Integration of procedural play for children undergoing cystic fibrosis treatment: A nursing perspective

Children with Cystic Fibrosis (CF) must undergo long-term and invasive treatment regimes. Research indicates that the emotional impact of invasive procedures associated with treatment are significantly stressful for the child-patient and his or her family. It is also documented that procedural play can significantly reduce these stress levels. Nurses are one of the primary health care professionals responsible for dealing with hospitalised children with CF. It is important that they are aware of the significant therapeutic role of procedural play. There is limited literature on nurses' understanding of procedural play in the acute paediatric environment. Thus, the purpose of this study is to describe factors, from a nursing perspective, that facilitate or inhibit the integration of play as a therapeutic tool for children undergoing invasive procedures for the treatment of CF in the context of an acute paediatric ward culture.

Using qualitative, descriptive phenomenological research methods seventeen registered nurses from four Australian hospitals were interviewed. The unstructured, open style interviews were transcribed verbatim and thematically analysed. Key findings showed that whilst nurses had an intuitive understanding of play they did not have a professional discourse of procedural play. The hospital system supports the prioritisation of clinical practice over the child's psychosocial needs during procedural interventions. This research makes an original contribution to the knowledge base in the field of paediatrics by providing insights into an important and unexplored area. The thesis details strong recommendations with regards to developing a supportive sub-culture of procedural play through educational strategies for the nursing profession.