Play Interventions to Reduce Anxiety and Negative Emotions in Hospitalized Children
Condition: Anxiety
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      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. 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.
    

Detailed description: 
      This study tested the effectiveness of play interventions to reduce anxiety and negative
      emotions in hospitalized children.

      Intervention

      Placebo control group

      In the control group, children received standard medical and nursing care, such as vital
      signs observation, pharmacological treatment and wound and pain management.

      Experimental group

      In the experimental group, participants received around 30 minutes of hospital play
      interventions each day, conducted by hospital play specialists. The interventions in this
      study consisted of structured and non-structured activities. All these activities were given
      at the patients' bedside, with or without parental supervision, either once or spreading over
      an hour, depending on the ward routine.

      Data Collection Methods

      Approval for the study was obtained from the hospital ethics committees. A research assistant
      collected demographic data from the parents and from the children's medical records after
      obtaining the consent form. The children's baseline anxiety levels were also documented. For
      the experimental group, the interventions started after the baseline data had been collected.
      The emotional behaviour of each child was observed by a research assistant for two
      consecutive days, at the end of which a research assistant documented the child's overall
      emotional behaviour, using the CEMS. The child's anxiety levels were reassessed and
      documented.

      Analysis

      The Statistical Package for Social Science (SPSS) software, version 20.0 for Windows was used
      for the data analysis. Descriptive statistics were used to calculate the means, standard
      deviations, and ranges of the scores on the various scales. The homogeneity of the two groups
      was examined using inferential statistics (independent t-test and chi-squared). The
      interrelationships among the scores on the different scales and the demographic variables
      were assessed using the Pearson product-moment correlation coefficient. Differences in the
      mean scores on the CEMS and the children's anxiety levels between the two intervention groups
      were investigated by an independent t-test and mixed between-within subjects ANOVA,
      respectively. Multiple regression analysis was performed to examine the effects of
      participants' demographic and clinical characteristics on the outcome measures.
    

Intervention name(s): Play intervention; control
Intervention type(s): Other; Other
Intervention description(s): participants received around 30 minutes of hospital play interventions each day, conducted by hospital play specialists. Such interventions consisted of structured and non-structured activities. All these activities were given at the patients' bedside, with or without parental supervision, either once or spreading over an hour, depending on the ward routine.; Children received standard medical and nursing care, such as vital signs observation, pharmacological treatment and wound and pain management as a control treatment
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care