Therapeutic play in pediatric hospitalization: a comprehensive care strategy beyond pain management
e202610084
DOI:
https://doi.org/10.67113/resp.v100i1.1374Keywords:
Pediatric hospitalization, Infant pain, Non-pharmacological distraction, Therapeutic play, Anxiety in children, Technology in children's health, Pediatric painAbstract
During pediatric hospitalization, invasive and painful procedures are frequently performed and may cause anxiety and fear, particularly among children who, due to their age, may not fully understand the situation. If pain is not adequately managed, it may be associated with negative consequences, such as sleep disturbances, needle phobia, and reluctance or refusal to seek or receive healthcare. Therefore, alleviating pediatric pain is both a right and a responsibility of healthcare institutions, which should implement effective pain management strategies.
Among these strategies, non-pharmacological distraction is an intervention used to reduce pain and distress associated with certain procedures. It may include sensory stimuli adapted to the child’s age and developmental level. In this context, play has gained relevance as a therapeutic tool, although its effects should be interpreted considering the type of intervention, the clinical context, and the quality of the available evidence.
Play promotes children’s emotional, cognitive, and social development and may improve their relationship with healthcare professionals and facilitate cooperation during treatment. Therefore, its incorporation from the time of hospital admission has been proposed, supported by specific institutional policies and professional training programs. Hospitals should also be provided with appropriate resources, and interdisciplinary collaboration should be promoted to ensure its effective implementation as a complementary therapeutic tool.
From a public health perspective, its systematic integration should also consider equity in access, differences in resources between healthcare settings, professional training, and outcome evaluation.
Downloads
References
1. Ugucu G, Uysal DA, Polat OG, Artuvan Z, Kulcu DP, Aksu D et al. Effects of cartoon watching and bubble-blowing during venipuncture on pain, fear, and anxiety in children aged 6–8 years: A randomized experimental study. J Pediatr Nurs. 2022;65:e107-114. DOI: https://doi.org/10.1016/j.pedn.2022.03.016
2. Chen Y, Min C, Wang Q, Zhou J, Xie A, Shen L et al. Procedural pain in hospitalized children in a Chinese children’s hospital. Pain Manag Nurs. 2021;22(3):414-422. DOI: https://doi.org/10.1016/j.pmn.2020.11.009
3. Bradford JY, Stapleton SJ, Horigian A, Barnason S, Foley A, Johnson M et al. Clinical practice guideline: needle-related or minor procedural pain in pediatric patients. J Emerg Nurs. 2019;45(4):437.e1. DOI: https://doi.org/10.1016/j.jen.2019.05.015
4. World Health Organization. Standards for improving the quality of care for children and young adolescents in health facilities. Geneva: WHO; 2018. Standard 7: Pain management and palliative care. ISBN: 9789241565554. Disponible en: https://www.who.int/publications/i/item/9789241565554 (consultado 8 septiembre 2026).
5. Southall DP, Burr S, Smith RD, Bull DN, Radford A, Williams A, Nicholson S. The Child-Friendly Healthcare Initiative (CFHI): Healthcare provision in accordance with the UN Convention on the Rights of the Child. Child Advocacy International. Department of Child and Adolescent Health and Development of the World Health Organization (WHO). Royal College of Nursing (UK). Royal College of Paediatrics and Child Health (UK). United Nations Children’s Fund (UNICEF). Pediatrics. 2000 Nov;106(5):1054-1064. doi: https://doi.org/10.1542/peds.106.5.1054 DOI: https://doi.org/10.1542/peds.106.5.1054
6. Birnie KA, Noel M, Chambers CT, Uman LS, Parker JA. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev. 2018 Oct 4;10(10):CD005179. doi: https://doi.org/10.1002/14651858.CD005179.pub4 DOI: https://doi.org/10.1002/14651858.CD005179.pub4
7. Thestrup J, Sørensen JL, Hybschmann J, Topperzer MK, Graber K, O’Farrelly C et al. Establishing consensus on principles and competencies for the use of play in clinical practice in hospitals: An international Delphi study. Eur J Pediatr. 2024;183(4):1595-1605. doi: https://doi.org/10.1007/s00431-023-05411-4 DOI: https://doi.org/10.1007/s00431-023-05411-4
8. Signorelli C, Robertson EG, Valentin C, Alchin JE, Treadgold C. A Review of Creative Play Interventions to Improve Children’s Hospital Experience and Wellbeing. Hosp Pediatr. 2023;13(11):e355-e364. doi: https://doi.org/10.1542/hpeds.2022-006994 DOI: https://doi.org/10.1542/hpeds.2022-006994
9. Alavi B, Makvandi B, Asgari P, Moradimanesh F. Effectiveness of individual play therapy on hope, adjustment and pain response of children with leukemia hospitalized in Shahrivar Hospital, Rasht, Iran. Prev Care Nurs Midwifery J. 2021;11(2):10-21. DOI: https://doi.org/10.52547/pcnm.11.2.10
10. Ramdaniati S, Lismidiati W, Haryanti F, Sitaresmi MN. The effectiveness of play therapy in children with leukemia: A systematic review. J Pediatr Nurs. 2023;73:7-21. doi: https://doi.org/10.1016/j.pedn.2023.08.003 DOI: https://doi.org/10.1016/j.pedn.2023.08.003
11. Nazari AM, Sarmadi S, Ghazanfari MJ, Gholami M, Emami Zeydi A, Zare-Kaseb A. The effectiveness of play therapy on depression and anxiety in hospitalized children with cancer: a systematic review. Support Care Cancer. 2025;33(2):88. doi: https://doi.org/10.1007/s00520-024-09144-4 DOI: https://doi.org/10.1007/s00520-024-09144-4
12. Kapkin G, Manav G, Karayagız Muslu G. Effect of therapeutic play methods on hospitalized children in Turkey: a systematic review. J Clin Pract Res. 2020;42(2):127. DOI: https://doi.org/10.14744/etd.2019.94940
13. Arnon Z, Hanan H, Mogilner J. The effect of a hypnotic-based animated video on stress and pain reduction in pediatric surgery. Int J Clin Exp Hypn. 2018;66(2):123-133. DOI: https://doi.org/10.1080/00207144.2018.1421353
14. Ortiz ÉEY. El juego como herramienta generadora de bienestar para niños hospitalizados: una revisión sistemática. Axioma. 2021;(25):73-81. DOI: https://doi.org/10.26621/ra.v1i25.729
15. Sánchez-Caballero E, Ortega-Donaire L, Sanz-Martos S. Immersive Virtual Reality for Pain and Anxiety Management Associated with Medical Procedures in Children and Adolescents: A Systematic Review. Children (Basel). 2024;11(8):975. doi: https://doi.org/10.3390/children11080975 DOI: https://doi.org/10.3390/children11080975
16. Gao Y, Xu Y, Liu N, Fan L. Effectiveness of virtual reality intervention on reducing the pain, anxiety and fear of needle-related procedures in paediatric patients: A systematic review and meta-analysis. J Adv Nurs. 2023;79(1):15-30. doi: https://doi.org/10.1111/jan.15473 DOI: https://doi.org/10.1111/jan.15473
17. Cáceres-Matos R, Castillo-García M, Magni E, Pabón-Carrasco M. Effectiveness of Virtual Reality for Managing Pain, Fear, and Anxiety in Children and Adolescents Undergoing Needle-Related Procedures: Systematic Review with Meta-Analysis. Nurs Rep. 2024;14(3):2456-2484. doi: https://doi.org/10.3390/nursrep14030182 DOI: https://doi.org/10.3390/nursrep14030182
18. Merino-Lobato C, Rodríguez-Gallego I, Pabón-Carrasco M, Romero-Castillo R, Jiménez-Picón N. Virtual reality vs. Buzzy®. Efficacy in pain and anxiety management during pediatric venipuncture. Systematic review and meta-analysis. J Pediatr Nurs. 2023;73:22-33. doi: https://doi.org/10.1016/j.pedn.2023.08.014 DOI: https://doi.org/10.1016/j.pedn.2023.08.014
19. World Health Organization. Global standards for quality health care services for adolescents. Geneva: World Health Organization; 2025. ISBN: 978-92-4-011401-2.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2026 Ana González-Díaz, Cristina Canals-Garzón, Juan Gómez-Salgado, Nora Suleiman-Martos, José Luis Gómez-Urquiza
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Usted es libre de:
Compartir — copiar y redistribuir el material en cualquier medio o formato.
La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia.
Bajo los siguientes términos:
Atribución — Usted debe dar crédito de manera adecuada , brindar un enlace a la licencia, e indicar si se han realizado cambios. Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
NoComercial — Usted no puede hacer uso del material con propósitos comerciales.
SinDerivadas — Si remezcla, transforma o crea a partir del material, no podrá distribuir el material modificado.
No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
Avisos:
No tiene que cumplir con la licencia para elementos del material en el dominio público o cuando su uso esté permitido por una excepción o limitación aplicable.
No se dan garantías. La licencia podría no darle todos los permisos que necesita para el uso que tenga previsto. Por ejemplo, otros derechos como publicidad, privacidad, o derechos morales pueden limitar la forma en que utilice el material.
![¿Cómo evaluar para la RESP? [PARA REVISORES]](https://ojs.sanidad.gob.es/public/site/images/rmartinb/pastilla-revisores-0eaa113abcbc4fc554c7c6c7840ca4c6.jpg)
![¿Cómo recibir avisos sobre nuevos artículos de la RESP? [PARA LECTORES]](https://ojs.sanidad.gob.es/public/site/images/rmartinb/pastilla-lectores-aa689338e95aab07df45b4b0d583188f.jpg)
