Rehabilitation including structured active play intervention for preschoolers with cancer during treatment: A RePlay qualitative study of parents' experiences.

PURPOSE: Preschool children receiving cancer treatment experience decreased gross motor function and challenges in personal and social development. For preschoolers, parents are critical for their child's cancer treatment trajectory, including their participation in physical activity. This study aimed to explore the parents' experiences with a novel rehabilitation intervention, including structured active play for preschoolers with cancer during treatment. METHOD: Through criterion sampling, 23 parents of 18 preschool children diagnosed with cancer were interviewed from August 2021 until April 2023. A hermeneutic-phenomenological-inspired inductive thematic analysis was performed. RESULTS: Based on 19 interviews with parents, three themes emerged: 1) pushing in the right direction, 2) sharing the responsibility, and 3) creating joyful experiences. The parents experienced that participation in the intervention resulted in physical progress for their child, and the child generally could develop personally and socially. The parents shared a common goal with a healthcare professional, who led the way in their child's physical development and gave them the space to participate with their child. The child actively chose to participate in structured active play, resulting in an altered perception of the hospital experience for both parents and children. CONCLUSION: The parents' experiences showed that with the support, knowledge, and expertise of an exercise professional, rehabilitation including structured active play can be a way to integrate movement and physical activity for preschoolers in their cancer treatment trajectory. The repetitive structure of the active play sessions was experienced as motivating for the children and simultaneously challenging their physical, social, and personal development. TRIAL AND PROTOCOL REGISTRATION: ClinicalTrials.gov: NCT04672681. Registered December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.

The potential of structured active play for social and personal development in preschoolers during cancer treatment: A qualitative RePlay study.

AIM: To explore the potential of a structured active play intervention to promote social and personal development in preschoolers during cancer treatment. DESIGN: A hermeneutic-phenomenological inspired explorative study. METHODS: Participant observations were conducted on 15 consecutively sampled children (aged 1-5 years) from April 2021 to April 2022. Observations were written as narrative scenic descriptions from field notes and were analysed inspired by hermeneutic-phenomenological analysis and using a thematic analysis structure. RESULTS: Observations were carried out during 67 group or individual structured active play sessions, resulting in 129 scenic descriptions. Observations of the children's emotional, verbal and bodily expressions and social interactions resulted in three main themes: (1) wanting to play, (2) gaining confidence in movement and (3) being part of a group. The findings showed how children, irrespective of age and the severity of their illness, wanted to play and expressed joy of movement. The children's daily physical state fluctuated and influenced their motivation to participate as well as their confidence in their physical abilities. Through structured active play and with support from their parents and healthcare professionals, the children had successful movement experiences and regained confidence in movement, supporting their personal development. Playing together with other children and accompanied by their parents, healthcare professionals supported the children's opportunities to practice social skills, such as turn-taking, waiting and taking charge. Familiarity, recognizability and fun were key motivational components for the children. CONCLUSION: Participating in structured active play during treatment has the potential to promote personal and social development in preschoolers with cancer. Parents play a crucial role in supporting the participation of their children. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The healthcare system and healthcare professionals should provide opportunities for preschoolers with cancer and other illnesses to participate in structured active play. IMPACT: What problem did the study address? Cancer treatment affects the development of preschoolers' gross motor-, personal and social skills-essential skills in childhood development. This study aimed to explore the potential for social and personal development through structured active play. What were the main findings? This study found that preschoolers want to play, and participating in structured active play can support their personal and social development through regained confidence in movement and becoming part of a group. Where and on whom will the research have an impact? The research impacts healthcare professionals working with preschoolers in the healthcare system. Creating opportunities for preschoolers to participate in structured active play throughout treatment can promote personal and social development. REPORTING METHOD: The study adheres to relevant EQUATOR guidelines and is reported according to the Standards for Reporting Qualitative Research (SRQR) checklist. PATIENT OR PUBLIC CONTRIBUTION: Participants in this study were preschoolers with cancer and their parents. No public or patient involvement in the design of this study. TRIAL AND PROTOCOL REGISTRATION: ClinicalTrials.gov: NCT04672681. Registered on December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.