Teddy bear clinics: a huge community project

"Teddy Bear Hospital Project" school visits improve pre-clerkship students' comfort explaining medical concepts to children

The "Teddy Bear Hospital Project" (TBHP) is a low cost, international initiative aimed at reducing children's fears associated with healthcare visits by modelling these interactions using teddy bears. The University of Ottawa program had the additional objective of assessing whether TBHP increased pre-clerkship medical students' comfort communicating medical concepts to children. Our student volunteers reported a statistically significant increase in their comfort communicating medical topics to young children and all volunteers would recommend TBHP to a colleague interested in pursuing family medicine or pediatrics. Our program could also be easily replicated by Pediatric Interest Groups at other Canadian medical schools.

Healthcare Professionals' Views for the Content of the Teddy Bear Hospital for a Child Sexual Abuse Prevention Module

Worldwide studies have reported a drastic increase in child sexual abuse (CSA) involving very young children. In Malaysia, several attempts have been made to combat this problem via educational programs. Teachers have reported a lack of confidence in teaching this topic; hence a less threatening approach is needed. The Teddy Bear Hospital (TBH) is an innovation whereby the children bring their teddies while visiting the volunteers assuming healthcare practitioners' role. This execution is effective in reducing the children's anxieties about hospitalization and increasing their health knowledge. Therefore, our objective is to explore healthcare practitioners' (HCP) views for the content of TBH and its approach as a personal safety module toward preventing CSA. Eighteen in-depth-interviews were conducted. Interviews were thematically analyzed. Participants suggest the TBH method as a good approach to teaching prevention of CSA among preschoolers. Four main themes emerged from this study: (1) educating children about personal safety, (2) moral values and faith as a medium to prevent child sexual abuse, (3) addressing social media use in children, and (4) general approach to content delivery. The involvement of parents is crucial. Addressing moral values and faith and usage of social media platforms are also essential factors to look into.

Effectiveness of pretend medical play in improving children's health outcomes and well-being: a systematic review

BACKGROUND

The healthcare setting is stressful for many people, especially children. Efforts are needed to mitigate children's healthcare-related anxiety. Medical play using the Teddy Bear Hospital (TBH) concept can expose children to healthcare settings and help them develop positive experiences in these settings. In this role-playing game, children bring their soft toys and act as parents to the 'sick' teddies in a pretend hospital or clinic play setting. The objective of this systematic review is to evaluate the effectiveness of the TBH in improving children's health outcomes and well-being.

METHODS

We searched the reference lists of included studies from four electronic databases (PubMed, CINAHL, Scopus and Google Scholar) from inception until November 2020. We included pre-post, quasiexperimental and case-control studies, as well as randomised controlled trials (RCTs) that discussed medical play using the TBH concept as an intervention. Studies that involved sick patients and used interventions unlike the TBH were excluded. We assessed the quality of the included studies using the Cochrane Collaboration's 'Risk of bias' tool.

RESULTS

Ten studies were included in this systematic review. Five specifically investigated the TBH method, while the others involved the same concept of medical play. Only three studies were RCTs. All of the studies report more than one outcome-mostly positive outcomes. Two report lower anxiety levels after intervention. Two found better healthcare knowledge, with one reporting increased feelings of happiness regarding visiting a doctor. Two studies found no change in anxiety or feelings, while another two found increased levels of fear and lowered mood after the medical play (which involved real medical equipment).

CONCLUSIONS

The practice of TBH has mostly positive outcomes, with lower anxiety levels and improved healthcare knowledge. Its effectiveness should be verified in future studies using a more robust methodology.

PROSPERO REGISTRATION NUMBER

CRD42019106355.

An Interactive Teddy Bear Clinic Tour: Teaching Veterinary Students How to Interact with Young Children

Although there are existing guidelines for teaching and learning skillful client communication, there remains a need to integrate a developmental focus into veterinary medical curricula to prepare students for interactions with children who accompany their companion animals. The objectives of this teaching tip are (1) to describe the use of a Teddy Bear Clinic Tour as an innovative, applied practice method for teaching veterinary students about clinical communication with children, and (2) to provide accompanying resources to enable use of this method to teach clinical communication at other facilities. This paper includes practical guidelines for organizing a Teddy Bear Clinic Tour at training clinics or colleges of veterinary medicine; an anecdotal description of a pilot study at the Ontario Veterinary College Smith Lane Animal Hospital; and printable resources, including a list of specific clinical communication skills, a sample evaluation sheet for supervisors and students, recommendations for creating a child-friendly environment, examples of child-friendly veterinary vocabulary, and a sample script for a Teddy Bear Clinic Tour. Informed by the resources provided in this teaching tip paper, the Teddy Bear Clinic Tour can be used at your facility as a unique teaching method for clinical communication with children and as a community outreach program to advertise the services at the facility.

Teddy and I Get a Check-Up: A Pilot Educational Intervention Teaching Children Coping Strategies for Managing Procedure-Related Pain and Fear

Background. Pediatric medical information provision literature focuses on hospitalization and surgical procedures, but children would also benefit from an educational program regarding more commonly experienced medical procedures (e.g., needles, general check-up). Objective. To determine whether an evidence-based educational program reduced children's ratings of fear of and expected pain from medical stimuli and increased their knowledge of procedural coping strategies. Methods. An educational, interactive, developmentally appropriate Teddy Bear Clinic Tour was developed and delivered at a veterinary clinic. During this tour, 71 5-10-year-old children (Mage = 6.62 years, SD = 1.19) were taught about medical equipment, procedures, and coping strategies through modelling and rehearsal. In a single-group, pretest posttest design, participants reported their fear of and expected pain from medical and nonmedical stimuli. Children were also asked to report strategies they would use to cope with procedural fear. Results. Children's ratings for expected pain during a needle procedure were reduced following the intervention. No significant change occurred in children's fear of needles. Children reported more intervention-taught coping strategies at Time 2. Conclusions. The results of this study suggest that an evidence-based, interactive educational program can reduce young children's expectations of needle pain and may help teach them procedural coping strategies.

Prevention is Better than Cure: A Hands-On, Play-Based, Innovative, Health and Well-Being Program in Remote Australia

A key to improving the quality of life in remote communities is the empowerment of children who are at health and educational risk. Between 2002 and 2009, at a remote Aboriginal school, students and community members participated in an innovative, play-based health and well-being program aimed at helping children to become self-determining and responsible for their own health and well-being. Holistic in its approach, and broad in its scope, the multi-faceted program encompassed the fundamentals of personal hygiene; understanding of body systems; the importance of nutrition, hydration, sleep and exercise; brain care; the biology of emotions, with particular emphasis on anger management and the critical interplay between emotions and behavior; the impact of substances of abuse on the brain; as well as the Hospital Familiarization Program (HFP) which prepares children for planned and unplanned hospitalization. Program outcomes included improved school attendance and student engagement; increased community awareness of the importance of a healthy lifestyle; improved self-concept, self-esteem and self-confidence; as well as increased respect and caring for self and others. A reduction in children's fear and anxiety when facing hospitalization and visits to the doctor was also evident. Each year, 12,500 children throughout Western Australia enjoy the benefits of the HFP.

Does a child's fear of needles decrease through a learning event with needles?

BACKGROUND

Most children have a fear of needles. Suitable preparation can decrease the pain and fear of needles in hospitals; however, few have examined how such preparation affects healthy children. This study examined whether learning with needles decreases fear of needles and changes motivation to get vaccinations in school-age children and the possible association between fear of needles and motivation toward vaccinations.

METHODS

This study included children participating in the "Let's Be Doctors" event, which was held in 4 child centers in Tsukuba city, Ibaraki, Japan. In this event, children learned about injections and how a vaccine works, and injected a vaccine (water) into skin (sponge) using a real syringe and imitation needle. Data were collected just before and after the event by anonymous self-assessment questionnaires that used a 4-point Likert scale to assess fear of needles, motivation to get vaccinations, recommendation of vaccinations, and fear toward doctors among the children. Answers were divided into two categories for statistical analysis.

RESULTS

In total, 194 children participated in the event and 191 children answered the questionnaire (response rate 98.5%). We analyzed 180 subjects, comprising 79 boys (43.9%) and 94 girls (52.2%), mean age of 8.1 ± 1.0 years. The number of children reporting a fear of needles decreased from 69 (38.3%) before the event to 51 (28.3%) after the event, and those unwilling to get vaccinations decreased from 48 (26.7%) to 27 (15.0%). Children who reported fear of needles before the event were more unwilling to get vaccinations than those with no fear of needles (36 [52.2%] vs. 12 [10.8%]), while after the event the number of needle-fearing children unwilling to get vaccinations decreased to 19 (27.5%).

CONCLUSIONS

Children's fear of needles and unwillingness to get vaccinations were decreased after experiencing a learning event with needles. The fear of needles is associated with a negative motivation to get vaccinations in children.

Teddy says "Hi!": Teddy bear clinics revisited

Teddy bear/doll clinics continue to offer a feasible, effective opportunity to reach the community's children and their health information needs. Many thanks to Sunny B. Lee, RN, BS (Swedish Covenant Hospital, Chicago), and Kathy Powell, RN, PhD, and Barb Pierce, RN, MS (Children's Hospital, Birmingham).

Let's pretend: a hospital teaches children about health care

A college of nursing and a hospital offer a "pretend hospital" to approximately 3,000 first graders each spring. The community service project, which has quadrupled in attendance over nine years, teaches first graders about health maintenance and the role of health care in their lives, and helps decrease their anxiety related to the hospital experience. Realistic and nonthreatening multisensory experiences of the simulated hospital prepare children for the healthcare consumer role. The simulation also provides nursing students an opportunity to translate concepts of growth, development, and communication into practice.