The Effect of Directed Medical Play on Young Children's Pain and Distress During Burn Wound Care

Abstract

Directed medical play is used to reduce children's pain and distress during medical treatment. In this pilot study, young children who attended the burn clinic received either directed medical play provided by a child life specialist or standard preparation from the burn clinic nurse, to prepare for their first dressing change. Data were collected using validated instruments. Children who participated in medical play experienced less distress during their dressing change (M= 0.5, n=12) than those receiving standard preparation (M=2.0, n=9). Children who received standard care reported a 2 point increase in pain during the procedure whereas children who participated in medical play reported a 1 point increase. Change in parental anxiety was similar for both groups. Parent satisfaction was higher for caregivers who observed medical play than standard preparation. Although all findings were in the hypothesized direction, none were statically significant, most likely because of the small sample size.

Efficacy and cultural appropriateness of psychosocial interventions for paediatric burn patients and caregivers: a systematic review

“…Music therapy reduced self-reported pain compared to standard care when provided immediately following CODs [58,59]; however, did not affect patients' self-reported pain when provided during CODs [58,59]. Likewise, 'medical play' prior to COD commencement did not affect patients' self-reported pain; however, did reduce nursing staff observations of pain and distress behaviour at insignificant levels [55]. In contrast, the use of Child Life Therapy (CLT) reduced patients' pain as observed by caregivers and an independent assessor; and increased nursing staff's observations of pre-procedural pain [49].…”

“…Therefore, its ability to meet the needs of First Nations people (respectfully used here in reference to Indigenous peoples globally) could not be ascertained [43]. Moore et al acknowledged the lack of cultural diversity within their study on medical play; however, this was brief and specific to the inclusion of African American and Hispanic families [55]. Similarly, Chester et al's study on hypnotherapy briefly acknowledged the lack of representation of Aboriginal and/or Torres Strait Islander children; however, did not elaborate on any potential implications or outline the ethnic/cultural diversity of included children [46].…”

Lessons from Freelancing, Lighting Design to Genetic Counseling

“…If psychosocial outcomes were the metric, Child Life -the arts-based division that decreases distress, reduces pain perception as well as anesthetic need, and improves coping -would be far better funded. (Moore et al 2015) (Tyson et al 2014) (Durand 2015) I want all pediatric sub-specialists who order genetic testing, and their patients, to have access to genetic counseling. Relative Value Units (RVUs) are a complicated calculation method used by the Centers for Medicare and Medicaid Services (CMS) to determine physician compensation.…”

Giving meaning to the teaching of Therapeutic Play: the experience of nursing students

“…3,6,7 Its use by the nurse in providing pediatric care is permeated by numerous benefits, not only for the child -who comes to comprehend better what is happening to her, becoming more calm, secure and collaborative -but also for the family, the nurse, the team and the care environment. 7 In the international literature, its use is highlighted as having a high therapeutic value for the child, contributing not only to physical improvement but also to the child's emotional well-being, 8 to reduction in pain and stress related to experiencing procedures such as venipuncture, 9 dressings, 10 inhalation therapies, 11 radiotherapy 12 and the preparation for surgery, 13,14 among others; it also has an effect on the reduction of the parents' anxiety, who come to understand this intervention's value. 15 Nevertheless, studies have not been identified related to the teaching of this strategy, it being the case that only one of these refers to the nurses' resistance regarding its use, due to their lack of familiarity with TP.…”