The feasibility and appropriateness of using therapeutic play in preparing children for surgery in Hong Kong Chinese context

Abstract

Background. Surgery is a stressful and anxiety-provoking experience, which can be emotionally devastating for children. During the past few decades, there has been an increase in the use of therapeutic play to help children cope with the stress of hospitalization in Western countries. However, play has traditionally been viewed as less important for hospitalized children by Chinese parents and health care staff when compared with physiological care or medical treatment in Hong Kong. It is not clear whether therapeutic play is an appropriate and feasible preoperative intervention for Chinese children and their parents. Objectives. To examine the effectiveness, feasibility, and appropriateness of using therapeutic play intervention in preparing Hong Kong Chinese children for surgery.

Method. A randomized controlled trial, two-group pretest and repeated posttest, between subjects design was employed. Hong Kong Chinese children admitted for elective surgery were invited to participate in the study. By using a simple complete randomization method, 97 children were assigned to the experimental group receiving therapeutic play intervention, and 106 children were assigned to the control group receiving routine information preparation.

Results. Both children and parents in the experimental group reported statistically significant lower state anxiety scores than the control group in pre- and post-operative periods. Children in the experimental group also exhibited statistically significant fewer instances of negative emotional behaviors. Additionally, parents in the experimental group reported statistically significant higher level of satisfaction with the preoperative nursing preparation given.

Conclusion. This study demonstrated the effectiveness, feasibility, and appropriateness of using therapeutic play intervention in preparing children for surgery in Chinese culture. In addition, the information from this study promotes awareness in nurses and parents that irrespective of different cultural backgrounds or settings, play is a very important part of children's lives and they need play even when they are ill.