El juego como herramienta generadora de bienestar para niños hospitalizados: Una revisión sistemática

La hospitalización es un evento estresante para el niño pues constituye una fuente de tensiones y conflictos debido a la presencia de sentimientos como ansiedad, miedo o dolor. El juego es una parte importante de la vida de los niños, por lo tanto, es necesario garantizar atención integral durante el proceso, incluyendo la posibilidad de jugar. El objetivo de este estudio fue analizar el efecto del juego en niños hospitalizados. Métodos: Se realizó una revisión sistemática. La búsqueda se realizó en PsycInfo, Scopus, Medline y Behavioral Sciences Collection. La ecuación de búsqueda fue "hospitalized children" or "pediatric patients" and "play intervention". La búsqueda se realizó en enero de 2021. Resultados: (n = 41) estudios fueron incluidos en la revisión. Los estudios revelan que la aplicación del juego en niños hospitalizados disminuye el dolor postoperatorio mejora el comportamiento y la actitud, y reduce la ansiedad durante la estancia hospitalaria. Conclusiones: el uso del juego tiene un impacto beneficioso en el cuidado de los niños hospitalizados y se siguiere sea implementado en unidades pediátricas.

Development and feasibility testing of a play-based psychosocial intervention for reduced patient stress in a pediatric care setting: experiences from Pakistan

Background Hospitalization can be a source of great stress for children and their families. In high-income countries, there are specialized staff to help children cope using different techniques including play. However, it is a major challenge in low and middle-income countries (LMIC) due to financial constraints and untrained human resource. The objective of study was to develop and test the feasibility and acceptance of a psychology trainee-delivered model postulated on employing play as a means of enhancing child-parent interactions leading to reduced stress during hospitalization. Methods This study was conducted in the paediatric ward of a tertiary care private hospital in Pakistan. Pre-intervention survey revealed that parental stress stemmed mainly from seeing their child irritable, distressed, or in pain. Using a theory of change model, a play-based psychosocial intervention was developed to address these factors. The intervention approach was informed by principles of Nurturing Care Framework and play therapy. Children between birth and 6 years admitted in the acute care ward were eligible. The intervention was delivered between March 2019 and December 2020 by psychology trainees who were supervised by a clinical psychologist. The play-based sessions were delivered at the bedside and ranged from 20 to 40 min. Parents receiving the intervention were later interviewed for their stress, child emotions, and feedback about the service using structured surveys administered by psychology graduates. The trainees delivering the intervention were requested to provide their feedback as a written qualitative open-ended narrative. These narratives were analyzed using an inductive approach. Results The survey was conducted with 223 families with about half of the sample having children under 2 years of age. Forty-five percent of parents reported play intervention to be one of 3 key factors in improving their experience during hospital stay. Only 5% of parents reported feeling stressed about the child illness after the intervention. Ninety to 96% parents felt respected, listened to, and understood by the therapists. Thematic analysis of the feedback by trainees indicated the internship to be a useful experience and a new avenue for professional life whereas physicians appreciated the interventions. Conclusions The authors conclude that psychology trainees can feasibly deliver a play-based intervention under supervision for reduced stress in children and their parents during hospitalization with mutual benefits.

Co-Composing an Aesthetic Self Through Play: Towards a Transformative Framework for Dementia Care

Background and Objectives Aging and deterioration mark a new phase in many older adults’ life, highlighting the importance of creativity and imagination. This article introduces the implementation of an innovative program, Play Intervention for Dementia (PID), at a nursing home in Hong Kong, with emphasis on its contribution to the conceptual framework for understanding selfhood of older adults with dementia. Research Design and Methods As a community-based participatory action research (CBPAR) project, this study democratized knowledge production by integrating voices of practitioners with diverse backgrounds through video-based methods. Results Play, as an activity replete with free expressions and impulsive interactions, is an ideal realm for exploring and establishing selfhood with older adults with dementia. It has been found that “aesthetic self”, an alternative self emerging from immediate aesthetic experience and carrying transformative power within the caring relationship, is a necessary element of self-construction in life with dementia. Discussion and Implications Integrating theories and practice, this framework provides a new lens for understanding and responding to selfhood, disease, and life.

Feasibility of the Go2Play Active Play intervention for increasing physical and social development in children with intellectual disabilities

Introduction An active play is designed to increase children’s physical activity levels and fundamental movement skills through outdoor play and is well-suited to the needs of children with intellectual disabilities. However, no active play interventions have included children with intellectual disabilities. This study aims to investigate the feasibility of a school-based active play intervention for children with intellectual disabilities. Method Children aged 7–12 years who had intellectual disabilities and were independently ambulatory were eligible. This single-group 17-week intervention was implemented in two additional support needs schools. It consisted of a weekly 1-h active play session incorporating 30 min of structured games and 30 min of free play. Feasibility of recruitment/retention, adherence, and outcome measures were investigated. Outcome measures included school-based physical activity (ActiGraph GT3X+ accelerometer), fundamental movement skills (Test of Gross Motor Development-2), and social interactions (Playground Observation of Peer Engagement). Staff feedback was collected via open-ended questionnaire. Feasibility was investigated using descriptive statistics and questionnaire data analyzed using thematic analysis. Potential pre-post changes were investigated for school-based physical activity, fundamental movement skills, and social interactions using paired samples t tests. The progression criteria were (1) > 50% of eligible participants recruited, (2) > 50% of recruited participants retained, (3) > 50% of active play sessions spent in MVPA, and (4) > 50% of participants complete outcome measurements. Results All progression criteria were met. Recruitment and retention rates were 100% (n=21 participants). Intervention adherence was high, based on data from n=1 school, with 90% of participants attending all sessions. Measuring physical activity using accelerometry and fundamental movement skills using the Test of Gross Motor Development-2 were feasible. The Playground Observation of Peer Engagement tool to measure social interactions was not feasible. The only significant increase post-intervention was for social interactions during structured play (pre–post mean difference: –1.46, 95% CI −1.99, −0.93). Staff feedback was positive with the intervention well received by schools and potential benefits post-intervention identified by teachers. Conclusion The Go2Play Active Play intervention is feasible for children with intellectual disabilities. Future research should further investigate feasibility and implementation on a larger scale using a pilot cluster randomised controlled trial. Trial registration ISRCTN registry: ISRCTN10277566.