A Review of Creative Play Interventions to Improve Children’s Hospital Experience and Wellbeing

Abstract

CONTEXT Being in the hospital can be stressful for children and caregivers. Evidence-based play interventions to reduce this stress, such as play therapy or Child Life services, have been introduced in hospitals globally, with growing awareness of potential benefits. OBJECTIVES To evaluate the impact of nonmedical/illness-specific creative or play-based programs in hospital settings on children’s (<18 years) and their caregivers’ hospital experiences, wellbeing, and other health outcomes. DATA SOURCES PubMed, CINAHL, Google Scholar. METHODS We conducted a systematic review of original articles published since 2011, screening 2701 de-duplicated articles. RESULTS We identified 25 eligible articles, representing 1629 children (57% male), 422 caregivers, and 128 health professionals. Included studies most commonly evaluated professional children’s entertainers (n = 8 studies), music therapy (n = 4), unstructured play (n = 3), and humanoid/animal robots (n = 3). Most studies evaluated the impact on the child’s level of anxiety (n = 14/25), mostly supporting a reduction (n = 13/14 studies). Several studies provided evidence for a reduction in children’s pain (n = 4/6), and negative emotional/behavioral outcomes (eg, sadness, anger, irritability; n = 5/6 studies). There was mixed evidence for the impact of the included interventions on physiologic outcomes (eg, systolic pressure, heart frequency; n = 3/5 studies) and fatigue (n = 1/2 studies). Evidence on caregiver outcomes and the impact on health care services was limited. CONCLUSIONS The findings of our review generally supported the value of play-based interventions on children’s’ wellbeing while in the hospital, particularly reducing anxiety and pain. Further evaluation of their impact on caregivers’ outcomes and the health care system is needed.