Exploring playful nursing care in pediatric wards: A qualitative study using participant observation and interview
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Ai Tokumura1, Miyuki Muramoto2, Mayumi Morisaki-Nakamura2
1Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Background:
Previous research has mainly focused on procedure-based play, and nurses' daily practices of playfulness remain underexplored. We aimed to explore the daily practices and underlying meanings of playful nursing care in pediatric wards to construct a conceptual model.
Methods:
Participant observations and semi-structured interviews were conducted with pediatric nurses at the pediatric medical center of a university hospital from July 2024 to August 2025. Observations covered all interactions with hospitalized children aged 0-12 years, while interviews captured the nurses' attitudes, perceptions, and emotions during the observed scenes. The data were analyzed using Braun and Clarke's Reflective Thematic Analysis.
Results:
Four themes and 13 subthemes were identified: 1. Immersing in the child's world with the belief that hospital experiences can be transformed into strength; 2. Ensuring the child's daily playful life to foster their development; 3. Capturing the child's heart to support adaptation to the unfamiliar and challenging hospital life; 4. Building a supportive circle to encourage the child, with everyone working together. Theme 1 formed the core, Themes 2 and 3 demonstrated specific practices, and Theme 4 involved comprehensive support from multidisciplinary teams, families, and peers.
Conclusion:
Playful nursing care is an everyday ethical practice sustained by nurses' commitment to entering the child's world, ensuring daily playful life and supporting adaptation to hospital life. Supported by multidisciplinary, family, and peer collaboration, this practice holds the potential to transform hospitalization into a positive opportunity for children's holistic development.
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