The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well‐being of children hospitalised with cancer
Abstract
Aims. To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. Background. There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer. Design. A non‐equivalent control group pretest–post‐test, between‐subject design was employed. Method. Hong Kong Chinese Children (8–16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14‐month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions. Results. The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children’s anxiety scores between the two groups on day 7. Conclusion. The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care. Relevance to clinical practice. The findings heighten the awareness in healthcare professionals that play is a very important part of children’s life and that they need play even when they are ill.
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After removal of a possible outlier (Li, Chung, and Ho 2011), the effect size of the other nine trials did not change significantly, but heterogeneity decreased significantly to a low level.
“It is important to note that after the removal of a possible outlier,39 the effect size of the other nine trials did not change significantly, but the heterogeneity decreased significantly to a low level.”
From Game-based digital interventions for depression therapy: a systematic review and meta-analysis (2014) · cites this paper as [39]
One study had a high risk of bias in random sequence generation, and two had a high risk of bias due to incomplete outcome data.
“One study had a high risk of bias in random sequence generation,41 and two had a high risk of bias due to incomplete outcome data.39,41”
From Game-based digital interventions for depression therapy: a systematic review and meta-analysis (2014) · cites this paper as [39]
Virtual reality computer games had an effect on reducing children's depression symptoms compared with usual care control.
“Li et al.39 also identified that virtual reality computer games had an effect on reducing children's depression symptoms in comparison with a control group in usual care.”
From Game-based digital interventions for depression therapy: a systematic review and meta-analysis (2014) · cites this paper as [39]
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
Eysenck, H. J. (1985) · Behaviour Research and Therapy · doi:10.1016/0005-7967(85)90087-7 · Cited by 32,026 · see citing works
“Stress: appraisal and coping,”
Folkman, S. (2013) · Encyclopedia of Behavioral Medicine · doi:10.1007/978-1-4419-1005-9_215 · Cited by 27,833 · see citing works
Cohen, J. (1992) · Psychological Bulletin · doi:10.1037//0033-2909.112.1.155 · Cited by 8,771 · see citing works
Nursing Research Generating and Assessing Evidence for Nursing Practice
Timmins, F. (2013) · Nurse Education in Practice · doi:10.1016/j.nepr.2013.04.001 · Cited by 5,505 · see citing works
Weissman, M. M., Orvaschel, H., & PADIAN, N. S. (1980) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198012000-00005 · Cited by 894 · see citing works
The application of virtual reality technology in rehabilitation.
Schultheis, M. T., & Rizzo, A. (2001) · Rehabilitation Psychology · doi:10.1037/0090-5550.46.3.296 · Cited by 744 · see citing works
Quality of life, self‐esteem and worries in young adult survivors of childhood cancer
Langeveld, N. E., Grootenhuis, M. A., Voûte, P. A., de Haan, R. J., & van den Bos, C. (2004) · Psycho-Oncology · doi:10.1002/pon.800 · Cited by 304 · see citing works
Adapting an immersive virtual reality system for rehabilitation
Kizony, R., Katz, N., & Weiss, P. L. (2003) · The Journal of Visualization and Computer Animation · doi:10.1002/vis.323 · Cited by 187 · see citing works
Weiss, P. L., Bialik, P., & Kizony, R. (2003) · CyberPsychology & Behavior · doi:10.1089/109493103322011650 · Cited by 177 · see citing works
Maurice‐Stam, H., Grootenhuis, M. A., Caron, H. N., & Last, B. F. (2005) · Psycho-Oncology · doi:10.1002/pon.920 · Cited by 127 · see citing works
Psychoeducational preparation of children for surgery: The importance of parental involvement
Li, W. H. C., López, V., & Lee, T. L. I. (2006) · Patient Education and Counseling · doi:10.1016/j.pec.2006.04.009 · Cited by 125 · see citing works
Self-citationThe Impact of Cancer on Children's Physical, Emotional, and Psychosocial Well-being
Li, W. H. C., Chung, J. O. K., & Chiu, S. Y. (2009) · Cancer Nursing · doi:10.1097/ncc.0b013e3181aaf0fa · Cited by 121 · see citing works
Self-citationThe BELLA Study Group, Barkmann, C., Erhart, M., & Schulte‐Markwort, M. (2008) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-008-1013-0 · Cited by 113 · see citing works
Virtual Reality as a Pediatric Pain Modulation Technique: A Case Study
Steele, E. J., Grimmer, K. A., Thomas, B. H., Mulley, B., Fulton, I., & Hoffman, H. G. (2003) · CyberPsychology & Behavior · doi:10.1089/109493103322725405 · Cited by 96 · see citing works
Symptom Monitoring and Dependent Care During Cancer Treatment in Children
Williams, P. D., Schmideskamp, J., Ridder, E. L., et al. (2006) · Cancer Nursing · doi:10.1097/00002820-200605000-00004 · Cited by 84 · see citing works
Depression in paediatric cancer: an overview
DeJong, M., & Fombonne, E. J. (2005) · Psycho-Oncology · doi:10.1002/pon.1002 · Cited by 77 · see citing works
Li, W. H. C., & López, V. (2006) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2005.12.004 · Cited by 76 · see citing works
Self-citationChemotherapy-Related Fatigue in Childhood Cancer: Correlates, Consequences, and Coping Strategies
Whitsett, S. F., Guðmundsdóttir, M., Davies, B. I., McCarthy, P., & Friedman, D. (2008) · Journal of Pediatric Oncology Nursing · doi:10.1177/1043454208315546 · Cited by 67 · see citing works
Dowling, J. S., Hockenberry, M. J., & Gregory, R. L. (2003) · Journal of Pediatric Oncology Nursing · doi:10.1177/1043454203254046 · Cited by 63 · see citing works
Therapeutic play and the hospitalized child.
Vessey, J. A., & Mahon, M. M. (1990) · PubMed · Cited by 59 · see citing works
The developing role of play preparation in paediatric anaesthesia
Armstrong, T. S. H., & Aitken, H. L. (2000) · Pediatric Anesthesia · doi:10.1046/j.1460-9592.2000.00406.x · Cited by 47 · see citing works
Incorporating play interventions into nursing care.
LeVieux-Anglin, L., & Sawyer, E. (1993) · PubMed · Cited by 38 · see citing works
Psychosocial Practice Trends in Pediatric Oncology
Hicks, M. D., & Lavender, R. (2001) · Journal of Pediatric Oncology Nursing · doi:10.1053/jpon.2001.24795 · Cited by 38 · see citing works
Evaluating depression in a sample of children and adolescents with cancer in Greece
Matziou, V., Perdikaris, P., Galanis, P., et al. (2008) · International Nursing Review · doi:10.1111/j.1466-7657.2008.00606.x · Cited by 34 · see citing works
Factorial structure of the Chinese version of the State Anxiety Scale for Children (short form)
Li, W. H. C., Wong, E. M. L., & López, V. (2008) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2008.02284.x · Cited by 26 · see citing works
Self-citationLi, W. H. C., & Chung, J. O. K. (2009) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2009.02913.x · Cited by 23 · see citing works
Self-citationA Therapeutic Play Group for Hospitalized Children with Cancer
Cooper, S. P., & Blitz, J. T. (1985) · Journal of Psychosocial Oncology · doi:10.1300/j077v03n02_03 · Cited by 19 · see citing works
A Psychosocial Program for Pediatric Oncology Patients
Penkman, L., Scott-Lane, L., & Pelletier, W. (2006) · Journal of Psychosocial Oncology · doi:10.1300/j077v24n02_07 · Cited by 13 · see citing works
optimising patient care: meeting the needs of the paediatric oncology patient
o'connor, G., & Drennan, C. (2003) · Journal of Diagnostic Radiography and Imaging · doi:10.1017/s1460472803000063 · Cited by 11 · see citing works
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Kim, M. J., Lee, C.-K., & Preis, M. W. (2020) · Telematics and Informatics · doi:10.1016/j.tele.2020.101349 · Cited by 361 · see citing works
Game-based digital interventions for depression therapy: a systematic review and meta-analysis
Li, J., Theng, Y.-L., & Foo, S. (2014) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2013.0481 · Cited by 219 · see citing works
Virtual Reality for the Enhancement of Emotion Regulation
Colombo, D., Díaz‐García, A., Fernandez‐Álvarez, J., & Botella, C. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2618 · Cited by 120 · see citing works
- Authors
- Li, W. H., Chung, J. O., & Ho, E. K.
- Affiliations
- University of Hong Kong (HK)
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2011-06-08
- Volume
- 20
- Issue
- 15-16
- Pages
- 2135-2143
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W2168855602
- Cited by
- 170
- References
- 30
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 14 · 2023: 10 · 2022: 17 · 2021: 17 · 2020: 30 · 2019: 8 · 2018: 12 · 2017: 5 · 2016: 3 · 2015: 9 · 2014: 13 · 2013: 3 · 2012: 3
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- Hong Kong Education Bibliographic Database (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- Hospital Authority
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- therapeutic play, childhood cancer, hospitalized children, anxiety, depressive symptoms, psychological well-being, Chinese children, psychological intervention
- MeSH terms
- Adaptation, Psychological, Adolescent, Child, Hong Kong, Humans, Neoplasms, Play and Playthings, User-Computer Interface
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