Therapeutic Play Intervention Research Articles

The effect of nursing interventions with therapeutic play and video animations prepared with psychodrama technique in reducing fear, anxiety, and pain of children at male circumcision: A randomized controlled study.

This research was carried out to reduce the fear, anxiety and pain of 4-6 age circumcised children with therapeutic play and video animation interventions. This research was conducted as a randomized controlled study between November 2019 and April 2021. Using block randomization, 30 (n = 30) children were assigned to the control group, 30 (n = 30) to the therapeutic puppet group and 30 (n = 30) to the video animation group. Before the circumcision surgery, therapeutic puppet and video animation interventions were applied to children with scenario prepared with psychodrama technique. Fear, anxiety, and pain findings of children before and after surgery were determined. The fear and anxiety scores of the children were similar before the nursing intervention in all groups, and that the fear and anxiety scores of therapeutic puppet play and video animation intervention groups had statistically lower than the control group after nursing intervention. The pain scores of the children from the therapeutic puppet play and video animation groups had lower pain scores than the control group after surgery (F = 5.24, p = 0.007). Therapeutic play and video animation intervention can be effective in reducing fear and anxiety of children aged 4-6 before and after circumcision surgery.

A Therapeutic Play Program for Children Undergoing Kidney Biopsy With Local Anesthesia: Construction and Feasibility Evaluation

PurposeTo construct a therapeutic play program for children undergoing preparation for kidney biopsy under local anesthesia and explore the feasibility of the program from stakeholders’ perspectives. DesignThe program was constructed by a multidisciplinary team and the feasibility and acceptability of the program were explored by a descriptive qualitative study. MethodsBased on Lazarus & Folkman's stress-coping model and Piaget's theory of play, and using on-site participatory field observation, a multidisciplinary team constructed a therapeutic play program for children undergoing kidney biopsy under local anesthesia. The feasibility and acceptability of the program were evaluated by interviewing children, their caregivers, and physicians. FindingsThe main tools constructed for the intervention were a 15-page picture book titled Kidney Biopsy Treasure Hunt and a homemade kidney biopsy play package. The therapeutic play intervention for kidney biopsy under local anesthesia was led by nurses and followed the steps of kidney biopsy, using the picture book, and group play simulation. Through informed in-depth interviews with 10 children and their caregivers, we showed that the therapeutic play program materials were accessible, clinically feasible, and necessary for kidney biopsy under local anesthesia in children. The children and their caregivers had high acceptance of the content of the picture book, the format of the play, and high satisfaction with the overall program. ConclusionsThe therapeutic play program we constructed for children undergoing kidney biopsy with local anesthesia was simple, feasible, and well accepted in the clinical setting.

QOLP-17. GROUP MEDICAL PLAY EFFECTIVELY IMPROVES HOSPITALIZATIONADAPTABILITY OF PEDIATRIC PATIENTS WITH NEUROTUMOR

Abstract OBJECTIVE To explore the effect of group medical games on the hospitalization adaptability of pediatric patients with neuro tumor. METHODS pediatric patients with neuro tumor (age:6 to 13 years) who were treated in hospital from June to December 2019 and were hospitalized for 1 month to 2 months. 29 pediatric patients(mean age:9y) were selected as the control group and treated as usual; 26 pediatric patients(meanage:8y) were selected as the experimental group for group therapeutic play intervention. Interventions last Monday, Wednesday and Friday of each week, with an average duration of one hour. Group medical play include: medical picture book education, medical preview game, emotional games, social table games. Two groups completed self-made questionnaires at the time of admission and two weeks after admission, including: diet, sleep, compliance, and social status, hospital adaptation and other related issues, two groups completed a satisfaction questionnaire after two weeks of admission, recorded analysis and compared the difference of questionnaire data and satisfaction of the two groups of pediatric patients. RESULTS There was no statistical difference in age and sex between the two groups, and there was no significant difference in baseline RESULTS: The re-test results showed that the experimental group was significantly better than the control group in terms of social status, hospital adaptation, compliance and family satisfaction(p＜0.05). CONCLUSION Group medical games can effectively improve the adaptability, compliance and family satisfaction of pediatric with neuro tumor.

Therapeutic play to teach children with type 1 diabetes insulin self-injection: A pilot trial in a developing country.

Child participation in type 1 diabetes (T1D) self-care is needed in developing countries due to a lack of resources, especially during the school day. This pilot study evaluated the feasibility of a therapeutic play intervention (ITP) versus standard education (SE)on the ability of children with T1D to correctly perform insulin injection technique. Children with T1D (7-12 years) were recruited at two diabetes clinics in Brazil and randomized to ITP or SE. Registered nurses received protocol training to deliver the intervention and perform data collection. ITP group received an education that included a story about a child with T1D who self-injects insulin at school; SEgroup received routine clinic-based education. Preintervention, children were video-recorded giving insulin injections to a doll; postintervention, children were rerecorded giving the doll an injection. The research team reviewed the videos and assessed the injection technique using validated checklists. Parents reported children's self-injection practices at baseline and 30 days. Children (N = 20, 40% male) were 9.6 ± 1.3 years old and had T1D for 3.6 ± 2.3 years; HbA1c was 9.1 ± 2.0%; 20% of ITP and 50% of SEchildren used syringes (vs. pens) for injections. At baseline, 80% of both groups knew how to self-inject; most were taught by a parent/relative. Injection technique scores were low in both groups; ITP group increased their scores significantly postintervention. Practices of self-injection did not change in either group after 30 days. The play-based intervention appeared to improve the injection technique in the short-term. Pilot findings support the development of a larger trial to evaluate the effectiveness of ITP on educating children on insulin injections.

The effectiveness of a preoperative multi-component non-pharmacologic preparation on post-tonsillectomy pain: A randomized controlled clinical trial

IntroductionTonsillectomy is a painful operation and some studies have suggested that preoperative non-pharmacologic preparations may decrease postoperative pain. In this randomized clinical trial study, we decided to determine which is more effective in the post-tonsillectomy pain; an informative booklet or a costly, time consuming, sophisticated, and multi-component preparation program. Materials and methodsPatients were randomly assigned into two groups. In the booklet group, children and their parents only received an informative booklet as routine information preparation. On the other hand, in the multi-component group; in addition to receiving the same booklet, children and their parents received our multi-component pre-operative preparation program. The following items were included in the package: preoperative tour in the ward, an educational DVD, and therapeutic play intervention. All patients were observed at least for 8 h as a day case or ambulatory tonsillectomy. The pain score was recorded according to the visual analog scale for seven days. Finally, the post-tonsillectomy pain scores were compared in the two groups. The multi-component group included 121 children and booklet group 120. ResultsMinimum and maximum age was 9 and 12 years. Regarding post-tonsillectomy pain, we found no significant difference between the multi-component group and the booklet group. ConclusionOur data revealed that a new concept which is more cost-effective and concise booklet is as effective as costly and sophisticated methods in post-tonsillectomy pain among 9–12 years old children.

Effects of therapeutic play on children undergoing cast-removal procedures: a randomised controlled trial

ObjectivesTo examine (1) the effectiveness of therapeutic play in reducing anxiety and negative emotional manifestations among children undergoing cast-removal procedures and (2) the satisfaction of parents and cast technicians with...

A mixed-method study of effects of a therapeutic play intervention for children on parental anxiety and parents' perceptions of the intervention.

To examine the effects of a therapeutic play intervention for children on parents' perioperative anxiety, the relationship between parents' and their children's anxiety and to explore parents' perceptions of the intervention. Therapeutic play intervention was found to reduce children's perioperative anxiety. Little is known about how such an intervention for children affects their parents' anxiety. A mixed method of randomized controlled trial with qualitative process evaluation was used. Ninety-five pairs of parents and children were recruited between November 2011-August 2013 and randomized into a control or an intervention group. The State Anxiety Scale for Children and the State Anxiety Scale for Adults were used to measure children's and parents' anxiety, respectively, at baseline, on surgery day and around 24 hours after surgery. Parents were interviewed about their perceptions of the intervention. Data were analysed using SPSS version 22·0 and thematic analysis. There was no difference in parents' anxiety after participating with their child in the intervention compared with usual care. There were significantly positive relationships between parents' and their children's baseline anxiety and parents' postoperative anxiety and their children's pre-operative anxiety. Four themes were identified: reducing anxiety, increasing knowledge and understanding about anaesthetic procedure, the worthiness of attending the intervention and suggestions for improvement of the intervention. Therapeutic play intervention had no significant effect on parents' perioperative anxiety. Parents' and their children's perioperative anxiety are correlated. Parents perceived the intervention as helpful preparation for themselves and for their children undergoing elective surgery.

Therapeutic play intervention on children's perioperative anxiety, negative emotional manifestation and postoperative pain: a randomized controlled trial.

To examine if therapeutic play intervention could reduce perioperative anxiety, negative emotional manifestation and postoperative pain in children undergoing inpatient elective surgery. Children undergoing surgery commonly experience anxiety and postoperative pain and exhibit negative emotional manifestations. Previous studies have shown inconsistent conclusions about the influence of therapeutic play on children's perioperative anxiety, negative emotional manifestation and postoperative pain. A randomized controlled trial was used. Suitable children were recruited from November 2011-August 2013. They were randomized to receive either routine care (control group, n=47) or a 1-hour therapeutic play intervention (experimental group, n=48). Children's state anxiety, negative emotional manifestations and postoperative pain were measured at baseline, on the day of surgery and around 24hours after surgery. Repeated measures analysis of covariance (ancova) and univariate ancova adjusting for all possible confounding factors were used in the data analysis. The time effect of state anxiety was significant, but no group and interaction (group x time) effects between the control and experimental groups were found. Compared with the control group, children in the experimental group demonstrated significantly lower scores of negative emotional manifestations prior to anaesthesia induction and postoperative pain. Therapeutic play intervention is effective in reducing negative emotional manifestations before anaesthesia induction and in reducing postoperative pain in children undergoing inpatient elective surgery. These results suggest that it is useful to give children with therapeutic play intervention prior to inpatient elective surgery.

PSY6 - The Effectiveness Of A Therapeutic Play Intervention On Children’s Perioperative Anxiety And Postoperative Pain: A Randomized Controlled Trial

PSY6 - The Effectiveness Of A Therapeutic Play Intervention On Children’s Perioperative Anxiety And Postoperative Pain: A Randomized Controlled Trial

A randomized controlled trial of the effectiveness of a therapeutic play intervention on outcomes of children undergoing inpatient elective surgery: study protocol

To report a trial protocol to determine if a therapeutic play intervention leads to significant reduction in perioperative anxiety, negative emotional manifestations and postoperative pain of children undergoing inpatient elective surgery and in their parents' perioperative anxiety. Children undergoing surgery often experience anxiety, exhibit negative emotional manifestations pre-operatively and postoperative pain. Previous studies report that therapeutic play intervention has positive effects on anxiety reduction, while few studies have examined the effects of such intervention on children undergoing major elective surgery. Randomized controlled trial with repeated measures is proposed. This study will recruit 106 pairs of 6-14-year-old children undergoing elective surgery in a Singaporean public hospital and their parents (protocol approved in October 2011). Eligible participants will be randomly allocated to either a control group (receiving routine care) or an experimental group (receiving 1-hour therapeutic play intervention plus routine care). Outcome measures include children's anxiety, emotional manifestation and postoperative pain, their parents' anxiety and process evaluation. Data will be collected at baseline (3-7 days before the operation), on the day of surgery and around 24 hours after the surgery. This study will identify a clinically useful and potentially effective approach to prepare children for surgery by reducing anxiety of both children and their parents during the perioperative period. The reduction of anxiety may lead to reduction of postoperative pain, which will eventually improve the physical and psychological well-being of children. This study was funded by the National Medical Research Council in Singapore.

The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well‐being of children hospitalised with cancer

To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer. A non-equivalent control group pretest-post-test, between-subject design was employed. Hong Kong Chinese Children (8-16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14-month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions. The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children's anxiety scores between the two groups on day 7. The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care. The findings heighten the awareness in healthcare professionals that play is a very important part of children's life and that they need play even when they are ill.

Enhancing the efficacy of psychoeducational interventions for paediatric patients in a randomised controlled trial: methodological considerations

This paper described a case study of a randomised controlled trial with the aim to illuminate how the intervention described takes into account the important methodological considerations for enhancing the efficacy of psychoeducational interventions for paediatric patients. Many nursing intervention studies commit a Type II error despite the fact that the intervention is effective. Lack of attention given to the threats of validity of an intervention study may lead to inaccurate inference about the efficacy of the intervention study, thereby precluding any definitive conclusions being drawn. A case study of a randomised controlled trial was described. Two hundred and three Hong Kong Chinese children, admitted for elective surgery, were invited to participate in the study. By using a simple complete randomisation method, 97 children were assigned to the experimental group and received therapeutic play intervention and 106 children were assigned to the control group and received routine information preparation. Children received preoperative therapeutic play intervention experienced lower anxiety levels, fewer negative emotions and lower heart rates and mean arterial blood pressures. This case study illustrates that the more a measure is sensitive to differentiate between the experimental and control groups, the greater the likelihood of documenting intervention efficacy. Besides, the timing of measuring a dependent variable that matches with peak response to an intervention is crucial in evaluating the efficacy of an intervention. Additionally, outcome measures that are sensitive enough to differentiate between the experimental and control groups are extremely important to ensure greater accuracy in evaluating the efficacy of psychoeducational interventions. It is anticipated that designing an effective psychoeducational intervention research design can facilitate the development of holistic and quality care in preparing children for hospitalisation.

Effectiveness and Appropriateness of Therapeutic Play Intervention in Preparing Children for Surgery: A Randomized Controlled Trial Study

This paper aims to examine the effectiveness and appropriateness of using therapeutic play in preparing children for surgery. A randomized controlled trial was employed. Children (7-12 years of age; n = 203) admitted for surgery during a 13-month period were recruited. The results support the effectiveness and appropriateness of using therapeutic play in preparing children for surgery. The study results promote awareness in nurses and parents that play is a very important part of children's lives, and heighten the importance of integrating therapeutic play as an essential component of holistic and quality nursing care to prepare children for surgery.

Orthodontic treatment using maxillary distraction osteogenesis on a patient with cleft soft palate, maxillary hypoplasia, total crossbite and mental retardation

It has been reported that the treatment of patients with mental retardation is difficult because their ability to cooperate with the treatment has been insufficient. This case report describes a successful orthodontic treatment with a maxillary advancement and expansion using distraction osteogenesis in an adult female who was mentally retarded, with the intelligence of a person around 9 years old. She was diagnosed as having an Angle Class III malocclusion with a cleft soft palate, maxillary hypoplasia, total crossbite and a skeletal Class III jaw relationship. This case report indicates an effective application of sympathetic nursing care and therapeutic play intervention to patient's psychological stress symptoms during hospitalization, and the treatment results of maxillary distraction and orthodontic treatment.

Evaluating the effectiveness of preoperative interventions: the appropriateness of using the children's emotional manifestation scale

This study aimed to compare the effectiveness of two preoperative nursing interventions and examining the appropriateness of using the Children's Emotional Manifestation Scale in evaluating the effectiveness of preoperative interventions. There is some evidence that the Children's Emotional Manifestation Scale can be used as an objective assessment tool in documenting children's emotional responses. However, it is uncertain from previous study that whether the scale can be used in evaluating the effectiveness of preoperative interventions. A randomized controlled trial, between subjects design was carried out in a well-established day surgery unit. Children (7-12 years of age; n = 203) admitted for elective day surgery during a 13-month period, were recruited. By using a simple randomization method, 97 of children were assigned to the experimental group receiving therapeutic play intervention and 106 children were assigned to the control group receiving routine information preparation. Children receiving therapeutic play preparation reported statistically significant lower anxiety levels, fewer negative emotions and lower heart rates and mean arterial blood pressures than children receiving information preparation. Children with high preoperative anxiety levels manifested more negative emotional behaviour during anaesthesia induction and were associated with faster heart rates and higher mean blood pressures. The study demonstrates the appropriateness of using the Children's Emotional Manifestation Scale in evaluating the effectiveness of preoperative nursing interventions and presents clear evidence to support the effectiveness of therapeutic play intervention in preparing children for surgery when compared with the information preparation approach. This study contributes towards enriching the experience of using child-sensitive research tools in evaluating the effectiveness of preoperative nursing interventions. The findings heighten the awareness of the importance of integrating therapeutic play as an essential component of holistic and quality nursing care to prepare children for surgery.

Psychoeducational preparation of children for surgery: The importance of parental involvement

Objective: To examine the effects of therapeutic play intervention on outcomes of children undergoing day surgery, and to highlight the importance of parental involvement in the psychoeducational preparation of children for surgery. Methods: A randomized controlled trial, two group pre-test and repeated post-test, between subjects design was employed. Hong Kong Chinese children (7–12 years of age; n = 203) admitted for elective surgery in a day surgery unit, along with their parents during a 13-month period, were invited to participate in the study. By using a simple complete randomization method, 97 of children with their parents were assigned to the experimental group receiving therapeutic play intervention, and 106 children with their parents were assigned to the control group receiving routine information preparation. Results: The results showed that both children and their parents in the experimental group reported lower state anxiety scores in pre- and postoperative periods. Children in the experimental group exhibited fewer instances of negative emotional behaviors and parents in the experimental group reported greater satisfaction. The results, however, find no differences in children’s post-operative pain between the two groups. Conclusion: The study provides empirical evidence to support the effectiveness of using therapeutic play intervention and the importance of parental involvement in the psychoeducational preparation of children for surgery. Practice implications: The findings heighten the awareness of the importance of integrating therapeutic play and parental involvement as essential components of holistic and quality nursing care to prepare children for surgery. # 2006 Elsevier Ireland Ltd. All rights reserved.

Psychoeducational preparation of children for surgery: The importance of parental involvement

Objective To examine the effects of therapeutic play intervention on outcomes of children undergoing day surgery, and to highlight the importance of parental involvement in the psychoeducational preparation of children for surgery. Methods A randomized controlled trial, two group pre-test and repeated post-test, between subjects design was employed. Hong Kong Chinese children (7–12 years of age; n = 203) admitted for elective surgery in a day surgery unit, along with their parents during a 13-month period, were invited to participate in the study. By using a simple complete randomization method, 97 of children with their parents were assigned to the experimental group receiving therapeutic play intervention, and 106 children with their parents were assigned to the control group receiving routine information preparation. Results The results showed that both children and their parents in the experimental group reported lower state anxiety scores in pre- and post-operative periods. Children in the experimental group exhibited fewer instances of negative emotional behaviors and parents in the experimental group reported greater satisfaction. The results, however, find no differences in children's post-operative pain between the two groups. Conclusion The study provides empirical evidence to support the effectiveness of using therapeutic play intervention and the importance of parental involvement in the psychoeducational preparation of children for surgery. Practice implications The findings heighten the awareness of the importance of integrating therapeutic play and parental involvement as essential components of holistic and quality nursing care to prepare children for surgery.