A Systematic Literature Study to Review Children’s Anxiety During Hospitalisation

Abstract

Hospitals admit a large number of patients each year for several health issues and a considerable proportion are admitted for various reasons. The statistics from different health organisations show an increase in the admission of patients aged below eighteen years, who are categorised as paediatric patients. Their admission can be due to several reasons, ranging from minor to long term and life-threatening illnesses. Regardless of the type of illness, a stay in hospital can be a troubling, demanding experience, due to different factors. These factors include the change in the routine, absence of loved ones and friends, inability to play, stress and painful medical procedures. All these can have a huge impact on a child’s both mental and physical health. This can cause a psychological breakdown of the personality, instigating a sense of fear, stress, depression and anxiety. Among all of these, anxiety is a negative emotion that can have both long- and short-term effects on the child’s life. explain that intense anxiety can exert a long-term psychological and behavioural impact on children. Moreover, it also affects the personal life of children and their parents, along with affecting the recovery process. For instance, an anxious child may not allow medical personnel to conduct the medical processes as effectively as required. Additionally, this negative emotion can also impede the natural healing process. Since extremely harmful impacts of anxiety have been recorded by numerous studies, it is essential for hospitals to take measures against this negative emotion. Several interventions aiming to reduce the anxiety of hospitalised children have been proposed in the literature. These can generally be categorised as pharmacological and non-pharmacological interventions. This study focused on identifying the effectiveness of non-pharmacological interventions, including play therapy, music therapy, clown therapy and pet therapy. Several

studies have implemented these interventions under different settings (with varying factors like the age of the patients, location of the patients, duration of the intervention and reason for admission). This study conducted a systematic literature review following the guidelines, protocols and study procedure formulated in the proposal. A prisma search strategy was applied to choose the most appropriate and relevant studies. Furthermore, the Critical Appraisal Skills Programme (CASP) qualitative checklist was utilised to assess the quality of the 20 studies that were selected for the detailed analysis. The information obtained by reviewing the selected studies was arranged in the form of tables and then analysed. The 20 selected studies included four major types of intervention: play, pet, clown and music interventions. The included play interventions can further be divided into five intervention. Four factors (the age of the patients, location of the patients, duration of the intervention and reason for admission), identified from the literature, that can affect the effectiveness of any interventions were also included, along with the intervention outcomes. Upon detailed examination, no clear pattern between the efficiency of an intervention, its duration or the age group concerned was found. However, a clear pattern was observed between some of the regions and the intervention types. Similarly, the reason for admission also appeared to influence the efficiency of the interventions. The results also proved the higher effectiveness of pet therapy over other interventions, with a hundred percent efficiency in reducing anxiety among hospitalised children in varying settings, whereas music therapy performed the worst of all.