E - Early days of play for children in hospital

Recently, I dipped back into the 1970s archives and looked at early work on play for children in hospital. Information unearthed was about the importance of play, the role of play workers/leaders and why play workers needed to be established as a paid profession as well as allocation of space for play.  Silvia Nash outlined a 1970s view of the role of play workers who have a primary concern for the emotional needs and development of the child. The play worker helps and encourages parents and families to support and participate in the care of their child acting as a buffer. Play workers explain treatments to children to fit their understanding and support nursing and medical staff. In the UK, the National Association of Hospital Play Staff has documented milestones celebrating 50 years of work.

In Canada and North America child life programs were designed to meet the social, emotional and physical activity needs of children in hospital and to help children and their parents adjust and cope with illness. Hospitalized children need the continuing presence of someone important to them, as well as a rich and stimulating environment and opportunities for exploratory behaviour and play. The Child Life Council has produced a timeline and history of the profession.

In 1976 AWCH held a seminar Play in Hospital, a first in Australia. AWCH was instrumental in bringing together a wide range of people, making recommendations for unified guidelines and including roles and training. AWCH went on to write a Policy relating to the provision of play for children in hospitals in 1986.

A new beginning for the profession in Australia took place in 2015. The evolution of the hospital play profession in Australia was celebrated during Child Life Therapy week including the launch of a new name and website. Look to the Association of Child Life Therapists Australia as the peak body of health care professionals specialising in child development, who utilize their knowledge and skills to work with children in the hospital…. ACLTA has produced a short history of hospital play in Australia.

Early days and resources at the AWCH Child Health Library

AWCH Child Health Library holds foundational resources including:

• Working with children in hospital by Emma Plank, referred to as the mother of the profession
• Child life: an overview & Child life activities: an overview published by ACCH
• The under fives in hospital: a report on their emotional well-being published by AWCH
• Hospital: a deprived environment for children? : The case for hospital play schemes, by Save the Children
• To help prepare children for hospital, the 1972 Paul in hospital, shows photos of a child in an oxygen tent

Important resources that identify the needs of children in hospital

• Platt report, which includes information on the importance of play
• A two year old goes to hospital, DVD
• Marking the 50th anniversary of the Platt Report: from exclusion, to toleration and parental participation in the care of the hospitalized child.

Recent resources available for loan include:

• In sickness and in play: children coping with chronic illness
• Therapeutic activities for children and teens coping with health issues
• Richard Thompson’s Handbook of child life and the Child Life Council bulletin

 Related resources can be borrowed on preparation for hospital, relaxation, mindfulness, coping with grief and living with serious illness.


Jillian Rattray
AWCH librarian
http://Library.awch.org.au
May 2015

D is for Diabetes

Australians can’t afford to ignore diabetes. Australian Institute of Health and Welfare (AIHW) reports, in 2011-2012 there were about 1 million Australians with diabetes. In the report How common is diabetes, you will see statistics on the different types of diabetes and prevalence in states/territories around Australia and a table including prevalence of Type 1 diabetes in children.

Resources available from AWCH Child Health Library

Awareness about diabetes is raised this week through Walk to Work Day WTW, organized by Diabetes Australia. This fundraising event promotes a healthy lifestyle for Australians building walking into their daily routine.

Another recent walking event held was the Walk to Cure for type 1 diabetes, T1D, hosted by JDFR (Juvenile Diabetes Research Foundation Australia). Find on JDFR website, information about type 1 diabetes, T1D is the fastest growing chronic disease amongst Australian children. Information for parents and carers includes JDRF’s role supporting families, meeting other kids with T1D, there’s a kid’s online community and  peer support program for parents.  Information resources for health professionals, school resources, JDFR research initiatives and more can be found on the website. JDFR was voted by Australian Charity Awards, Charity of the Year 2014.

Diabetes Australia is Australia’s leading Diabetes organization and is located around Australia. Diabetes NSW hosts a website for teens and kids with type 1 diabetes, from here find multilingual resources and resources for kids such as Professor Bumblebee's guide to type 1 diabetes, D-Zone for teens and parents and teachers will also find useful links.

Many people will find helpful, basic information to increase understanding, such as the difference between type 1 diabetes and type 2 diabetes. Here’s two information sheets with a child and family focus.

• Type 2 diabetes in children & adolescents.Talking diabetes information sheet no. 40 [series].

 Find essential information about type 2 diabetes including what is, the differences between type 1 and type 2 diabetes, risk factors for type 2 diabetes, how it develops, diagnosis and management. With clear and easy descriptions adults and young adults will find the medical and educational information is reliable, reviewed by the Health Care and Education Committee of Diabetes Australia. From this starting point there are links to State/Territory Diabetes Australia organizations websites.

• What is type 1 diabetes? An information sheet for support persons: Type 1 diabetes children and adolescents. Talking diabetes information sheet no. 37, revised 2012 [series].

This is a brief overview of information and includes the symptoms and causes of type 1 diabetes. Causes or triggers of diabetes are explained as well as lifelong management and the diabetes team. Type 1 diabetes is not related to lifestyle or caused by eating too many sweets. Some people carry the genes which make them more likely to get type 1 diabetes.

There are many other diabetes information sheets on medical and educational topics the category of information is listed with topics such as healthy eating, going to hospital/day surgery, taking control, medications, mental health etc. They are available for download or can be purchased in bulk.

Diabetes Australia has an extensive links page to authoritative sources such as Health direct from Australian government partners. Link through to myDr and Diabetes: tips for children or Diabetes: tips for teenagers.  On myDr, Type 2 diabetes,  find out how type 2 diabetes was often known as adult-onset diabetes or non-insulin diabetes, more  younger people are being affected and so terminology has changed.

Key organisations, such as Diabetes Australia point to this manual for parents, Caring for diabetes in children and adolescents, a parent’s manual, edited by Geoffrey Ambler and Fergus Cameron (3 MB). The AWCH Child Health Library holds a copy of the earlier edition, it is exciting to see the third edition is now online and so easily accessible (joint project of the Children's Hospital at Westmead and the Royal Children's Hospital). This comprehensive parent manual comes with illustrations and clear text covering a wide range of topics from medical to educational and social and emotional aspects of living with diabetes.

For a helpful overview of diabetes in adolescents including transition, visit Women and Children’s health network page, parenting and child health, SA.

Health professionals will refer to Clinical practice guidelines: Type 1 diabetes in children and adolescents, prepared by the Australasian Paediatric Endocrine Group for the Department of Health and Ageing, March 2005.

The AWCH Child Health Library has DVD’s and books on diabetes available for loan, such as

• Professor Bumblebee's guide to type 1 diabetes,  
• Young people & type 1 diabetes: speaking from experience,  
• Dido has diabetes,  
• It’s time to learn about diabetes and  
• Sweet kids: how to balance diabetes control & good nutrition with family peace.

Jillian Rattray

AWCH librarian
http://library.awch.org.au/
November 2014

C is for Children's and youth participation

Photo: Charter of the Rights of the Child in Hospital
Second Department of Paediatrics, University of Athens

It was only this week that I took part in my second focus group, this one was held at my children’s school. All those who took part seemed interested and had to peel themselves away to go and meet their children. You may be surprised at my baby steps. There are so many instances where people seek our opinion today via telephone surveys, market research or when visiting a website. We are all consumers and in the surge to capture people’s attitudes it is worth stopping to ask what of those areas where people are under-represented, excluded or brushed aside? A lot surely comes back to who is involved and what kind of collaborative process they are working towards. With a flood of information the buzz seems to be around what to do with it, meaningful evaluation and feedback.

Photo: Charter of the Rights of the Child in Hospital
Second Department of Paediatrics, University of Athens

 The care of children in healthcare, like any other area, faces flat-lining budgets and administrators’ scrutiny. Many argue it is still important to look at children themselves and engage with them regarding their healthcare journey. Child friendly services and economic considerations can combine.  I have compiled a bibliography with a selection of resources on children’s participation. Key points about children’s and youth participation described are what it means both generally, in the healthcare environment and for healthcare design. The information touches on the significance of children’s participation for individuals, collectively and as a future imperative. Children’s participation is described not as a single event but as an ongoing process. Evaluation looks at some examples of best practice, literature reviews, models and research studies. There are also links to projects where value has been enhanced through children’s participation and work that points to benefits of children’s participation.

Photo: Charter of the Rights of the Child in Hospital
Second Department of Paediatrics, University of Athens

The Charter of Rights of the Child in Hospital, Greece, simply puts it in child-friendly terms “I have the right to participate in improvement of the Hospital”. Referring to article 12 United Nations Convention of the Rights of the Child, “we will ask you what services you need”, “we will seek your opinion on the design/planning of services, we will ask your opinion about the context of health programmes”.

The Children’s Hospital Australasia, CHA, partnered with Association for the Wellbeing of Children in Healthcare, AWCH, to produce the Charter on the Rights of Children and Young People in Healthcare Services in Australia. The Charter outlines 11 rights of children in healthcare, including the right to be involved and participate. Children should not be brushed aside.


The selected bibliography with current* links to information is entitled “C is for children’s and youth participation – who is involved?”. It has been compiled because this is an area where definitions can be many and varied and database searching is not easy. It is another aspect of AWCH’s advocacy work on patient and family centred care.

Link to some AWCH library resources on:

• Children’s participation in healthcare design
• Children's participation in healthcare decisionmaking

 

Photo: Charter of the Rights of the Child in Hospital
Second Department of Paediatrics, University of Athens

Jillian Rattray 
AWCH librarian
library.awch.org.au
October 2014

(*current at the time of posting)