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Associations between Pretend Play, Psychological Functioning and Coping Strategies in Pediatric Chronic Diseases: A

Daniela Di Riso1, Elena Cambrisi1, Simone Bertini1

  • 1Department of Developmental Psychology and Socialization, University of Padova, 35121 Padova, Italy.

International Journal of Environmental Research and Public Health
|June 24, 2020
PubMed

Insights

Symbolic play aids children with chronic illnesses in coping with emotional challenges and daily adjustments. This study found play and coping strategies are linked to adjustment in children with type 1 diabetes mellitus and cystic fibrosis.

Area of Science:

  • Child Psychology
  • Pediatric Health
  • Clinical Psychology

Background:

  • Children with chronic illnesses face significant adjustment challenges, often leading to internalizing psychological problems.
  • Symbolic play offers a potential avenue for these children to process and manage their difficulties.

Purpose of the Study:

  • To evaluate pretend play, coping mechanisms, and psychological symptoms in school-aged children with pediatric chronic diseases.
  • To compare these factors across different chronic conditions, including type 1 diabetes mellitus (T1DM), cystic fibrosis (CF), and leukemia.

Main Methods:

  • Assessed 44 Italian school-aged children with T1DM, CF, or leukemia using the Affect in Play Scale-Brief version (APS-Br) and the Children's Coping Strategies Checklist-Revision1 (CCSC-R1).
  • Administered the Separation Anxiety Symptom Inventory for Children (SASI-C) and the Strengths and Difficulties Questionnaire (SDQ) to children with T1DM and CF.
  • Utilized Cohen's d for effect size calculations and performed comparative analyses between clinical and normative samples, as well as between disease groups.

Main Results:

  • Children exhibited more organized play but a more negative affect tone and less frequent affect expression compared to normative samples.
  • Significant differences in play dimensions (APS-BR) and coping strategies (CCSC-R1) were observed among the three disease groups.
  • Children with CF reported higher separation anxiety scores than those with T1DM; correlations revealed links between play, coping, and adjustment in T1DM and CF groups.

Conclusions:

  • Symbolic play serves as a crucial tool for chronically ill children to express emotions and understand their challenges.
  • Findings underscore the interconnectedness of play, coping strategies, and psychological adjustment in pediatric chronic illness.
  • This research aids clinicians in understanding and supporting children navigating the complexities of chronic health conditions through play-based interventions.

Keywords:
Affect in Play Scale—Brief (APS-Br)copingcystic fibrosisleukemiapsychological adjustmentseparation anxietytype 1 diabetes mellitus (T1DM)

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