JOPHON NCPD (2022 Jan/Feb) - Playing With a Purpose: The Impact of Therapeutic Recreation During Hospitalization-Playing With a Purpose: The Impact of Therapeutic Recreation During Hospitalization

Playing With a Purpose: The Impact of Therapeutic Recreation During Hospitalization

Pdf Summary

This study examined whether adding therapeutic recreation (TR) to standard psychosocial care benefits hospitalized youth receiving cancer treatment or hematopoietic stem cell transplant (HSCT). Hospitalization can disrupt normal development and reduce physical activity, leisure participation, social interaction, and mood. TR, delivered by a Certified Therapeutic Recreation Specialist, uses tailored leisure activities (e.g., games, movement-based play, art, music) to support functioning and quality of life, but has been understudied in pediatric inpatient oncology.<br /><br />Using a single-site interventional design with historical controls, 49 patients ages 8–17 participated (29 controls; 20 in the TR-available period). Participants wore a Fitbit for three days to measure steps and completed self-report measures of mood (PROMIS Positive Affect; BASES-R mood disturbance), peer relationships (PROMIS), and health-related quality of life (BASES-R), plus a recreation satisfaction survey. TR sessions (30–90 minutes) were offered but not mandatory; 25% of intervention participants declined TR.<br /><br />Compared with historical controls, the TR group reported significantly better mood outcomes: higher positive affect and lower mood disturbance (both p = 0.03). They also reported better sleep quality on the BASES-R (p = 0.003) and greater satisfaction with the hospital’s leisure programming, including more age-appropriate and interesting activities and more opportunities for recreation (p values 0.04 to 0.002; overall satisfaction p = 0.01).<br /><br />TR did not increase objectively measured physical activity (median steps remained under ~2,000/day in both groups), nor did it improve somatic distress, cooperation with care, or interactions with staff/caregivers. Peer relationship scores were low in both groups (about one standard deviation below norms), suggesting persistent lack of peer companionship during hospitalization. The authors conclude TR can improve mood and sleep and enhance leisure experiences, but future work should better leverage TR to increase physical activity and social connectedness.

Keywords

therapeutic recreation

pediatric inpatient oncology

hematopoietic stem cell transplant

psychosocial care

mood improvement

sleep quality

leisure satisfaction

Fitbit step count

peer relationships

quality of life