Department of Paediatrics and Child Health, The Aga Khan University, National Stadium Road, Karachi, Pakistan.
Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
BMC Pediatr. 2024 Apr 4;24(1):239. doi: 10.1186/s12887-024-04659-5.
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.
养育关怀框架（NCF）涵盖了父母和其他照顾者的回应式照护、健康、营养、安全和保障。它可以改善儿童的健康、发育和幸福感。医院环境可能不利于儿童的发展和情感需求，因此 NCF 可以应用于住院儿童。
本研究旨在确定（i）由非专业提供者（照顾者）进行的游戏刺激干预是否可以改善住院儿童的精神状态；（ii）检验不同提供者之间的差异；（iii）以及儿童年龄和疾病严重程度是否存在差异。
这是一项在巴基斯坦卡拉奇的儿科病房进行的单组预-后测试研究，采用了目的性抽样方法，研究时间为 2017 年 11 月至 2019 年 12 月。3 个月至 6 岁的儿童由受训的心理学家提供游戏刺激。使用专为该研究开发的观察工具——精神状态检查量表（MSE-S）来衡量结果。
共为 351 名儿童提供了 524 次干预。当由受训者（平均差异=9.95，CI=8.11，11.7）、母亲（平均差异=5.86，CI=5.30，6.42）、父亲（平均差异=5.86，CI=4.48，7.24）和非专业提供者[照顾者（平均差异=5.40，CI=3.91，6.89）]提供游戏刺激时，MSE-S 在干预前后的均值差异显著。在不同的年龄组和疾病严重程度中，MSE-S 的均值差异也显著。
游戏刺激不仅影响儿童的行为，而且由照顾者和受训者提供时也会有所不同。因此，涉及父母的干预措施是可行的。
