play

2. THERAPEUTIC PLAY:
Therapeutic play is the specialised
play activities by which a child acts out or
expresses his unconscious feelings. It is a
central mechanism in which children cope,
communicate, learn & master a traumatic
experience such as hospitalisation.

3. IMPORTANCE OF PLAY:
CHILD:
 Enhance coping abilities
 Express fear, anxiety, tension, anger,
fantasies.
 Understand hospital procedures.
 Communicate & reduce emotional trauma.
 Continue growth & development.
 Get rid of boredom.

4. IMPORTANCE OF PLAY:
Health team members:
 Gain co-operation & trust of the child.
 Diagnose child’s feelings & behaviour.
 Find out & correct misconceptions & beliefs
 Reassure the parent
 Promote parent participation in child care

5. FUNCTIONS 0F PLAY:
 Provides diversion
 Brings about relaxation
 Helps feel secure
 Lessen stress of separation & home sickness
 Release tension, expression of feelings
 Encourages interaction
 Develop positive attitudes towards others
 Outlet for creative ideas or interests
 Opportunity for choices & be in control
 Accomplish therapeutic goals.

6. TYPES OF PLAYS:
Emotional outlet/dramatic play:
 Used to express child’s anxiety
 Solve conflicts
 Diagnostic tool

7. Instructional play:
 Instruction is given for therapeutic play
according to their past experiences, coping
abilities & physiological status

8. Physiological enhancing play:
 Used to improve & maintain physical health
& body functions
 Selected to treat pathological condition

9. SOCIAL PLAYS:
1. Onlooker play:
 Watch other children play
 No interest in participation

10. 2. Solitary play:
 Play alone with different toys used by other
children
 Enjoys others presence but no effort to
speak or get close

11. 3. Parallel play:
 Children play independently with toys as that
of other children
 No group association
 Characteristic play of toddlers

12. 4. Associative play:
 Play together & engaged in similar activities
 Never directs others action or establishes
rules
 No group goal, one child initiates an activity
& others follow

13. 5. Co-operative play:
 Organised & they play in groups
 Set goals & try to attain it
 Organisation of activities, division of labour &
playing roles
 Leader follower relationship is established

14. PLAY THERAPY:
Non-directive play therapy:
 Client centred or unstructured play therapy
 If allowed to play freely, children resolve their
own problem & work towards their own
solution
 Few boundaries & can be used at any age

15. Directive play therapy:
 Directions given for play
 Causes faster change & more structured
than non-directive play
 Games chosen by the child, therapists give
directions

16. CATEGORIES OF PLAY:
Physical play:
 Social in nature- involves other children
 Provides exercise, which is essential for
normal development
 Eg. Run, jump etc.

17. Expressive play:
 Gives opportunity to express feelings
 Parents take an active role
 Eg. Play using coloured pencils, crayons,
markers, water colours etc..

18. Manipulative play:
 Children control or master their environment
 Starts in infancy
 Move objects like puzzle pieces to
understand it better
 Eg: Drops a toy, Wait for the parent to pick it,
clean it & return it, & they drop it again.

19. Symbolic play:
 Helps explain child’s problem in a symbolic
way
 No rules, can use to reinforce, learn about, &
imaginatively alter painful experiences
Dramatic play:
 Child act out situations experienced by them
 Either spontaneous, guided or therapeutic

20. Surrogate play:
 For children who are severely ill
 Parent/another child is a surrogate
 Watching the surrogate play, stimulates the
sick child

21. COMMON PROBLEMS:
 Challenge, as child cant voluntarily engage
 Parents need to understand the importance
 Play activities vary depending on cultural &
socio-economic circumstances
 Not knowing the group languages

22. SAFETY ISSUES:
 Should be washable
 Should have no sharp edges & no small
parts
 Tossing ball to a child with cast fall
 Chasing ball falls, collisions
 If toy is used for a long time, can use it in
unsafe way

23. NURSES RESPONSIBILITIES:
 Organise play activities
 Flexibility in play time
 Play materials should b placed in separate room
 Age appropriate play articles should be provided
 Involve all members for play
 Interact during play
 Observe & record child’s behaviour
 Protect & guide children when aggressive
 Participate with the children during play
 Teach the importance of play

24. NURSING CARE & FAMILY PRINCIPLES &
PRACTICES:

25. PREVENTING OR MINIMIZING SEPARATION
 Primary goal
 Welcome the presence of parents
 Family centred care
 Provide support- both parents & child
 Frequent parental visits
 Leave a favourite article, if the parents can’t
room-in

26. MINIMIZING LOSS OF CONTROL:
 Promoting freedom of movements
 Place child on parent’s lap during procedures
 Mechanical freedom can be provided
 Maintain child’s routines
 Encouraging independence
 Concept of self care
 Promote understanding
 Inform children about their rights

27. PREVENTING OR MINIMIZING FEAR OF BODILY
INJURY:
 Preparation of children for painful procedures
 Manipulating procedural techniques
 Stress the reason for a procedure & evaluate
child’s understanding
 Employ pain reduction techniques

28. STRATEGIES TO COPING & NORMAL
DEVELOPMENT:
 Focus on physiological, psychosocial &
developmental needs
 Promote effective coping
 Provide developmentally appropriate
activities like rooming in, therapeutic play &
therapeutic recreation & child life programs

29. CHILD LIFE PROGRAMS:
 Focuses on psychosocial needs of hospitalised
child
 Professional child specialist, Para professionals
& volunteers –staff
 Plan age appropriate play
 Assist children in working through feeling about
illness
 Eg. Playing with medical equipment
 Child specialist & nurses together assist
children in their needs

30. ROOMING IN:
 Have a parent stay in child’s hospital room
 Parent should assist in child care
 Communication between nurse & parent, so
that parent’s desire for involvement is
supported

31. THERAPEUTIC PLAY:
 Helps reduce stress
 Means to learn about health care, express
anxieties, achieve mastery over control &
frightening
 Helps assess child’s knowledge of his/her
illness

32. THERAPEUTIC RECREATION:
 Planned recreation program for adolescents to meet
development needs during hospitalisation
 Telephone contact & visits from friends
 Interaction with the teenagers
 Physical activities that provide an outlet for stress
recommended
 Assist to regain control
 Giving options & letting to choose promotes feeling of
independence
 Acutely ill child may enjoy listening to stories
 Children must be taught to take care of their toys
 Nurse should participate in play activities

33. REFERENCES:
1. Marlow R Dorothy, Redding A Barbara.
Textbook of Paediatric Nursing. 6st ed.
2. Datta Parul. Paediatric Nursing. 2nd ed.
3. Gupta Piyush. Essential Paediatric Nursing.
2nd ed.
4. Terri Kyle. Essentials of Paediatric
Nursing.1st ed.
5. Tom Lissauer, Graham Clayden. Illustrated
Textbook of Paediatric. 3rd ed

34. JOURNALS:
 Hirani Shela Akbar Ali. International Journal
Of Nursing Care. Vol1, Issue1. Apl3, 2013.
Use of play therapy in educating asthmatic &
diabetic pediatric patients
 Sylvia Cassel. Journal of Paediatrics. Vol71,
Issue2. The role of puppet therapy on the
emotional responses of children hospitalised
for cardiac catherisation

35. RESEARCH STUDIES
 The role of puppet therapy on the
emotional responses of children
hospitalized for cardiac catheterization
 Use of play therapy in educating
asthmatic & diabetic pediatric patients.