# Effect of play-based intervention on children’s mental status and caregiver involvement during hospitalization: findings from Pakistan

## TL;DR

A study in Pakistan found that play-based interventions improved hospitalized children's mental status, with similar effects from caregivers and trainees.

## Contribution

The study demonstrates the feasibility and effectiveness of caregiver-led play interventions in improving children's mental status during hospitalization.

## Key findings

- Play stimulation significantly improved children's mental status scores across all provider types.
- Interventions showed significant variation in effectiveness based on child age and illness severity.
- Caregivers and trainees had comparable impacts on children's mental status outcomes.

## Abstract

The nurturing care framework (NCF) encompasses responsive caregiving, health, nutrition, safety and security by parents and other caregivers. It improves health, development and wellbeing of children. A hospital environment can be detrimental to the developmental and emotional needs of children hence NCF can be applied to hospitalized children.

The objective was to determine if (i) play stimulation intervention mediated by non-specialist providers (caregivers) improves mental status of children who are hospitalized; (ii) to examine if difference varies between different providers and iii) if there is variation based on child age and criticalness of illness.

A one-group pretest-posttest research was carried out using purposive sampling in a pediatric unit in Karachi, Pakistan, from November 2017 to December 2019. Children aged 3 months to 6 years were offered play stimulation by trainee psychologists. The outcome was measured through an observation tool, the Mental Status Examination Scale (MSE-S) developed for the study.

A total of 524 sessions were delivered to 351 children. Significant mean difference was observed on MSE-S before and after the intervention when it was provided by trainees (9.95, CI = 8.11, 11.7), mothers (mean difference = 5.86, CI = 5.30, 6.42), fathers (mean difference = 5.86, CI = 4.48, 7.24) and non-specialist providers [caregivers (mean difference = 5.40, CI = 3.91, 6.89). Significant differences in mean was observed on MSE-S across different age groups and criticalness of illness.

It was concluded that play stimulation not only affects the behaviour of children but also varies when delivered by caregivers and trainees. Hence, interventions that involve parents are feasible.

The online version contains supplementary material available at 10.1186/s12887-024-04659-5.