Advertisement

Playful interventions to promote the subjective wellbeing of pediatric cancer inpatients during laboratory and imaging exams: A qualitative study

Published:January 10, 2022DOI:https://doi.org/10.1016/j.ejon.2022.102094

      Highlights

      • Four playful interventions were proposed as supportive care initiatives.
      • Playfulness during laboratory and imaging exams may increase children's wellbeing.
      • The PERMA-V model may help plan playful interventions for subjective wellbeing.

      Abstract

      Purpose

      We investigate the experience of pediatric oncology patients with objects and equipment involved in laboratory and image examinations during hospitalization for cancer treatment while generating guidelines for playful interventions to improve their subjective wellbeing.

      Method

      The study was carried out at a public tertiary referral teaching hospital in Southern Brazil. Data collection was based on participatory observations with six children aged 4–8 years. Their experiences with exams were observed through pretend play and recorded in field diaries, audio, and video. Data were analyzed using Thematic Analysis and discussed according to the PERMA-V model, a theoretical framework from positive psychology.

      Results

      Several objects and equipment that seem to affect the wellbeing of children during exams were identified. Four playful interventions were proposed as supportive care initiatives: use of technology to allow immersive experiences in learning about treatment and medical condition; design for personalization; gamifying experiences to allow positive reinforcement; and design for focus redirection.

      Conclusions

      Guidelines for playful interventions to foster the subjective wellbeing of hospitalized children during image and laboratory exams were proposed. The PERMA-V model provided a solid base for the analysis of the interventions, which will be implemented and tested in future studies in clinical settings.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Oncology Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ångström-Brännström C.
        • Lindh V.
        • Mullaney T.
        • Nilsson K.
        • Wickart-Johansson G.
        • Svärd A.M.
        • Nyholm T.
        • Lindh J.
        • Engvall G.
        Parents' experiences and responses to an intervention for psychological preparation of children and families during the child's radiotherapy.
        J. Pediatr. Oncol. Nurs. 2017; 35: 132-148https://doi.org/10.1177/1043454217741876
        • Bakke A.
        • King D.
        A fundamental aspect of supportive care delivery: the nurse's opportunity to shape the caring encounter.
        J. Pediatr. Oncol. Nurs. 2000; 17: 182-187https://doi.org/10.1053/jpon.2000.8067
        • Biazzin C.
        • Siegler J.J.
        Super formula case for project management courses: improving the project statement of work.
        Oper. Manage.Educ. Rev. 2016; 10: 91-102
        • Bruggers C.S.
        • Baranowski S.
        • Beseris M.
        • Leonard R.
        • Long D.
        • Schulte E.
        • Shorter A.
        • Stigner R.
        • Mason C.C.
        • Bedrov A.
        • Pascual I.
        • Bulaj G.
        A prototype exercise–empowerment mobile video game for children with cancer, and its usability assessment: developing digital empowerment interventions for pediatric diseases.
        Front. Pediatr. 2018; 6: 69https://doi.org/10.3389/fped.2018.00069
        • Clermidia P.
        • Podevinc G.
        • Crétolle C.
        • Sarnacki S.
        • Hardouin J.
        The challenge of measuring quality of life in children with Hirschsprung's disease or anorectal malformation.
        J. Pediatr. Surg. 2013; 48: 2118-2127https://doi.org/10.1016/j.jpedsurg.2013.03.071
        • Collins J.J.
        • Byrnes M.E.
        • Dunkel I.J.
        • Lapin J.
        • Nadel T.
        • Thaler H.T.
        • Polyak T.
        • Rapkin B.
        • Portenoy R.K.
        The measurement of symptoms in children with cancer.
        J. Pain Symptom Manag. 2000; 19: 363-377https://doi.org/10.1016/S0885-3924(00)00127-5
        • Cook A.
        • Encarnação P.
        • Adams K.
        Robots: assistive technologies for play, learning and cognitive development.
        Technol. Disabil. 2010; 22: 127-145https://doi.org/10.3233/TAD-2010-0297
        • Coyne I.
        Children's experiences of hospitalization.
        J. Child Health Care. 2006; 10: 326-336https://doi.org/10.1177/1367493506067884
        • de Paula G.K.
        • Bezerra Góes F.G.
        • Santana da Silva A.C.S.
        • Medeiros de Moraes J.R.M.
        • Faria da Silva L.
        • da Anunciação Silva M.
        Play strategies in nursing care for the hospitalized child.
        J. Nurs. UFPE/Rev. de Enferm. UFPI. 2019; 13https://doi.org/10.5205/1981-8963.2019.238979
        • Dodge R.
        • Daly A.P.
        • Huyton J.
        • Sanders L.D.
        The challenge of defining wellbeing.
        Intern. J. Wellbeing. 2012; 2https://doi.org/10.5502/ijw.v2i3.4
        • Drewes A.A.
        Play-based interventions.
        J. Early Child. Infant Psychol. 2006; 2: 139-157
        • Ebesutani C.
        • Regan J.
        • Smith A.
        • Reise S.
        • Higa-McMillan C.
        • Chorpita B.F.
        The 10-item positive and negative affect schedule for children, child and parent shortened versions: application of item response theory for more efficient assessment.
        J. Psychopathol. Behav. Assess. 2012; 34: 191-203https://doi.org/10.1007/s10862-011-9273-2
        • Edvardsson J.D.
        • Sandman P.O.
        • Rasmussen B.H.
        Sensing an atmosphere of ease: a tentative theory of supportive care settings.
        Scand. J. Caring Sci. 2005; 19: 344-353https://doi.org/10.1111/j.1471-6712.2005.00356.x
        • Enskär K.
        • Darcy L.
        • Björk M.
        • Knutsson S.
        • Huus K.
        Experiences of young children with cancer and their parents with nurses' caring practices during the cancer trajectory.
        J. Pediatr. Oncol. Nurs. 2019; 104345421987400https://doi.org/10.1177/1043454219874007
        • Frankenfield P.K.
        The power of humor and play as nursing interventions for a child with cancer: a case report.
        J. Pediatr. Oncol. Nurs. 1996; 13: 15-20https://doi.org/10.1177/104345429601300105
        • Frygner-Holm S.
        • Russ S.
        • Quitmann J.
        • Ring L.
        • Zyga O.
        • Hansson M.
        • Ljungman G.
        • Höglund A.T.
        Pretend play as an intervention for children with cancer: a feasibility study.
        J. Pediatr. Oncol. Nurs. 2020; 37: 65-75https://doi.org/10.1177/104345421987469
        • Gershon J.
        • Zimand E.
        • Pickering M.
        • Rothbaum B.O.
        • Hodges L.
        A pilot and feasibility study of virtual reality as a distraction for children with cancer.
        J. Am. Acad. Child Adolesc. Psychiatry. 2004; 43: 1243-1249https://doi.org/10.1097/01.chi.0000135621.23145.05
        • Giacomoni C.
        • Hutz C.
        Multidimensional life satisfaction scale for children: development and validation studies.
        Estud. Psicolog. 2008; 25: 23-35https://doi.org/10.1590/S0103-166X2008000100003
        • González-González C.S.
        • Toledo-Delgado P.
        • Padrón M.
        • Santos E.
        • Cairós M.
        Including gamification techniques in the design of TANGO: H platform.
        J. Teknol. 2013; 63: 77-84https://doi.org/10.11113/jt.v63.1958
        • Kato P.M.
        • Beale I.L.
        Factors affecting acceptability to young cancer patients of a psychoeducational video game about cancer.
        J. Pediatr. Oncol. Nurs. 2006; 23: 269-275https://doi.org/10.1177/1043454206289780
        • Kerr L.M.J.
        • Harrison M.B.
        • Medves J.
        • Tranmer J.E.
        • Fitch M.I.
        Understanding the supportive care needs of parents of children with cancer: an approach to local needs assessment.
        J. Pediatr. Oncol. Nurs. 2007; 24: 279-293https://doi.org/10.1177/1043454207304907
        • Kuo A.
        Brave new world of warcraft: a conceptual framework for active escapism.
        J. Consum. Market. 2016; 33: 498-506https://doi.org/10.1108/JCM-04-2016-1775
        • Li W.H.
        • Chung J.O.
        • Ho E.K.
        The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well‐being of children hospitalised with cancer.
        J. Clin. Nurs. 2011; 20: 2135-2143https://doi.org/10.1111/j.1365-2702.2011.03733.x
        • Lindsay S.
        • Rampterab L.
        • Curran C.
        Therapy through play: advancing the role of robotics in paediatric rehabilitation.
        in: Everyday Technologies in Healthcare. Edition1st. CRC Press, 2019: 11-30
        • Marshall C.
        • Rossman G.B.
        Designing Qualitative Research.
        third ed. Sage publications, London2014
        • McCaffrey C.N.
        Major stressors and their effects on the well-being of children with cancer.
        J. Pediatr. Nurs. 2006; 21: 59-66https://doi.org/10.1016/j.pedn.2005.07.003
        • Mullaney T.
        • Nyholm T.
        • Edvardsson D.
        Wellbeing in healthcare environments: a human-centred design research approach to improving the cancer patient experience during radiation therapy.
        in: Proceedings of the 1st European Conference on Design 4 Health 2011. 2011. Art & Design Research Centre, 2011: 255-265
        • O'Brien E.
        PERMA-V: Training with Rigor & Vigor.
        2014
        • O'Neill J.E.B.
        What is supportive care and why is it important?.
        J. Pediatr. Oncol. Nurs. 2000; 17: 133-134https://doi.org/10.1053/jpon.2000.8164
        • Rouvenat F.
        Salas de quimioterapia se transformam em 'aquários' no Rio. G1 Rio.
        2015
        • Ryan R.M.
        • Deci E.L.
        On happiness and human potentials: a review of research on hedonic and eudaimonic well-being.
        Annu. Rev. Psychol. 2001; 52: 141-166https://doi.org/10.1146/annurev.psych.52.1.141
        • Seligman M.E.
        Flourish: A Visionary New Understanding of Happiness and Well- Being.
        Atria, New York, NY2011https://doi.org/10.5860/choice.48-7217
        • Tennant M.
        • McGillivray J.
        • Youssef G.J.
        • McCarthy M.C.
        • Clark T.J.
        Feasibility, acceptability, and clinical implementation of an immersive virtual reality intervention to address psychological well-being in children and adolescents with cancer.
        J. Pediatr. Oncol. Nurs. 2020; 37: 265-277https://doi.org/10.1177/1043454220917859
        • Watson D.
        • Clark L.A.
        • Tellegen A.
        Development and validation of brief measures of positive and negative affect: the PANAS scales.
        J. Pers. Soc. Psychol. 1988; 54: 1063-1070
        • Weinstein A.
        • Henrich C.C.
        Psychological interventions helping pediatric oncology patients cope with medical procedures: a nurse-centered approach.
        Eur. J. Oncol. Nurs. 2013; 17: 726-731https://doi.org/10.1016/j.ejon.2013.04.003
        • Wilson A.S.
        • McDonagh J.E.
        A gamification model to encourage positive healthcare behaviours in young people with long term conditions.
        EAI Endorsed Transac. Game Base. Learn. 2014; 14: e3https://doi.org/10.4108/sg.1.2.e3