ObjectivePlay is a non-invasive, safe and inexpensive intervention that can help paediatric patients and their families manage difficult aspects of being ill or hospitalised. Although play has ...existed in hospitals for decades, research on hospital play interventions is scarce. This review aimed to categorise and synthesise the last 20 years of research on hospital play interventions.DesignScoping review.Data sourcesPubMed, CINAHL, CENTRAL, ERIC and PsycINFO (1 January 2000– 9 September 2020).Study selection and data extractionWe systematically searched for original peer-reviewed articles, written in English, on hospital play interventions in paediatric patients (0–18 years) in non-psychiatric settings. Two reviewers independently screened titles and abstracts, reviewed full text of relevant articles and extracted data. We thematically synthesised the data from the included studies, and a descriptive analysis, based on a developed framework, is presented.ResultsOf the 297 included articles, 78% came from high-income countries and 56% were published within the last 5 years. Play interventions were carried out across all ages by various healthcare professionals. Play interventions served different roles within four clinical contexts: A) procedures and diagnostic tests, B) patient education, C) treatment and recovery and D) adaptation. Across these contexts, play interventions were generally facilitated and purpose-oriented and had positive reported effects on pain, stress, and anxiety.ConclusionsPlay in hospitals is an emerging interdisciplinary research area with a significant potential benefit for child and family health. Future research should further describe principles for play in hospitals. High-quality studies investigating short-term and long-term effects are needed to guide when and how to best integrate play in hospitals.
Families of children and adolescents with cancer strive to maintain routines and normalcy during the child's treatment trajectory that requires frequent hospital visits. Intravenous chemotherapy at ...home can reduce time spent on the frequent hospital visits and mitigate disruption in daily life. Studies on home chemotherapy for children and adolescents with cancer are limited, as is knowledge of family and health care professionals' needs, and knowledge required to inform adaptation or replication of interventions in other settings. The aim of this study was to develop and describe an evidence-based home chemotherapy intervention that is feasible and safe for children and adolescents and suitable for future feasibility testing.
The Medical Research Council's guidance for developing complex interventions in health care and the framework of action developed by O'Cathain et al. was used as theoretical frameworks to structure the development process. A literature search, an ethnographic study, and interviews with clinical nurse specialists from adult cancer departments formed the evidence base. Educational learning theory to support and understand the intervention was identified. Stakeholder perspectives were explored in workshops with health care professionals and parent-adolescent interviews. Reporting was qualified using the GUIDED checklist.
A stepwise educational program to teach parents how to administer low-dose chemotherapy (Ara-C) to their child at home and a simple and safe administration procedure were developed. Key uncertainties were identified, including barriers and facilitators impacting future testing, evaluation, and implementation. Causal assumptions and reasoning for how the intervention leads to short-term outcomes and long-term impact were clarified in a logic model.
The iterative and flexible framework allowed for integration of existing evidence and new data and was successfully applied to the development process. The detailed report on the development process of the home chemotherapy intervention can enhance adaptation or replication of the intervention to other settings and thereby mitigate family disruption and stress of frequent hospital visits for these treatments. The study has informed the next phase of the research project that aims to test the home chemotherapy intervention in a prospective single-arm feasibility study.
ClinicalTrials.gov ID: NCT05372536.
Aim
To explore how an AV1 telepresence robot helps school‐aged children and adolescents with cancer to remain socially and academically connected with their school classes during cancer treatment.
...Design
Qualitative pilot study.
Methods
Data were collected through semi‐structured interviews with school‐aged children and adolescents (N = 3, 12–14 years) diagnosed with cancer, their parents (N = 3), teachers (N = 2), classmates (12–14 years, N = 15, focus group interviews) and healthcare professionals (N = 4). Participant observation was performed in the child or adolescents' homes and in the classrooms during education participation via an AV1 telepresence robot.
Results
Five themes emerged: expectations, sociality, learning, spatiality and technology. Participants experienced the robots as facilitating social interaction processes with classmates and inclusion in learning activities, reducing their sense of loneliness and lacking behind educationally. Nevertheless, multiple factors determine whether the robot is perceived as exclusive, including the technical functionality of the robot, spatiality in the classroom and mutual expectations of the parties involved.
Interprofessional education in childhood cancer is a multifaceted field involving multiple healthcare professionals with general and specialised knowledge and skills. Complex treatment, care and ...rehabilitation require continuous professional development and maintenance of healthcare professionals' competencies in their field of expertise. However, limited knowledge exists in comparing interprofessional and monoprofessional education. Only a few randomised studies have evaluated the effectiveness and efficiency of interprofessional education. The objective of this single-centre, investigator-initiated cluster randomised trial is to study the effect of interprofessional versus monoprofessional case-based learning on healthcare professionals' knowledge of gastrointestinal side effects and attitudes towards team collaboration.
This study will randomise healthcare professionals to participate in either the experimental interprofessional group or the control monoprofessional group of case-based learning. The topic of the case-based intervention will be gastrointestinal side effects, one of six categories identified in a three-round Scandinavian Delphi study as relevant for interprofessional education in childhood cancer. The primary outcome is the self-reported questionnaire Assessment of Interprofessional Team Collaboration Scale. Secondary outcomes are measured by the self-reported questionnaires Readiness for Interprofessional Learning Scale Questionnaire, Safety Attitudes Questionnaire, and knowledge will be evaluated using a multiple-choice quiz. Participants will receive the self-reported questionnaires about 2 weeks before and 1 month after the intervention. On the day of the intervention, participants will answer a multiple-choice quiz before and after the case-based learning. Linear mixed models will be used to compare differences between the two groups in mean scores postintervention, adjusting for preintervention scores.
This study will provide insight into the differences between interprofessional and monoprofessional case-based learning and how it affects healthcare professionals' knowledge of gastrointestinal side effects and attitudes towards team collaboration.
The intervention was registered at Clinical Trials.gov : NCT04204109 on December 102,019 and with the National Committee on Health Research Ethics: H-19087506 December 112,019 and the Danish Data Protection Agency: P-2019-637 October 152,019.
The aim of this article is to provide researchers a detailed framework for conducting high-quality research with young children 3-6 years of age. We argue that young children's insider perspectives, ...perceptions and experiences are underrepresented in research owing to methodological challenges. In this article, we present a narrative and play-based approach to eliciting the perspectives of young children, 3-6 years of age, through a developmentally sensitive and child-centred approach to interviewing. We will present a practical step-by-step guide to conducting narrative and play-based interviews with young children. Throughout the article, we will provide practical examples and insights from young children. We will discuss the theory and guiding principles of child-centredness and the child's perspective that underpin the method. Last, we will consider the advantages and limitations of the method.
This paper presents a feasibility study assessing the acceptability, demand, implementation, and practicality of postgraduate interprofessional case-based learning in childhood cancer at Copenhagen ...University Hospital—Rigshospitalet. Healthcare professionals included nurses, doctors, social workers, physiotherapists, occupational therapists, pharmacists, pharmacologists, dieticians, nursing assistants, and professionals with a supportive function (teachers, secretaries, priests, and daycare workers). All participated in a postgraduate interprofessional case-based learning session. Feasibility was assessed using Bowen’s focus areas of acceptability, demand, implementation, and practicality. Before and after the intervention session, three measurement tools were used 2–3 weeks before participation and 3–4 weeks after participation to collect data: Assessment of Interprofessional Team Collaboration Scale, Readiness for Interprofessional Learning Scale, and Safety Attitudes Questionnaire. Representing 13 occupational groups, 49 participants completed the case-based learning sessions, indicating acceptability and practicality. The pre- and post-intervention questionnaires were completed by 79% of the participants, 88% of whom rated the professional content as good or very good. A change over time was detected on all three scales measuring mean difference post-intervention scores. The outcome measures can be used to assess the effect of the intervention. Postgraduate interprofessional case-based learning in childhood cancer is feasible in terms of acceptability, demand, implementation, and practicality. Implementation requires leadership commitment at all levels.
BackgroundComplex treatment, care and rehabilitation require continuous healthcare professional development and maintenance of competencies in collaboration with other professionals. ...Interprofessional education in childhood cancer involves several groups of healthcare professionals with both general and specific knowledge and skills.ObjectiveTo establish consensus on content and interprofessional learning objectives for an interprofessional education in childhood cancer.DesignA three-round Delphi survey in Scandinavian childhood cancer departments.ParticipantsHealthcare professionals appointed by their head of departments and head nurses based on their profession and their involvement in continuing professional development.Main outcome measuresA prioritised list of interprofessional learning objectives with a mean score of ≥3 on a five-point scale (1=not relevant, 5=extremely relevant).Results12 childhood cancer departments participated with 30 healthcare professionals: 11 nurses, 10 medical doctors, 5 social workers, 2 physiotherapists and 2 pedagogues. In total, 28 (93%), 25 (83%) and 22 (73%) completed the first, second and third round, respectively. In the first round, we asked open-ended questions and used directed content analysis to analyse 386 statements. We formulated 170 interprofessional learning objectives in six categories: (1) acute life-threatening situations, (2) gastrointestinal toxicities and side effects, (3) pain, (4) palliation, (5) play and activity, and (6) prescription and administration of medicine. The second round resulted in 168 interprofessional learning objectives receiving a mean score of ≥3 on a five-point scale. Final agreement in the third round resulted in a prioritised list of 168 learning objectives.ConclusionsConsensus on content and interprofessional learning objectives for an interprofessional education in childhood cancer was established across five groups of healthcare professionals in three countries. Some learning objectives are generic and can be applied in settings other than childhood cancer, where healthcare professionals collaborate to provide patients and families optimal treatment and care.
To explore young children's (age 3–6 years) own experiences and perceptions of treatment and care when living with a chronic illness.
The study employed a qualitative research design using a ...narrative and play-based interview approach. Individual face-to-face, narrative and play-based interviews were conducted with eight young children age 3–6 years with type 1 diabetes or cystic fibrosis. The play sessions took place at the home of the children and were video recorded. Interpretative phenomenological analysis was used to analyse the data and frame the study.
Our analysis identified six main themes: 1. Children understood illness through their bodily experience of treatment and care, 2. Children's experience of care and treatment ranged from a feeling of powerlessness to a sense of agency, 3. Children depended on their parents to provide comfort, advocacy and protection, 4. Children's perceptions of treatment and care were inherently related to their experiences of familiarity, interpersonal relationships and trust, 5. Children with type 1 diabetes did not perceive that they played an active role during consultations, and 6. Children associated medical treatment with receiving tangible rewards or positive feedback.
Children expressed a need to feel safe and build agency. They experienced this through participation and interpersonal relationships with healthcare professionals.
We should prioritize the establishment and implementation of age-appropriate psychosocial care practices that support young children in participating, forming relationships, and building trust.
•Young children can provide valuable insights into their care needs.•Perceptions of care are related to experiences of relationship and trust.•Children's experiences range from feelings of powerlessness to a sense of agency.•Insights into relationship-based care of young children's mechanisms and importance.
Although play has existed in paediatric hospitals for decades, a shared understanding of why and how healthcare professionals use play in clinical practice is lacking. This study aims to reach ...consensus on a common set of principles and competencies for play interventions and practices in hospitals. We conducted a three-round Delphi study that included healthcare professionals selected by hospital management. The first round comprised open-ended questions on the use of play in clinical practice. Principles and competencies, including learning objectives, were established using content analysis through an iterative process. Participants rated the importance of each principle and learning objective in the second and third rounds. Among the 66 participants, 45 (68%) responded in round 1 and 41 (62%) in rounds 2 and 3. The participants represented ten countries and nine different health professions. After the three rounds, we identified 33 principles and six overall competencies: building trusting relationships; delivering information and increasing understanding; promoting cooperation and participation; reducing procedure-related anxiety and pain; supporting coping and development; and ensuring a professional approach to play, which comprised 20 learning objectives.
Conclusion
: According to healthcare professionals, play in clinical practice can be used to communicate and build relationships with paediatric patients and thus potentially help provide patient-centred care. Our findings may help guide and prioritize future research initiatives and operationalize play interventions and practices in hospitals.
What is Known:
• Evidence suggests that using play in clinical practice can help paediatric patients during hospitals stays.
• Despite the evidence supporting the use of play, a shared understanding of why and how paediatric healthcare professionals use play is needed.
What is New:
• This international Delphi study contributes to a shared interprofessional understanding of the principles, competencies and learning objectives for the use of play in clinical practice.
• The findings have the potential to aid initiatives in developing training programmes for healthcare professionals in using play to provide care with a patient-centred approach.
Play can help paediatric patients cope with hospitalisation. Education on the use of play for healthcare professionals (HCPs) is lacking, with playful interactions often occurring unsystematically ...without formal training. This scoping review systematically describe the frameworks, design, and evaluation methods of educational programmes for HCPs on the use of play in paediatric clinical practice.
We conducted the scoping review by searching nine databases for white literature and websites for grey literature. Two reviewers independently screened titles/abstracts and reviewed full texts. Kirkpatrick's evaluation model was applied to report the evaluation methods of educational programmes.
After identifying 16534 white and 955 grey items we included twenty articles but no grey literature. The educational programmes vaguely defined play for procedural and normalising purposes and mostly targeted mono-professional groups, mainly nurses. The evaluation methods identified in the articles were reported in accordance with Kirkpatrick levels 1: reaction (
= 13); 2a: attitude (
= 7); 2b: knowledge (
= 3); 3: behaviour (
= 6); 4a: organisational practice (
= 1) and 4b: patient outcomes (
= 4).
The few educational programmes available on the use of play for HCPs are not uniformly described. Future educational programmes would benefit from integrating the needs of HCPs, patients and parents, and using a theoretical framework and systematic evaluation.
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