Play and paediatric health: exploring children's perspectives of play in the context of early health adversity
Background Children possess rights to play and to express themselves on matters related to childhood. Though it is recognised that children can be experts of their own lives, the realisation of these rights and children’s agency is contextually dependent, especially in circumstances of health adversity in childhood. Play is recognised as critically important in childhood and associated with children’s health and wellbeing, yet there is a dearth of evidence that includes children’s own perspectives on the role and value of their play in situations of health-related challenges during childhood. This research seeks to address the question: what are children’s experiences of play amidst early health adversity? Children’s perspectives are an integral component of this investigation, focusing on experiences of play in the context of widespread health adversity (the COVID-19 pandemic) and acute, personal health adversity (paediatric hospitalisation). Studies and Methods This thesis consists of three studies to support this exploration. The first study, conducted at the outset of the COVID-19 pandemic, is a rapid review on the impact of quarantine or isolation on children’s play. Building upon those findings, the second study presents a remotely conducted, qualitative exploration of children’s perspectives on play during the COVID-19 pandemic. Finally, moving from broad societal to individual health adversity, the third study combined ethnographic observations and qualitative interviews to investigate paediatric patients’ perspectives on play during inpatient hospitalisation. Results The results of the rapid review revealed a limited amount of research regarding the impact of restrictive circumstances on play, particularly related to health adversity and disease outbreaks. The findings showed that access to play is affected amidst restrictions and indicated that play can be utilised to support children enduring restrictive circumstances, but critically highlighted a lack of data on children’s own perspectives of their experiences. The subsequent study about children’s perspectives on play during the pandemic demonstrated the unique qualities of children’s viewpoints on their play amidst health adversity. Children expressed that play persisted in the face of restriction and uncertainty, demonstrating adaptability and positivity related to their play. The final study of children’s perspectives on play during hospitalisation illustrated the dynamic relationship between children’s wellbeing and their play, children’s sense of ownership and expertise regarding their play, and the capacity for play to make young patients feel like children when experiencing childhood in the atypical context of a hospital. Conclusion This thesis highlights the need to gather, listen, and attend to children’s perspectives on elemental aspects of childhood, such as play, that can be affected by early health adversity and distinctly impact children’s lives. Including children’s perspectives supports the recognition of children as experts of their childhoods and their play. Additionally, it has the potential to enhance understanding of children’s experiences of health crises and improve the care and consideration for supporting childhood amidst early health adversity. This requires improved realisation of children’s rights and agency and improved recognition of the value of play in collective society.
childhood, children's perspectives, COVID-19, health, healthcare, hospital, paediatric, play
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