Play specialists and other health professionals use play preparation to help psychologically prepare children and young people and their families for hospital procedures that may be frightening and or painful. Using a wide range of tools – such as photographs, real hospital equipment, preparation dolls and role play - the play specialist can help children and young people at a developmentally appropriate level with the procedure they are going to experience. This will help to alleviate any concerns and assist coping as the child or young person gains a sense of control through understanding.
Play specialists should get as much information as possible about the child or young person and their understanding of the procedure before preparing them. This can be done by talking to them and their family, observing them and discussing with the nursing team the understanding of the child or young person. It is voiced that though some procedures may be unpleasant they are necessary. It is important that health professionals are honest with the child or young person about such things this is essential in building a trusting relationship between them and staff.
During the preparation, the patient and their family will have the opportunity to ask and discuss any questions they may have regarding their procedures. Play preparation may be a one-off event or an ongoing piece of work, for example a child or young person with a needle phobia may require several sessions with a stepped approach to de-sensitise them.
In the main, play preparation is done before a procedure, but sometimes the play specialist may accompany the child or young person and their parent/carer, providing support and distraction during the procedure. Distraction therapy, sometimes known as attentive focus, can help children and young people cope with procedures and can include bubble blowing, noisy books, counting games and breathing exercises. Psychological approaches to reducing pain and anxiety require hard work but can make a significant difference to the child or young person’s experience of repeated and painful procedures. [1]
Preparation and distraction techniques successfully reduce the need for therapeutic holding under force and immobilisation. “The restraint of children within healthcare settings maybe required to revent harm to the child themselves” [2].
Following the procedure/treatment the play specialist may return and provide post procedural play, giving opportunities for the child or young person to express any feelings and to offer ongoing support and reassurance, providing coping strategies where appropriate. Good play preparation can dramatically cut down on the stress levels for all involved – professional, patient and family [3].
References
[1] Liossi C (2002) Procedure-related Cancer Pain in Children. Radcliffe Medical Press
[2] Royal College of Nursing (RCN) (2010) Restrictive physical intervention and therapeutic holding for children and young people: Guidance for nursing staff. www.rcn.org.uk
[3] Spence,N. 2004 Play in the community, quality care for children with cancer. Cancer nursing practice 3(8)