Poster-based Play Interventions to Reduce Pediatric Hospital Anxiety: A Systematic Review and Thematic Synthesis

BACKGROUND: Children often face stress or crises in hospitals, and while they lack coping mechanisms during times of increased stress, they become more defenseless against anxiety associated with diseases and hospitalization. Anxiety can delay a pediatric patient’s treatment response. Playing is an essential part of children’s development and is frequently used to help pediatric patients with stress during hospitalization. This systematic review examines the impact of various leadership strategies on implementing poster-based play therapy in pediatric hospital settings for patients aged 3–18 years. OBJECTIVES: To investigate the therapeutic potency of visual stimuli, such as posters, to develop a poster-based play intervention in pediatric settings, to inform implementation in Saudi Arabian hospitals; however, the available primary studies were international, and their findings may be interpreted for cultural and practical application in Saudi hospitals. METHODS: A systematic review and thematic synthesis were performed across seven qualitative and mixed-methods studies published between 2016 and 2021, as of January 2022. The search was conducted in Scopus, APA PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed (Medline). The phrases “coping,” “hospitalization,” “posters,” “images,” “play,” “children,” and “experience or viewpoint” were used in a systematic peer-reviewed search. Included studies were conducted in multiple countries; where direct evidence from Saudi Arabia was lacking, the synthesis emphasised translation of findings to the Saudi cultural and clinical setting. RESULTS: The results revealed four major effective themes in the thematic synthesis of the original research for developing a supportive environment to alleviate stress in pediatric patients. Visual stimuli enhance the positive development of children’s behaviors based on several factors, including poster content and color scheme, leadership style, and play therapy in the healthcare context. CONCLUSIONS: Although research on the direct medical effects of poster-based play interventions is limited, a potential positive impact may lie in considering the necessary resources and training for pediatric nurses, as well as the use of visual play therapies in children’s hospital rooms. Recommendations emphasise cautious generalisation, in which conclusions are drawn from international literature and adapted for relevance to Saudi Arabian hospitals, highlighting the need for local evaluation and culturally tailored implementation studies.