The effectiveness of play therapy in children with leukemia: A systematic review

Play-based training program for overcoming hospital fear in children

PURPOSE

Whether or not they have had medical procedures in hospitals before, children experience fear of medical procedures performed in hospitals or in general. These children need to be given information about the medical procedures or general procedures performed in the hospital in an effective way through different methods. One of these methods is play. This study aims to determine the effect of play-based training program on the fear of medical procedures in healthy children aged 7-12 years.

DESIGN AND METHODS

The research was conducted in an intervention with the control group. The study was conducted with 120 children who met the inclusion criteria in two different primary and secondary schools in Türkiye. Training was given to 60 children in the intervention group for four weeks. Data were collected from both groups using the Medical Procedures Fear Scale at three different stages: pre-training, post-training, and follow-up. Analyses were performed using the SPSS 25 program.

RESULTS

It was observed that the control group's post-test and follow-up test medical procedure fear score was greater than that of the intervention group (p < 0.05). Intervention group's post-test and follow-up test medical procedure fear score was more significant than the pre-test (p < 0.05).

CONCLUSION

Play-based hospital fear overcoming training is a method that reduces the fear of medical procedures in healthy children aged 7-12 years. It may benefit children if these training practices are carried out in schools with the co-operation of healthcare professionals.

PRACTICAL IMPLICATIONS

Play-based training programs can be implemented in various healthcare settings to reduce children's fear of medical procedures and improve their overall well-being through collaboration among healthcare professionals and community organizations.

The effectiveness of play therapy on depression and anxiety in hospitalized children with cancer: a systematic review

BACKGROUND

The presence of cancer and its treatment will induce anxiety and various effects, not only on a physical level but also on a psychological level. Play therapy can be used by children to articulate their emotions and foster proficient communication with healthcare professionals and caregivers. Play therapy emerges as a highly effective method for the management of illness in children diagnosed with cancer.

MATERIAL AND METHODS

A thorough search was conducted across multiple databases including PubMed, Web of Science, Scopus, Google Scholar, and Cochrane Library. Our review included only interventional studies published from inception to 1 March 2024 that investigated the impact of play therapy on depression and anxiety in hospitalized children with cancer. For each study, information was gathered regarding the study's objective, participant characteristics, conditions, intervention details, comparisons made, study duration, and outcome measures.

RESULTS

Following the retrieval of 2158 records, 12 studies were found to meet the eligibility criteria and were thus selected to include in the synthesis. Play therapy has been explored in several studies using interventions like cognitive-behavioral-based play therapy, family-based play therapy, group-based play therapy, virtual reality-based play therapy, and play therapy combined with other therapeutic approaches. Specifically, six studies investigated the effects of play therapy on anxiety, two studies on depression, and four studies on anxiety and depression.

CONCLUSION

Play therapy is highly recommended due to its simplicity, minimal requirement of tools and materials, ease of implementation, affordability, and suitability for hospitalized preschool and school-age children with cancer.

Cognitive-Behavioral Intervention for Children With Hematological Cancer Receiving Chemotherapy: A Randomized Controlled Trial

OBJECTIVE

Cognitive-behavioral intervention (CBI) has shown positive effects in improving psychological and health-related outcomes in children with cancer. However, no evidence has been found in Ethiopia. This study aimed to evaluate the effects of CBI on anxiety, depression and quality of life (QoL) in Ethiopian children with hematological cancer receiving chemotherapy.

METHODS

A parallel, two-armed, assessor-blinded, randomized controlled trial was conducted among 76 children randomized (1:1) to receive CBI or usual medical care. The intervention group received five weekly face-to-face CBI sessions of 30-40 min each, which included an introduction to CBI; identifying and challenging maladaptive thoughts, beliefs and behavior; behavior activation; deep breathing exercises; and treatment evaluation and relapse prevention. The outcomes were measured at baseline (T0), immediately post-intervention (T1) and 1 month post-intervention (T2).

RESULTS

The intervention group showed a significant reduction in anxiety scores from T0 at T1 (β = -6.67, 95% CI [-9.16, -4.19], p < 0.001) and T2 (β = -8.14, 95% CI [-10.70, -5.57], p < 0.001), depression at T1 (β = -4.09, 95% CI [-6.94, -1.23], p = 0.005) and T2 (β = -6.12, 95% CI [-9.10, -3.13], p < 0.001) and improvement in QoL at T2 (β = 3.02, 95% CI [0.49, 5.56], p = 0.019) compared with the control group.

CONCLUSIONS

CBI has positive effects in reducing anxiety and depression and in improving QoL in children with hematological cancer receiving chemotherapy. The results suggest the need to incorporate CBI into pediatric hematology-oncology and studies on its long-term effects and cost-effectiveness are warranted.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT05270655). Registered on 08 March 2022.

Effect of toys made from medical materials on anxiety among hospitalized children: A randomized controlled trial

PURPOSE

This study was conducted as a randomized controlled trial to examine the effect of toys made from medical materials on anxiety among hospitalized children.

DESIGN AND METHODS

This study was conducted with pediatric patients aged 4-6 years who were hospitalized in the pediatrics department of a teaching and research hospital in the Southeastern Anatolia Region. The study was completed with 90 children, allocated to the toys made of medical materials group (45) and the control group (45). Children, in the toys made of medical materials group, were given medical materials and asked to make toys. The anxiety levels of children in both the toys made of medical materials and control groups were assessed using the Children's State Anxiety (CSA) scale.

RESULTS

Analysis based on children's self-reports revealed a significant reduction in the post-test anxiety scores of children in the toys made of medical materials group. No significant difference was observed in the anxiety scores of children in the control group. In the comparison between groups based on mothers' reports, it was found that the post-test anxiety scores of children in the toys made of medical materials group were significantly lower than those of children in the control group.

CONCLUSIONS

Our study found that toys made from medical materials were effective in reducing children's anxiety.

PRACTICE IMPLICATIONS

Healthcare workers can relieve children's anxieties by making toys using medical materials that are easily accessible in the clinic.

The effect of drama on psychosocial problems and emotional states of hospitalized children with cancer

BACKGROUND AND PURPOSE

Hospitalization is a traumatic experience for children. Especially in the case of childhood cancers that require long-term hospitalization, children need psychosocial support. The study aimed to examine the effectiveness of drama in reducing psychosocial problems in hospitalized paediatric children diagnosed with cancer.

METHODS

The study used a mixed method approach, combining both qualitative and quantitative methods with a single group. Drama sessions prepared according to the Tasks and Skills Model were used to support their psychosocial conditions. The Facial Expression Form, The Assessment Scale for Psychosocial Symptoms in Hospitalized Children, and the Drawing and Writing Technique were used before and after the drama sessions.

RESULTS

This study differs from others in its use of drama intervention to reduce psychosocial problems in children undergoing cancer treatment. As a result of the study, it was found that there was a decrease in anxiety, hopelessness, anger-aggression and communication difficulties among psychosocial problems and a change in mood towards feeling happy. The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients.

CONCLUSION

The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients.

PRACTICE IMPLICATIONS

Applying drama to children undergoing long-term hospital treatment can help alleviate psychosocial problems by reducing stress, emotional suppression, and compensating for trauma.