Investigation of the effect of education given by therapeutic play method on psychosocial symptoms of 6-12 year old children with bone marrow transplantation

Procedures requiring long-term hospitalization are used in the treatment of life-threatening diseases. It is known that long-term hospitalizations in childhood affect the development process of the child and cause psychosocial symptoms. Bone marrow transplantation (BMT) is one of the treatment methods used in life-threatening diseases. Long-term hospitalization during the BMT process, painful invasive procedures, unknown environment, being treated in an isolated room for at least 4 weeks, being separated from loved ones, not attending school, and applying aggressive treatments cause the development of psychosocial symptoms in children. It is also known that preparing children for hospital, illness, treatments, painful invasive interventions with therapeutic game method is effective. It was planned and applied to examine the effect of education on psychosocial symptoms of 6-12-year-old pediatric patients undergoing bone marrow transplantation with a story book describing the bone marrow transplantation process before transplantation.The sample of the study consisted of 24 children between the ages of 6-12 who were hospitalized in the Pediatric BMT services of three private hospitals in Istanbul for transplantation between 11.11.2019 and 30.12.2020 and the children were randomized into each group (experiment and control). Among the children who accepted to participate in the study and met the inclusion criteria, the first child who was hospitalized for transplantation was included in the control group (the group in which only the scale will be used instead of the story book) and the second child in the experimental group (the group in which the story book was read, and the scale was applied). Data Collection Form for 6-12 Age Group Children with Bone Marrow Transplantation and Their Parents was applied to the parents in both groups. The child in the experimental group was first administered the Psychosocial Symptoms Diagnostic Scale for Hospitalized Children, and then read the book which is named "Can is Getting A Bone Marrow Transplant!" and prepared by the researcher. Control group was given to routine practice. The study was terminated by repeating the scale in both groups after transplantation. Before collecting data, an information form was given to the children and their parents who undergoing bone marrow transplantation. Psychosocial Symptoms Diagnostic Scale for Hospitalized Children was evaluated bu the researcher at before and after transplantation. Data were evaluated in SPSS 22.0 program, descriptive statistical analysis (number, percentage, mean, standard deviation, minimum-maximum value), Independent Sample-t, Paired Sample-t, Anova, Mann-Whitney U, Wilcoxon and Pearson-χ2 test statistics. Before starting the research, ethics committee approval was obtained from the Yeditepe University Clinical Research Ethics Committee. As a result of the study, it was found that there was no statistically significant difference between the children and parents in the experimental and control groups in terms of their introductory characteristics affecting psychosocial symptoms (p> 0.05). There was no statistically significant difference between the mean scores of the scale before and after the transplantation of the experimental and control groups, there was no statistically significant difference between the scale subscale anxiety mean scores, the scale subscale hopelessness mean scores, the scale subscale communication difficulty scores, and the scale subscale anger and aggression mean scores (p> 0.05). While there was no statistically significant difference between the experimental and control groups (p> 0.05), a statistically significant difference was found between the regression subscale mean scores of the experimental group before and after transplantation (p <0, 05). It was found that the education given to children with therapeutic play method before bone marrow transplantation did not affect the psychosocial symptoms that occur during the transplantation process. It is recommended that studies investigating the effect of education given by therapeutic play method on psychosocial symptoms in the BMT process should be conducted with more sample groups and the effectiveness of therapeutic play in other treatment procedures applied during the BMT process.