent Med J. 2017; 19(3): 1-8. doi: 10.5812/ircmj.41178.
Francischinelli AGB, Almeida FA, Fernandes DMSO. Routine use of therapeutic play in the care of hospitalized children: nurses' perceptions. Acta Paul Enferm. 2012; 25(1): 18-23.
Mathias EG, Pai MS, Guddattu V, Bramhagen A-C. Non-pharmacological interventions to reduce anxiety among children undergoing surgery: A systematic review. J Child Health Care. 2023; 27(3): 466-487. doi: 10.1177/13674935211062336. Epub 2022 Jan 31.
Delvecchio E, Salcuni S, Lis A, Germani A, Di Riso D. Hospitalized children: anxiety, coping strategies, and pretend play. Front Public Health. 2019; 7: 250. doi: 10.3389/fpubh.2019.00250.
Frauman AC, Gilman CM. Creating a therapeutic environment in a pediatric renal unit. ANNA J. 1989 Feb; 16(1): 20-2, 26.
Koukourikos K, Tzeha L, Pantelidou P, Tsaloglidou A. The importance of play during hospitalization of children. Mater Sociomed. 2015; 27(6): 438-441. doi: 10.5455/msm.2015.27.438-441.
Court H, Greenland K, Margrain TH. Predicting state anxiety in optometric practice. Optom Vis Sci. 2009; 86(11): 1295-302. doi: 10.1097/OPX.0b013e3181bb4212.
Li WHC, Chung JOK, Ho KY, Kwok BMC. Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Paediatric. 2016; 16: 36. doi: 10.1186/s12887-016-0570-5.
Ibrahim HA, Arbiyaningsih, Amal AA, Huriati. The Effectiveness of Play Therapy in Hospitalized Children with Cancer: Systematic Review. J Nursing Pract. 2020; 3(2): 233-243. Doi: 10.30994/jnp.v3i2.92.
William Li HC, Lopez V, Lee TLI. Effects of preoperative therapeutic play on outcomes of school-age children undergoing day surgery. Res Nurs Health. 2007; 30(3): 320-332. doi: 10.1002/nur.20191.
Potasz C, Varela MJ, Carvalho LC, Prado LF, Prado GF. Effect of play activities on hospitalized children's stress: a randomized clinical trial. Scand J Occup Ther. 2013; 20(1): 71-9. doi: 10.3109/11038128.2012.729087. Epub 2012 Oct 18.
Karimi H, Masoudi Alavi N. Florence Nightingale: The Mother of Nursing. Nurs Midwifery Stud. 2015; 4(2): e29475. doi: 10.17795/nmsjournal29475.
Goktas N, Avci D. The effect of visual and/or auditory distraction techniques on children's pain, anxiety and medical fear in invasive procedures: A randomized controlled trial. J Pediatr Nurs. 2023; 73: e27-e35. doi: 10.1016/j.pedn.2023.07.005. Epub 2023 Jul 15.
Landreth GL. Play therapy [electronic resource]: the art of the relationship. 3rd ed. New York: Brunner-Routledge; 2012.
Liu MC, Chou FH. Play effects on hospitalized children with acute respiratory infection: an experimental design study. Biol Res Nurs. 2021; 23(3): 430-441. doi: 10.1177/1099800420977699. Epub 2020 Dec 17.
Sarman A, Günay U. The effects of goldfish on anxiety, fear, psychological and emotional well-being of hospitalized children: A randomized controlled study. J Pediatr Nurs. 2023; 68: e69-e78. doi: 10.1016/j.pedn.2022.11.012. Epub 2022 Nov 18.
Allen R. Free improvisation and performance anxiety among piano students. Psychol Music. 2013; 41(1): 75-88. doi: 10.1177/0305735611415750.
Olsen O, Sjøhaug M, Van Beekvelt M, Mork PJ. The effect of warm-up and cool-down exercise on delayed onset muscle soreness in the quadriceps muscle: a randomized controlled trial. J Hum Kinet. 2012; 35(1): 59-68. doi: 10.2478/v10078-012-0079-4. Epub 2012 Dec 30.
Li WH, Kwok MB. Effectiveness of Therapeutic Play in Minimizing Anxiety and Negative Emotions of Hong Kong Chinese Hospitalized Children. University of Hong Kong School of Nursing [Internet Report]. 2014. Available from: https://www.playright.org.hk/wp-content/uploads/2018/12/2014-Final-Report_Playright.pdf.
Ezz HA, Shama AA, Eloraby MA. Postoperative analgesia of ultrasound-guided rectus sheath catheters versus continuous wound catheters for colorectal surgery: a randomized clinical trial. Egypt J Anaesthesia. 2016; 32(3): 375-83. doi: 10.1016/j.egja.2016.02.001.
Zamani M, Sigaroudi AE, Pouralizadeh M, Kazemnejad-Leili E. Effect of the Digital Education Package (DEP) on prevention of anxiety in hospitalized children: a quasi-experimental study. BMC Nurs. 2022; 21(1): 1-8. doi: 10.1186/s12912-022-01113-8.
Ugucu G, Uysal DA, Polat OG, Artuvan Z, Kulcu DP, Aksu D, Altintas MG, Cetin H, Temel GO. Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6–8 years: A randomized experimental study. J Pediatr Nurs. 2022; 65: e107-e114. doi: 10.1016/j.pedn.2022.03.016. Epub 2022 Apr 8.
McMurtry CM, Noel M, Chambers CT, McGrath PJ. Children's fear during procedural pain: Preliminary investigation of the Children's Fear Scale. Health Psychol. 2011; 30(6): 780-8. doi: 10.1037/a0024817. Epub 2011 Aug 1.
A?kan F, Bakar DL. The Effect of Hand Massage on Preoperative Anxiety Level and Hemodynamic Variables in Children: A Randomized Controlled Trial. J PeriAnesth Nurs. 2023; 38(5): 773-781. doi: 10.1016/j.jopan.2023.01.013. Epub 2023 Jul 15.
Ayan G, ?ahin ÖÖ. Effect of therapeutic play-based training program on pre-and postoperative anxiety and fear: A study on circumcision surgery in Turkish Muslim children. J Pediatr Urology. 2023; 19(4): 431.e1-431.e9. doi: 10.1016/j.jpurol.2023.04.032.
Akca SO, Gozen D, Akpinar YY. The effects of pre-op training on the anxiety levels of children in Corum/Turkey. Rev Assoc Med Bras (1992). 2015; 61(2): 121-5. doi: 10.1590/1806-9282.61.02.121.
Simsek DC, Sahinoglu M. Stress-Relieving Effects of Colour-by-Number Mandalas in Children Hospitalized due to a Chronic Disease. Gevher J Med Health Sci. 2023; 8(1): 220-227. doi: 10.5281/zenodo.7602648.
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