‘Eat, sleep, internet and talk’: an exploratory study of play profile for children living with palliative care needs

Background: Play is central to children’s lives. Children living with palliative care needs experience disruption in their play. In this study, we sought to discover the characteristics and patterns of children’s play when receiving care in children’s hospital wards and hospices in Kuwait and the United Kingdom. Methods: A qualitative nonparticipatory observation design was used. Thirty-one children were observed, between the ages of 5 and 11 years, all diagnosed with life-limiting or life-threatening conditions and receiving palliative care. The data were analysed using content analysis. Results: The children’s illnesses were negatively impacting their ability to have typical play for their age and development. The children’s interactive play was with grown-ups and very rarely with other children. This was associated with isolation precautions, the child’s need for assistance and a lack of play resources that match children’s physical and cognitive abilities. This gave rise to their engagement in more sedentary, solitary play. The findings of the study did not indicate significant cultural differences between the two countries. Conclusion: Children living with palliative care needs may be socially isolated due to their illnesses and their play participation can be limited. Understanding the influencing factors that determine these children’s play is essential for implementing effective modifications to enhance their play routines

Play in Children With Life-Threatening and Life-Limiting Conditions: A Scoping Review

Importance: Play is essential to children and provides opportunities to promote their health and well-being. Children living with life-threatening and life-limiting conditions experience deprivation in play. Objective: To conduct a scoping review of studies that examined play of children with a life-threatening or life-limiting condition to explore their play characteristics and possible factors influencing their participation in play. Data Sources: A search of literature published between 1990 and 2017 was conducted in the health, social care, and built-environment fields. The scoping review included multiple searches in electronic databases, a gray literature search, and manual searches of relevant journals and reference lists of included articles. Study Selection and Data Collection: Defined criteria were used to select articles describing studies that examined the daily play of children ages 5–11 yr with life-threatening and life-limiting conditions; articles that focused on play as therapy or that used parents’ accounts of a service were excluded. The identified articles were critically appraised with the Critical Appraisal Skills Programme and the Joanna Briggs Institute Critical Appraisal Tools. Findings: Thirteen articles were reviewed. The findings indicate that children’s play is influenced by their health conditions and play opportunities and by the limited availability of appropriate play equipment and spaces allowing play and social interaction. Conclusions and Relevance: Available appropriate play opportunities need to be maximized for children living with life-threatening and life-limiting conditions. This goal can be achieved by understanding and considering the needs of these children and by facilitating environmental enablers and limiting barriers. What This Article Adds: Promoting the participation in play of children who live with life-threatening and life-limiting conditions is important to their health and well-being and can be achieved by targeting the cultural, social, and physical environmental factors that shape the children’s play

The social and physical environmental factors associated with the play of children living with life threatening/limiting conditions: A Q methodology study

Objectives: Living with a life threatening/limiting condition changes and challenges children’s play. The environment is known to support participation in play, yet there is a lack of evidence highlighting its specific factors contributing the most to children’s play. The aim of this study was to investigate the perspectives of these children about the environmental factors that are related to their play at inpatient healthcare facilities. Methods: Twenty-seven children took part in this study. Participants were aged between 5y and 11y, diagnosed with life threatening/limiting conditions and were receiving care at either a children’s hospital or hospice in either both Kuwait or the UK.. Children were asked to rank-order the Q set according to their perceived importance. The Q set used in this study comprised of twenty-eight written and pictorial items of social and physical environmental factors. The data were analysed using factor analysis and content analysis. Findings: Two shared viewpoints were identified, representing children from both countries. Being surrounded by others was considered important for children to play. The children had relatively little concern for having outdoor area and for the type of play activities to engage in. An exception for this was the art and craft play activities. Conclusions: Play settings are important to support rich, social play experiences and opportunities that match their play preferences. Children living with life threatening/limiting conditions in Kuwait and the UK have relatively similar play needs

Unilateral Striae Distensae Affecting the Right Axilla in a 16‐Year‐Old Boy: Brief Report

Striae distensae or stretch marks are a common skin condition that occurs frequently in association with adolescent growth spurts and pregnancy. They are characterized by linear symmetrical asymptomatic smooth bands of atrophic‐appearing skin on the thighs, buttocks, and breasts in girls and on the shoulders, outer thighs, and lumbosacral areas in boys. We present a rare case of unilateral striae distensae affecting the right axilla in a 16‐year‐old boy