Preparation and Distraction: Why We Bother

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Preparation and DistractionWhy We Bother

• Bev Williams
• Play Specialist
• Stepping Hill Hospital

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Normalising Play
Normalising play is the foundation of
intervention on which more focused play support
can be developed. (Webster PN 2000)

• Normalise the clinical environment
• Help support children and families feel they are
  in a safe environment
• Provide links to home
• Assess the childs developmental level

Familiar play helps to
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QUOTE FROM PAEDIATRIC CONSULTANT

• Play Specialists are essential members of the
  in-patient team. When children come into hospital
  they are frightened and often very nervous of
  what is going to happen. Thanks to the Play
  Specialists their hospital stay is made happier
  and less traumatic. Without Play Specialists a
  children's ward could not function adequately.
• Dr Roger J. Harris

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Play Preparation offers a chance for all
children to be included in decisions affecting
their lives in an age appropriate way.(UNICEF
2000, Children Act 1989)
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Pre-admission Programmes/Pre Assessment Clinics

• Provide a positive opportunity for the child to
  visit the hospital environment with their
  families support.
• Empowers parents through accurate information
  sharing and discussion on how to prepare their
  child.
• Common procedures and who does what can be
  explained
• Confusion or worries, misconceptions and fears
  can be identified.

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Preparation

• Hospital procedures can cause a great deal of
  anxiety in both children and their
  parents/carers.
• Play preparation given in a structured, tailored
  manner for children of different ages as well as
  for the individual can help to eliminate this
  anxiety.
• An informed child is a less vulnerable child.
• Feeling able to cope encourages cooperation.
  (Heiney 1991).
• If the reasons for treatment are well understood
  they can help to manage their own care.
• The child can then understand what to expect and
  what is expected of them.

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Play Mediums, Uses and Benefits

• Dolls - Used in imaginative play to demonstrate
  procedures, benefits are easily identified by the
  child and allows concrete thinking.Ages 2 and up
• Play mobil - used for symbolic play , opens up
  discussions ideal for picking up any
  misconceptions and allows concrete thinking. Ages
  3 and up.
• Books - Provide information and expands on
  explanations for the parents as well as the
  child,Child and parents can read over again and
  at their own pace. Ages 2 and up.
• Leaflets - as above, but can be more specific for
  certain procedures. Ages 2 and up.
• Photo Diary - Opens discussions on information
  and explanation specific for the test or
  procedure.If the child makes their own it can be
  shown to the family therefore involving them.
  Ages 6/7 and up.
• Video - information and explanation specific to
  procedure and opens discussion. Good for the
  child who may be shy and reluctant to play or
  participate, can be used at childs own pace.
  Ages 5 and up.

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Distraction Therapy

• Gather information about the procedure i.e where
  it will take place, how long and who will be
  there.
• If possible form a good relationship with the
  child and family. If not introduce yourself and
  role.
• Gather information if possible, childs hobbies,
  past experiences good and bad, if the parent
  wants to be there, does the child want to look if
  venepuncture.
• Prepare the child for the procedure.Ask the child
  what techniques they want and if time practice
  it.
• During the procedure ensure that all other people
  involved with the child are aware that you are
  doing the distraction therapy.
• Other people trying to distract at the same time
  will prove to be very negative and could upset
  the child.

• Plan the position of the child and distraction
  method carefully to gain maximum effect.
• Introduce distraction implement at the correct
  time.
• For the distraction therapy to succeed, the child
  must be receptive.If the child becomes distressed
  stop the distraction but stay in the room. Let
  the child play with the distraction tool after if
  they wish.
• Give the child ample praise when the procedure is
  over. Stickers and certificates work very well.
• Document the work you have done and the outcome
  in the childs notes for future reference.
• Spend time with the child afterwards to see if
  the child and family have any upsets.

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Laughter Works
Laughter is a fantastic distraction tool.
Laughter and humour come out as a way of helping
children cope with pain, I call it the balloon
syndrome, to put a little bit of air in it to
help everyone relax Frances Binns Play
Consultant CMMC