(searched for: doi:10.35940/ijpmh.a2005.111120)
RICERCHE DI PSICOLOGIA pp 1-15; https://doi.org/10.3280/rip2021oa12716
Paediatric surgery elicits anxiety in children and their parents. The present study tests the impact of Play Specialist-based intervention (PS) on children's and parents' anxiety pre and post thoracoplasty. The study was held at Gaslini pediatric hospital (Genoa, Italy) and involved families with a child undergoing thoracoplasty to correct children's pectus carinatum (PC) or excavatum (PE). Children provided with PS-based intervention (n=40) were compared with control children (n=32). The mothers of PS children (n=40) were compared with the control mothers (n=32), and the fathers of PS children (n=40) were compared with the control fathers (n=32). Visual Analog Scale (VAS) was administered to assess pre and post thoracoplasty anxiety. T-tests and Analyses of Covariance (ANCOVA), Bayes factors for t-tests and ANCOVA were computed. A significant interaction effect between time and group (i.e., PS and controls) emerged for children, mothers, and fathers. Bonferroni post-hoc analyses revealed that PS children's and PS mothers' postoperative anxiety was lower than controls' postoperative anxiety. PS fathers' experienced greater preoperative anxiety than controls and no significant differences with control fathers emerged in postoperative anxiety. PS-based intervention emerged to reduce children's and parents' anxiety over time, and to diminish children's and mothers' postoperative anxiety in comparison with the controls.
Frontiers in Psychology, Volume 12; https://doi.org/10.3389/fpsyg.2021.687292
Article 31 of the Convention on the Rights of the Child of the United Nations identifies play as a human right (Lundy, 2012) and the European Association for Children in Hospital (1988) lists play among the fundamental children's rights in healthcare (article 1–10). Playing is also a parameter to monitor the child's physical, emotional, cognitive, and executive development and well-being (Sutton-Smith, 1999; Koukourikos et al., 2015). Entering a medical setting exposes the child to many different risks for mental health (e.g., depression, withdrawal, regression, sleep problems, anxiety, hypochondria) because his/her familiar routine is disrupted (Chambers, 1993). In these cases, structured play-activities with a specialized professional can provide the child with a sense of continuity with the life before the illness (Romito et al., 2021) or with an imaginary escape from reality (Tanaka et al., 2010; Bukola and Paula, 2017). In the 1920s, F. Nightingale and F. Erikson were the first nurses intuiting the importance of systemizing playing sessions to ameliorate children's hospitalization experience and adherence to medical procedures (Frauman and Gilman, 1989; Francischinelli et al., 2012). Then, the books “Working with Children in Hospital” (Plank, 1962), “Children in the Hospital” (Bergmann, 1965), “Play in Hospital” (Harvey and Hales-Tooke, 1972) highlighted that introducing a specialist in play-activities in the hospital was fundamental for the child's psychosocial well-being. By the same token, Brooks (1970) remarked that the “Play Lady” should not be considered a recreational figure for hospitalized children but a psycho-pedagogical intervener that supports the child when he/she is coping with the illness. As Rubin (1992) points out, a large body of synonyms (e.g., play lady, puppet lady, playing checkers, playing teacher, recreational therapist) was used between the '60 and the '80 to describe the same role. Nowadays, there are still many synonyms describing these professionals (e.g., Healthcare Play Specialist, Certified Child Life Specialist, Child Play Specialist, Medic Pedagogic Healthcare worker), and the need for creating scientific consensus around this role is urgent. As emerged from 29th January 2021 Virtual Round Table “Playing in the Hospital,” most of the international stakeholders indicated the term “Play Specialist” (PS) as an encompassing worldwide macro-label to describe this professionalism (Porto dei Piccoli, 2021). The PS differs from the play-therapist since play therapy is a counseling technique used in psychoanalytic psychotherapy (Leblanc and Ritchie, 2001). All over the world, hospitals, trusts, and charities often promote the PS in the pediatric care settings. No-profit organization are crucial to promote the PS in countries where the role is not integrated yet in the healthcare system. The lack of international guidelines for the PS practice leads these professionals to theoretical and operative fragmentation, challenges, and issues that Covid-19 pandemic is further stressing out. The aim of the present paper is promoting knowledge about the PS by defining the professionalism, analyzing the obstacles that hinders the PS practice, and emphasizing the reasons why promoting the PS in pediatric care settings (e.g., hospitals, home-based care). Notwithstanding countries terminological differences (e.g., in the UK the PS is named Healthcare Play Specialist, in the USA and Canada is named Certified Child Life Specialist), the PS can be described in the light of a common body of practice. Firstly, all over the world, becoming a PS requires a specific training accessible with a bachelor's degree in psychological or pedagogical sciences as a prerequisite (Harvey, 1984; Lookabaugh and Ballard, 2018). In several countries (e.g., Netherlands, UK, US) the Play Specialist is an official education degree, in others (e.g., Italy) the training is organized and financially supported by trust and charities, with discretion in the duration and total hours. Generally, the PS training focuses on the child development's milestones (e.g., physical, cognitive, communicative, emotion regulation, social skills maturation) from a medical, psychological, and pedagogic point of view, to enable PS to provide children with age-specific and diagnoses-specific play activities (Beickert and Mora, 2017). Completing a certified training is crucial because it predicts the use of research-based strategies by the PS to work with the child (Bandstra et al., 2008). Once trained, the PS can support children with various play techniques. Among a wide range of actions, the most practiced ones are the normative play and medical play (Burns-Nader and Hernandez-Reif, 2016). The normative play encompasses all the play activities that the child would experience at home. It conveys the message that the child can play and be creative in the hospital as he/she does in well-known places. On the other hand, the medical play helps the child to learn about health and illness and to familiarize herself/himself with the hospital context, aiming at reducing the child's anxiety toward medical procedures. According to Barry (2008), such activities can also occur outside the hospital ward by organizing house-visits and experiential weekends. Such experiential occasions help children with specific chronic conditions (e.g., diabetes) to increase their health-related self-efficacy outside their comfort-zone. A few studies have attempted to profile the PS. In the US, Lookabaugh and Ballard (2018) survey on the Child Life Specialists reports that most PS work in hospitals (93% of the respondents, n = 147). Bottino et al. (2019) add that the Child Life Specialists are mostly females, in their thirties, with 88% respondents (total n = 110) working to ameliorate children's coping, family perception of support, children collaboration in medical...
Published: 1 January 2021
International Journal of Science Annals, Volume 4, pp 45-47; https://doi.org/10.26697/ijsa.2021.1.7
For developmental psychologists, playing is a crucial parameter to monitor children and adolescents’ physical, emotional, cognitive, and executive development and wellbeing. In the psychotherapy setting, play is a promotor of positive therapeutic change because it allows the child to express beliefs, memories, wishes, feelings, and subconscious contents, from a safe and indirect point of view. Play is a fundamental human right during the whole life cycle, and it becomes even more important for those children and adolescents who are hospitalized or experiencing medical treatments at home (European Association for Children in Hospital, 1988). Entering a medical setting can elicit children’s and adolescents’ distress on many levels (e.g., anxiety, depression, hypochondria, acting out, externalizing, and internalizing problems) since their familiar routine is temporarily disrupted. The aim of the study. To foster scientific community consideration about the Play Specialist role, paying attention to the state of the art, the international field of practice, the evidence supporting the effectiveness of the Play Specialist intervention, the main challenges, and the everyday issue that these professionals have to face to gain proper integration in the national and international healthcare system.