Research Article| Volume 66, e16-e21, September 2022

The importance of an outdoor playground for children with epilepsy and their family during and after hospitalization: A qualitative study of parents' experiences


      • Play supports children with epilepsy and their families to cope with hospitalization and their illness
      • Play outdoor during hospitalization improves children with epilepsy and their families physical and emotionalwell-being
      • Healthcare professionals can use an outdoor playground in the hospital environment in their clinical and therapeutic care



      To explore parents' experiences of using an outdoor playground during hospitalization with their child with epilepsy.


      The study is based on a qualitative exploratory design. Semi-structured individual interviews were conducted with 10 parents with a child with epilepsy (6–11 years). A phenomenological- hermeneutic approach was taken, inspired by Ricoeur. Data analysis and interpretation have been conducted at three levels: naive reading, structural analysis, and critical interpretation and discussion.


      During hospitalization the playground was the children's territory, where children felt safe, in control and normality. Parents experienced valuable time with their children through participation, and play facilitated communication and reduced pain and negative emotions. The playground improved parents and children's emotional well-being during hospitalization. Further, it supported coping with epilepsy, and contributed to gain successful experiences thus children developed self-esteem.


      The study indicates that to the parents, an outdoor playground at the hospital environment is valuable for supporting children with epilepsy and their families to cope with hospitalization and everyday life, and it contributes to improve the family's physical, social and emotional well-being. The results emphasize that play at an outdoor playground could be integrated in the care and treatment during hospitalization.


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        • Antonovsky A.
        Unraveling the mystery of health: How people manage stress and stay well.
        Jossey-Bass, San Francisco1987
        • Clark D.C.
        Sickness and in play: Children coping with chronic illnesses.
        Rutgers University Press, Cindy Dell Clark. New Brunswick, NJ2003
        • Declaration of Helsinki
        (Available from:) (Accessed 01/11/2021)
        • Eberle S.
        The elements of play: Toward a philosophy and a definition of play.
        American Journal of Play. 2014; 6: 214-233
        • Eddy C.M.
        • Rizzo R.
        • Gulisano M.
        • Cali P.
        • Robertson M.M.
        • Cavanna A.E.
        Quality of life in young people with treatment-responsive epilepsy: A controlled study.
        Epilepsy & Behavior. 2010; 19: 623-626
        • Eklund P.G.
        • Sivberg B.
        Adolescents’ lived experience of epilepsy.
        The Journal of Neuroscience Nursing. 2003; 35: 40-49
        • Elliott I.M.
        • Lach L.
        • Smith M.L.
        I just want to be normal: A qualitative study exploring how children and adolescents view the impact of intractable epilepsy on their quality of life.
        Epilepsy & Behavior. 2005; 7: 664-678
        • Favara-Scacco C.
        • Smirne G.
        • Schilirò G.
        • Di Cataldo A.
        Art therapy as support for children with leukemia during painful procedures.
        Medical and Pediatric Oncology. 2001 Apr; 36: 474-480
        • Gold K.
        • Grothues D.
        • Jossberger H.
        • Gruber H.
        • Melter M.
        Parents’ perceptions of play-therapeutic interventions to improve coping strategies of liver-transplanted children: A qualitative study.
        International Journal of Play Therapy. 2014; 23: 146-160
        • Haiat H.
        • Bar-Mor G.
        • Shochat M.
        The world of the child: A world of play even in the hospital.
        Journal of Pediatric Nursing. 2003; 18: 209-214
        • Jacoby A.
        • Austin J.K.
        Social stigma for adults and children with epilepsy.
        Epilepsia. 2007; 48: 6-9
        • Jakobsen A.V.
        • Møller R.S.
        • Nikanorova M.
        • Elklit A.
        The impact of severe pediatric epilepsy on experienced stress and psychopathology in parents.
        Epilepsy & Behavior. 2020; 113107538
        • Jennum P.
        • Christensen J.
        • Ibsen R.
        • Kjellberg J.
        Long-term socioeconomic consequences and health care costs of childhood and adolescent-onset epilepsy.
        Epilepsia. 2016; 57: 1078-1085
        • Kampra M.
        • Tzerakis N.
        • Lund Holm Thomsen L.
        • Katsarou E.
        • Voudris K.
        • Mastroyianni D.
        • Gatzonis S.
        The challenges that parents of children with epilepsy face: A qualitative study.
        Epilepsy & Behavior. 2017 Jun; 71: 94-103
        • Koukourikos K.
        • Tzeha L.
        • Pantelidou P.
        • Tsaloglidou A.
        The importance of play during hospitalization of children.
        Mater Sociomed. 2015; 27: 438-441
      1. Kvale, S. & S. Brinkmann. Interviews : learning the craft of qualitative research interviewing. 3 ed. Thousand Oaks, California: Sage Publications; 20143.

        • Melnyk B.M.
        Intervention studies involving parents of hospitalized young children: An analysis of the past and future recommendations.
        Journal of Pediatric Nursing. 2000; 15: 4-13
        • Moore M.
        • Russ S.W.
        Pretend play as a resource for children: Implications for pediatricians and health professionals.
        Journal of Developmental and Behavioral Pediatrics. 2006; 27: 237-248
        • Morse J.M.
        Drowning in data.
        Qualitative Health Research. 1993; 3: 267-269
        • Pedersen
        • Sygeplejepraksis B.D.
        Sprog & Erkendelse [Nursing practice Language and cognition].
        (PhD thesis)3 ed. The Faculty of Health Science, University of Aarhus, Denmark2005 (1999/2005)
        • Ricoeur P.
        Interpretation theory: Discourse and the surplus of meaning.
        Texas Christian University Press, 1976
        • Runeson I.
        • Hallstrom I.
        • Elander G.
        • Hermeren G.
        Children’s needs during hospitalization: An observational study of hospitalized boys.
        International Journal of Nursing Practice. 2002; 8: 158-166
        • Shuy R.W.
        In-person versus telephone interviewing.
        in: Gubrium J.F. Holstien J.A. Handbook of interview. Sage, Thousand Oaks, CA2002: 537-555
        • Sirven J.I.
        Epilepsy: A Spectrum disorder.
        Cold Spring Harbor Perspectives in Medicine. 2015; 5 (Article a022848)
        • Tieffenberg J.A.
        • Wood E.I.
        • Alonso A.
        • Tossutti M.S.
        • Vicente M.F.
        A randomized field trial of ACINDES: A child-centered training model for children with chronic illnesses (asthma and epilepsy).
        Journal of Urban Health. 2000; 77: 280-297
        • Wright L.M.
        Nurses and families : A guide to family assessment and intervention.
        6. Edition. F.A. Davis, Philadelphia2013
        • Zosh J.M.
        • Hopkins E.J.
        • Jensen H.
        • Liu C.
        • Neale D.
        • Hirsh-Pasek K.
        • Whitebread D.
        Learning through play: A review of the evidence (white paper).
        The LEGO Foundation, DK2017