Hospitals are often scary places for kids:
Children make up a significant proportion of healthcare users; in the UK during a 10-year period within the NHS, there were over 7 million primary care consultations, 2 million outpatient visits and almost 200,000 elective admissions to hospital for children under the age of 15 years (1). Research demonstrates that even interactions of a routine nature can be perceived as emotionally threatening, inducing negative feelings such as fear, anxiety and pain (2). The COVID-19 pandemic has served to exacerbate this, with healthcare workers wearing intimidating-looking PPE and hospitals being regarded as a place to be afraid of.
Current psychological support for children undergoing healthcare procedures is inadequate:
We know that anxiety surrounding healthcare interactions is linked to poor patient experiences and worse outcomes (3). We also know that providing better psychological support is needed reduce peri-procedural anxiety (4). Despite this, healthcare organisations are extremely limited by time and cost resources in providing the type of support that we at Little Journey believe all children deserve. Too often, service efficiencies take priority, with patient-centric care and an appreciation of the individual taking a back seat.
Play is a vital resource in supporting children throughout their hospital journey:
Play is a universal, crucial component in the healthy development of all children; it is used innately by kids in order to make sense of the world, to learn and practice skills, to explore thoughts and feelings, and to help cope with life’s challenges. Play empowers children to develop skills such as self-regulation and resilience, and to practice strategies to help overcome stress and manage their anxiety. Play encourages the feeling of agency, of taking control, helping to reduce those feelings of uncertainty and anxiety that are all too common within healthcare interactions.
“A child’s right to play is enshrined in Article 31 of the United Nations Convention of the Rights of the Child”
Half of children do not have access to play when in hospital:
However, play is too frequently overlooked in the busy hospital environment. The UK based charity, Starlight Childrens Foundation, highlights the variations in children’s access to play when in hospital in their 2021 report, “The Importance of Play in Hospital” (5). Their research (using CQC and survey data) found that more than half of all UK hospitals have no budget for play and a third of hospitals do not have dedicated play professionals. In the minority of organisations that did have funds for play, more than 60% had a budget of less than £500 for the whole year.
Little Journey is an innovative, low-cost digital solution that enables access to play-based psychological support within healthcare settings.
The Little Journey smartphone app allows families to access support and information at a time and location convenient to them. Familiarising and desensitising children to the clinical environment through interactive virtual tours and immersive games helps to reduce uncertainty and anxiety; relaxation animations help teach the development of positive coping strategies. All content is tailored to the child’s age, procedure type and hospital (including 360-degree images of the actual rooms visited by patients), helping to provide a more personalised experience.
Learning through Play – the LEGO way:
Over the past couple of months, the team at Little Journey have been lucky enough to engage with The LEGO Foundation). This has given us valuable insight into the importance of, and theory behind, Learning through Play. We have been introduced to the five characteristics of playful learning: Joyful, Meaningful, Actively Engaging, Socially Interactive, and Iterative; and learnt about the importance of variety in play - using both free-form and guided play. Their paper, “Learning to cope through play” (6) highlights the importance of providing opportunities for play within healthcare in order to channel negative emotions and practice strategies to overcome anxiety and distress.
Partnering with a super team at Founders Intelligence and the charity Nasen (https://www.nasen.org.uk), we have explored how we can incorporate even more aspects of play-based learning into our award-winning app, helping children develop life-long skills that can be used not just within healthcare settings but in all aspects of life.
We look forward to taking this learning further, helping to support more children, all across the world, to better health.
- Ruzangi J, Blair M, Cecil E, et al. Trends in healthcare use in children aged less than 15 years: a population-based cohort study in England from 2007 to 2017. BMJ Open 2020;10:doi: 10.1136/bmjopen-2019-033761
- Lerwick J, Minimising paediatric healthcare-induced anxiety and trauma. World Journal of Pediatrics 2016;5(2):143-150.
- Kain ZN, Mayes LC, Caldwell-Andrews AA, Karas DE, McClain BC. Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery. Pediatrics. 2006 Aug;118(2):651-8. doi: 10.1542/peds.2005-2920. PMID: 16882820.
- Meletti D et al. Psychological preparation reduces preoperative anxiety in children. Randomized and double-blind trial. Journal of Pediatrics 2019; 95:545-51.