Hospitalized Children and Play

   The play is a part of real life and an effective learning process, which is the basis of physical, cognitive, language, emotional and social development, which is performed or not for a particular purpose or is performed without rules or rules, but in which case the child is willing and likes to be involved (Bilir, 1995). As the child grows, the game's features change and it has the ability to maximize their latent powers in environments where they have the ability to play appropriate games. The child is emotionally relaxed through play and maintains personality development by playing a role in his relationship with the surrounding individuals (Akt. Bilir, 1995). In particular, because it is a process with difficulties to help children who are not open to reactions during communication, these children's play types, expressions during play, and the pictures they draw are important in revealing the child's mental state (Bilir 1995).
In the cases where hospitalized children are prevented from interacting with their environment for physical or psychological reasons or unable to play games, they experience problems such as developmental and learning retardations, stress or disorientation. According to Barnes (1992), the physical and social isolation of the child due to his limitations in the hospital can be reduced by the game.
   Hospitalized children living during the daily life experience and experience is limited due to the lack of self-control experiences. The intensity of stress-creating experiences is increasing in the course of illness and hospitalization. In a study conducted by Ak and Bilgin (2013), the meaning of health was examined by the child's eye, in the 4-6 age group, 37% of the children defined the health as not being sick, 84% to be clean and 10% to go to the hospital. In the study by Gönener and Görak (2009), although children considered hospitalization as a necessity, 50% of the children described the hospital as a bad place. For this reason, hospitals should be made suitable for children by using art methods such as painting, sculpture and photography. Teksöz and Ocakçı (2013) suggested that in order to improve the quality of life of children in the hospital, designing the hospital to be suitable for children, different painting of the walls, painting and coloring of the tables and paintings, making play areas such as play rooms, playgrounds, theater facilities, clowns. proposed the planning of artistic activities. In the similar study of Yıldırım and Muslu (2006), it was suggested that the colors used in designing the child polyclinics should be made according to the choices of the children, and that animals and cartoon characters should be used on the walls.
The benefits of many artistic activities such as art therapy (Tunç, 2007), play therapy (Findling, 2004), occupational therapy (Coşkun, 1998; Yilmaz, Oltuoglu, Hanazay and Aylaz, 2011) and creative drama (Boran, 2010; Teksöz and Ocakçı, 2011)in children who are traumatized due to illness and hospitalization are revealed through research  (Teksöz ve Ocakçı, 2014).
   The hospitalization of the child away from such as friends, school environment, the game activity is also restricting. Performing the games with the play requirement of the child or the play activities after the operation allows the trauma of the child to be solved. Often defined as the work of children, the game is an invaluable aspect of hospital care.
The room in the service, colorful toys, television and video movies, as well as toys brought from home, provide a warm hospital environment (Ekşi 2011). According to Arslan et al. (2013), 49% of parents wanted their children to spend time playing games (Teksöz & Ocakçı, 2014). While the play activities in the hospital environment entertain the child, it also decreases the burnout of the parent and provides the opportunity for the parent to take their time and relax (Aks. Teksöz & Ocakçı, 2014). In the preoperative period, state and continuity anxiety levels of the parents who were given information about the operation together with their children and who played with their children were found to be lower than the parents who were given routine hospital preparation (Tural and Bolışık, 2013).
After understanding the function of the game in dealing with stress, therapeutic games have been initiated in developed countries in order to reduce the stress of the experiences related to hospital and disease in children, to increase their adaptation to experiences and to support their normal development in this process. For a game played with children to qualify as a therapeutic game;
   1) Encouraging the expression of emotions (eg, revitalization of experiences while playing with infants),
   2) Provides education on children's hospital experiences and
   3) To be a game to provide physiological benefit (eg to blow foam to improve lung function, to inflate a balloon) should include at least one of the properties.
   The child can revitalize his experiences while playing, and at the same time catches up with the opportunity to participate effectively in the experience, reducing the feeling that he has control over experiences and the feeling of internal control.
REFERENCES
Alataş Ak B, Bilgin NÇ. (2013). Çocukların Gözüyle Sağlık. 4. Ulusal Pediatri Hemşireliği Kongresi. Kongre Kitabı, Sözel Bildiri (34), Adıyaman, 62.
Barnes LP (1992) Don’t forget the play, The American Journal of Maternal/Child Nursing, 17:18         
Bilir, Ş., & Dönmez, B. (1995). Hastanede Oyun-Yaş Gruplarına Göre Hastanede Yatan Çocuklar, Çocuk ve Hastane, 2. baskı. Ankara: Sim Matbaacılık.
Ekşi A. (2011). Ben Hasta Değilim. 2. Baskı. Nobel Tıp Kitapevleri, İstanbul, 398-402.
Gönener D, Görak G. (2009). Okul Yaş Grubu Çocukların Hastane ve Hastalığı ile ilgili Bilgilendirme Durumlarının Endişe Kaynakları ile Etkileşimi. Gaziantep Tıp Dergisi, 15:1, 41-48.
Teksöz E, Ocakçı AF. (2013). Sanat Temelli Bir Hemşirelik Girişimi. Marmara Üniversitesi, Sağlık Bilimleri Enstitüsü, Çocuk Sağlığı Ve Hastalıkları Hemşireliği Doktora Tezi.
Tunç A. (2007). Ergenlerin Olumsuz Beden İmgelerine Yönelik Geliştirilen Bilişsel-Davranışçı Ve Değiştirilmiş Sanat Terapisi Programlarının Etkililiklerinin Karşılaştırılması. Ankara Üniversitesi Sosyal Bilimler Enstitüsü Tiyatro (Çocuk Tiyatrosu, Oyun-Tiyatro-Drama) Anabilim Dalı, Yayınlanmış Yüksek Lisans Tezi. Ankara.
Tural E, Bolışık B. (2013). Ameliyat Öncesi Dönemde Çocukları ile Birlikte Eğitim ve Terapötik Oyuna Katılan Annelerin Kaygı Düzeylerinin İncelenmesi. 4. Ulusal Pediatri Hemşireliği Kongresi. Kongre Kitabı, Poster Bildiri (106), Adıyaman, 157.
TEKSÖZ, E., OCAKÇI, A.F. ( 2014). Çocuk Hemşireliği’nde Sanat Uygulamaları. Deuhyo Ed. 7(2), 119-123
Yıldırım K, Muslu MS. (2006). Poliklinik Bekleme Alanlarında Çevresel Faktörlerin Kullanıcıların Fonksiyonel ve AlgıDavranışsal Performansına Etkisi: Gazi Hastanesi Çocuk Polikliniği. Politeknik Dergisi, 9:1, 39-51.