Play in Children With Life-Threatening and Life-Limiting Conditions: A Scoping Review

Importance: Play is essential to children and provides opportunities to promote their health and well-being. Children living with life-threatening and life-limiting conditions experience deprivation in play. Objective: To conduct a scoping review of studies that examined play of children with a life-threatening or life-limiting condition to expore their play characteristics and possible factors influencing their participation in play. Data Sources: A search of literature published between 1990 and 2017 was conducted in the health, social care, and built- environment fields. The scoping review included multiple searches in electronic databases, a gray literature search, and manual searches of relevant journals and reference lists of included articles. Study Selection and Data Collection: Defined criteria were used to select articles describing studies that examined the daily play of children ages 5-11 yr with life-threatening and life-limiting conditions; articles that focused on play as therapy or that used parents' accounts of a service were excluded. The identified articles were critically appraised with the Critical Appraisal Skills Programme and the Joanna Briggs Institute Critical Appraisal Tools. Findings: Thirteen articles were reviewed. The findings indicate that children's play is influenced by their health conditions and play opportunities and by the limited availability of appropriate play equipment and spaces allowing play and social interaction. Conclusions and Relevance: Available appropriate play opportunities need to be maximized for children living with life- threatening and life-limiting conditions. This goal can be achieved by understanding and considering the needs of these children and by facilitating environmental enablers and limiting barriers. What This Article Adds: Promoting the participation in play of children who live with life-threatening and life-limiting conditions is important to their health and well-being and can be achieved by targeting the cultural, social, and physical environmental factors that shape the children's play.