Paediatric surgery elicits anxiety in children and their parents. The present study tests the impact of Play Specialist-based intervention (PS) on children's and parents' anxiety pre and post thoracoplasty. The study was held at Gaslini pediatric hospital (Genoa, Italy) and involved families with a child undergoing thoracoplasty to correct children's pectus carinatum (PC) or excavatum (PE). Children provided with PS-based intervention (n=40) were compared with control children (n=32). The mothers of PS children (n=40) were compared with the control mothers (n=32), and the fathers of PS children (n=40) were compared with the control fathers (n=32). Visual Analog Scale (VAS) was administered to assess pre and post thoracoplasty anxiety. T-tests and Analyses of Covariance (ANCOVA), Bayes factors for t-tests and ANCOVA were computed. A significant interaction effect between time and group (i.e., PS and controls) emerged for children, mothers, and fathers. Bonferroni post-hoc analyses revealed that PS children's and PS mothers' postoperative anxiety was lower than controls' postoperative anxiety. PS fathers' experienced greater preoperative anxiety than controls and no significant differences with control fathers emerged in postoperative anxiety. PS-based intervention emerged to reduce children's and parents' anxiety over time, and to diminish children's and mothers' postoperative anxiety in comparison with the controls.
Covid-19 pandemic has changed the routines of families all over the world. From March 2020 up to today, Italian families are still struggling for adaptation. Parents of children and adolescents with a clinical diagnosis are more at risk for parental burnout, depression, and anxiety, and they are now experiencing restrictions in many services families relied on. Home-based and hospital-based interventions based on the Play Specialist’s approach have been limited due to anti-covid norms. Internationally, Play Specialist intervention has been empirically demonstrated effective in diminishing children’s negative emotions in relation to medical procedures and in increasing adaptation and compliance towards medical settings. Plus, Play Specialist’s intervention indirect effect on parental wellbeing is still unexplored. In Italy, differently from UK and USA, the Play Specialist intervention is not certified in the health-care system yet. The present study tests the effects on parental psychosocial health of a telematic adaptation of the Play Specialist approach (TPS), conducted in the post-lockdown months in Italy. Two groups of parents (N=33, Mean age=43.36, SD=9.81, Female= 66% receiving the TPS intervention, and N=33 Mean age=41.84, SD=6.15, Female=78% controls) of children in clinical conditions are compared. Parental burnout, anxiety, stress, depression, social support, and parental perception of children’s emotional problems have been measured via self-report questionnaires. Analysis of covariance reveals that the TPS group is less stressed, perceives higher social support, lower parental burnout (i.e., emotional distancing, contrast with other/previous Self, fed-up feeling), lower emotional and behavioural child’s problems than the control group. These findings are addressed at encouraging both research and practice around the Play Specialist’s intervention beyond the hospital-context.
Il gioco rappresenta un diritto fondamentale del bambino ed assume un ruolo cruciale du-rante l'esperienza dell'ospedalizzazione. Le figure del Child Play Specialist e del Child Life Specialist (riconosciute rispettivamente nel sistema sanitario del Regno Unito e degli Stati Uni-ti) forniscono programmi di gioco che normalizzino l'esperienza di ricovero del bambino e aiutino la familiarizzazione con il contesto medico. La presente rassegna persegue tre principali obiettivi: i. definire il ruolo dello specialista del gioco, la sua formazione, le tecniche implemen-tate, le aree di similitudine e differenza tra CPS e CLS; ii. esaminare l'evoluzione storica di questa professione; iii. indagare gli effetti dell'intervento dello specialista del gioco sulla salute bio-psico-sociale del paziente pediatrico. Di 613 fonti complessive (n=193 da Scopus, n=403 da Pubmed, n=17 da PsycInfo), 17 pubblicazioni sono state incluse, avendo applicato criteri inerenti lingua, tipologia di pubblicazione e pertinenza dei contenuti. Dalle fonti esaminate ri-sulta che: I. CLS e CPS presentano percorsi di training e tecniche simili. Emergono peculiarità di approccio diverse per CPS e CLS; II. Le esperienze pionieristiche di programmi di gioco in ospedale risalgono agli anni '20 con contributi significativi di Plank, Bergmann e Brooks; III. I principali effetti sulla salute infantile documentati sono il potenziamento del coping e la ridu-zione del ricorso a terapie farmacologiche per la gestione del dolore. Si evidenzia la necessità di un consenso internazionale sulla definizione del ruolo dello specialista del gioco, al fine di accrescere la ricerca empirica rispetto a tali professionisti della salute.
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