Unstructured play for anxiety in paediatric inpatient care

Purpose: The purpose of this study was to examine the effects of unstructured play activities on the anxiety levels of hospitalized children. Methods: A nonequivalent control group pretest posttest designwas employed for this study. The sample included children (N = 165) ages 4'7 years admitted to a large pediatric referral center in the United Arab Emirates. The control group (n = 84) received usual care, while the experimentalgroup (n = 81) engaged in age-appropriate unstructured play activities using disposable games and toys. Parents and siblings, if present, were encouraged to participate. Research assistants conducted the play activities twice a day, with 30-min morning and evening sessions. Anxiety was measured at baseline and at the end of days 2 and 3with a translated form of the Short'State-Trait Anxiety Inventory Children. Results: Anxiety scores in both groups were similar at baseline and decreased significantly over the 3 days. Compared with the control group, anxiety scores in the intervention group were significantly lower on day 2 (12.7 ± 2.3 vs. 10.7 ± 2.5, p = .003) and day 3 (10.6 ± 2.2 vs. 9.47 ± 2.4,p < .001). The greatest decrease occurred in the percentage of children in the experimental group with medium-level anxiety scores: baseline (n = 61, 75%), day 2 (n = 24, 30%), and day 3 (n = 0, 0%). Conclusions: This simple, low-cost play intervention implemented by nurses resulted in statistically and clinically significant decreases in the anxiety levels of children in an acute inpatient setting.