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:center dot 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.center dot 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.center dot 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: NCT04672681. Registered on December 17, 2020. .