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Development and feasibility testing of a play-based psychosocial intervention for reduced patient stress in a
Muneera A Rasheed1,2, Vardah Bharuchi3, Waliyah Mughis3
1Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. muneera.rasheed@uib.no.
Insights
Psychology trainees can deliver a supervised play-based intervention to reduce hospitalization stress in children and parents. This approach enhances child-parent interaction and improves the family
Area of Science:
- Child Psychology
- Pediatric Health
- Psychosocial Interventions
Background:
- Hospitalization causes significant stress for children and families, particularly in low and middle-income countries (LMICs) due to resource limitations.
- Existing psychosocial support in high-income countries often utilizes play therapy, a resource-intensive approach.
- Addressing the gap in LMICs requires feasible, cost-effective interventions to mitigate hospitalization-related stress.
Purpose of the Study:
- To develop and assess the feasibility and acceptance of a play-based intervention model.
- To evaluate the effectiveness of psychology trainee-delivered play sessions in enhancing child-parent interaction.
- To measure the impact of the intervention on reducing stress for hospitalized children and their families.
Main Methods:
- A play-based psychosocial intervention was developed based on the Nurturing Care Framework and play therapy principles.
- The intervention was delivered by supervised psychology trainees to children aged 0-6 years in a Pakistani tertiary care hospital.
- Feasibility and acceptance were assessed through parent surveys and qualitative feedback from trainees and physicians.
Main Results:
- 45% of parents identified the play intervention as a key factor in improving their hospital experience.
- Post-intervention, only 5% of parents reported stress related to their child's illness.
- High parent satisfaction (90-96%) was reported, with trainees finding the experience beneficial.
Conclusions:
- Psychology trainees can feasibly deliver a supervised play-based intervention to reduce pediatric hospitalization stress.
- The intervention effectively enhanced child-parent interactions and improved the overall hospital experience.
- This model offers mutual benefits for patients, families, trainees, and healthcare professionals in resource-limited settings.
Background:
Hospitalization can be a source of great stress for children and their families. In high-income countries, there are specialized staff to help children cope using different techniques including play. However, it is a major challenge in low and middle-income countries (LMIC) due to financial constraints and untrained human resource. The objective of study was to develop and test the feasibility and acceptance of a psychology trainee-delivered model postulated on employing play as a means of enhancing child-parent interactions leading to reduced stress during hospitalization.
Methods:
This study was conducted in the paediatric ward of a tertiary care private hospital in Pakistan. Pre-intervention survey revealed that parental stress stemmed mainly from seeing their child irritable, distressed, or in pain. Using a theory of change model, a play-based psychosocial intervention was developed to address these factors. The intervention approach was informed by principles of Nurturing Care Framework and play therapy. Children between birth and 6 years admitted in the acute care ward were eligible. The intervention was delivered between March 2019 and December 2020 by psychology trainees who were supervised by a clinical psychologist. The play-based sessions were delivered at the bedside and ranged from 20 to 40 min. Parents receiving the intervention were later interviewed for their stress, child emotions, and feedback about the service using structured surveys administered by psychology graduates. The trainees delivering the intervention were requested to provide their feedback as a written qualitative open-ended narrative. These narratives were analyzed using an inductive approach.
Results:
The survey was conducted with 223 families with about half of the sample having children under 2 years of age. Forty-five percent of parents reported play intervention to be one of 3 key factors in improving their experience during hospital stay. Only 5% of parents reported feeling stressed about the child illness after the intervention. Ninety to 96% parents felt respected, listened to, and understood by the therapists. Thematic analysis of the feedback by trainees indicated the internship to be a useful experience and a new avenue for professional life whereas physicians appreciated the interventions.
Conclusions:
The authors conclude that psychology trainees can feasibly deliver a play-based intervention under supervision for reduced stress in children and their parents during hospitalization with mutual benefits.
