Puzzle Play Therapy for Hospitalization-Related Anxiety In A Preschool Child With Pneumonia: A Case Report
Keywords:
Preschoolers, hospitalization emergencies, pneumonia, play therapy, puzzleAbstract
Background: Hospitalization in preschoolers with pneumonia can trigger anxiety due to unfamiliar environments, medical procedures, limitations in play, and changes in routine. Anxiety can manifest through fear, crying, sleep disturbances, and lack of cooperation. Puzzle play therapy has the potential to distract, reduce anxiety, and increase comfort during hospitalization.
Method: This descriptive case study involved a 6-year-old girl with pneumonia who was treated at the Child Intensive Care Unit (PICU) of the University of Muhammadiyah Malang Hospital. Data were collected through parental interviews, observations, physical examinations, and medical documentation. Anxiety was assessed using the Face Image Scale (FIS). Puzzle therapy was given for 15–20 minutes, accompanied by parents, accompanied by therapeutic communication and explanations according to the child's age. Publication consent was obtained from the patient's parents.
Results: Patient An. H experienced shortness of breath, productive cough, rhonchi, 27 times/minute breathing rate, and 96% oxygen saturation. Patients were afraid of health workers and medical procedures, cried during examinations, woke up frequently, and had limited play activities. After puzzle therapy, patients appeared calmer, cryed less often, were more interested in playing, and were more cooperative. The FIS score showed that the child's anxiety level decreased from 1 (very anxious) on April 13, 2026 to 5 (very calm) on April 18, 2026.
Conclusions: Puzzle play therapy is associated with improved anxiety responses in preschoolers with pneumonia during hospitalization. This therapy can be a complementary nonpharmacological nursing intervention in atraumatic care, with adjustments to the clinical condition and the child's psychological response.
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