Play has proven to play an extremely important factor in the psychosocial needs of hospitalized children. The findings of studies conducted by Al-Yateem and Rossiter (2016), and Silva et al. (2017) are examined in this paper. The former study reports that unstructured play had a significant result in decreasing the anxiety of children who have been hospitalized, while the former examines the effects of Dramatic Therapeutic Play and findings show not real significance among their participants. This paper will also look into the importance that medical play and doll play have on the psychosocial elements of children with chronic illness, such as the value that play has on preparing children for invasive procedures.
Implications of the study are highlighted along with considerations for the awareness of the importance of play in healthcare and hospital settings.
Hospitalization for a chronic illness can be terrifying for anyone, but it can be especially traumatizing to children. We have come a long way with our medical practices regarding children, from exiling ill children to boats to suffer in isolation, to understanding the process of emotions and attachment according to Bowlby’s historic findings. However, one thing remains the same; the fact that a hospital can be a scary place to children, filled with sick patients and doctors with needles. To calm their fright and ease their transition, children require assistance for a number of different elements, one of which would be allowing them to explore and manage through play. While play not seem like such an important aspect to a child’s health and healing process, studies are being conducted that examine the importance of play and the impact is has on a child’s restorative process.
Children who are hospitalized for chronic illnesses face a extreme change in their lives. They experience a change in their environment, in their daily routines, and their social lives as well. These children are suddenly thrust into a world that is uncomfortable and scary for them, which causes a lot of stress and anxiety, something that play can be critical in helping reduce. A study was conducted in United Arab Emirates on the effect that unstructured play has on the stress and anxiety of hospitalized children (Al-Yateem & Rossiter, 2016). A sample size of 165 children were chosen, and participants were divided into a control group, who received regular care, and an experimental group, who were presented with toys and games to engage with (Al-Yateem & Rossiter, 2016).
The study took place over 3 days of hospitalization, and results demonstrated a substantial difference between the control group and the experimental group. The children who were given the opportunity to explore through unstructured play showed much lower levels of anxiety than those who just received regular care, deducting that play actually did reduce anxiety for hospitalized children (Al-Yateem & Rossiter, 2016). As demonstrated by this study, having play integrated into the daily routines and life of hospitalized children can have significant positive impacts on children’s moods and attitudes toward their illness.
Play can be helpful tool when trying minimize the stress and anxiety about hospitalization and disease. A Study conducted by Silva et al. (2017) examines the therapeutic effects that play could have on children who have been hospitalized. The article discusses Therapeutic Play Technique, a method that is thought to reduce emotional distress and aid physical health as well (Silva et al. , 2017).
The focus of this study was primarily on Dramatic Therapeutic Play (DTP) in hospitals, which is a structured type of play revolving around role-playing and pretend play (Silva et al. , 2017). This type of play can be used as an outlet for children as it allows them the opportunity for free and emotional expression of thoughts and feelings. Participants of this study consisted of 28 children from two hospitals in São Paulo. While the results showed that 75% percent of children within the study had low anxiety levels, that was for both the control and intervention groups (Silva et al. , 2017).
Therefore, their study exhibited no significant difference between children who received DTP and those who did not, implying that DTP may not have as much of a significant effect on anxiety as much as free, unstructured play on its own (Silva et al. , 2017). However, researchers did propose that, perhaps if the sample size was larger than what they had, more accurate results could be obtained (Silva et al. , 2017). Medical Play Children hospitalized for chronic illnesses, more often than not, have no control over the situations they are in regarding how long their stay at the hospital is, the course of treatment, where they go, and what they do.
This absence of control leaves many children feeling vulnerable and helpless (Li et al. , 2016). Play gives children the opportunity to recreate what is going on in their lives, and give themselves some of that control back, allowing them to cope with feelings of unease towards their illness (Burns-Nader & Hernandez-Reif, 2016). Specifically, medical play allows for children to address particular concerns and anxieties about treatments and procedures, which can put them at ease when preparing and going through those processes (Koller, 2018). This also gives them a sense of control over their situation by allowing them to understand what is happening and what is going to happen to them, preparing them for invasive, uncomfortable procedures (Koller, 2018). During medical play, children have the opportunity to experiment with some tools and supplies that may be used on them, such as a stethoscope or thermometer. Through this interactive play, children can gain an understanding of how it will be used on them, which can ease anxiety and allow them to familiarize themselves with tools that will be around them often (Burns-Nader & Hernandez-Reif, 2016). Doll Play
Playing with dolls is another form of medical play that can be beneficial for children. Doll play gives children, or even the doctor or member of the medical team the opportunity to act out and demonstrate certain steps or operations on a doll (Koller, 2018). Playing doctor is another way that children can cope by using dolls. For example, if a child is particularly nervous about needles, perhaps they can take a turn being the doctor by administering needles on the doll, after which they may be more content to receive a needle, or more understanding as to why they need to receive one (Koller, 2018).
There are so many aspects of medical play that can really be crucial to easing anxiety and stress in hospitalized children, which is why medical play is often considered the play of choice (Koller, 2018). ImplicationsAs found in the above research, play has a strong impact on the psychosocial aspects of hospitalized children, particularly in regards to anxiety and stress. Studies conducted by Silva et al. (2017), Yateem and Rossiter (2016), and Li et al. (2016), had a participants from a large range of ages, no younger than 3 and no older than 12 years of age overall. While these are broad age ranges, it still limits the results for younger children and toddlers, as well as young teens, making the findings less plausible for these other ages, and therefore a less valid finding for all ages. As for future prospects, there seems to be a strong importance of medical play on children.
As shown by Li et al. (2016), implementing play into hospital routines can be beneficial in easing anxiety in children. While Burns-Nader and Hernandez-Reif (2016) discussed using medical supplies such as stethoscopes and thermometers in medical play, Koller (2018) suggests that implementing the use of actual medical equipment such as needles and intravenous tubes would be most efficient for children who may be having a difficult time coping.
The effect that play can have on hospitalized children is remarkable. The studies examined in this paper highlight the importance that different types of play can have on a child’s well-being. From completely unstructured play, to dramatic and medical play, there are many options that give children the sense of control that they need to feel comfortable in understanding their diagnoses, and the approaches being taken with their treatments. We have made great advances in our methods to understanding the psychosocial needs of children with chronic illness, and promoting a greater understanding of the developments as discussed is critical in all areas of managing chronic illnesses in children.
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