Table 1 Summary of the intervention package

Intervention Package/Materials

Play Stimulation Package

Intervention manual

Empirical based play activities on physical, language, cognitive and psychosocial development for different age groups.

Families of children aged newborn to six years

Training Package for Therapists

Training

Child development, importance of play in hospital, roles and responsibilities of therapists, principles of the program, and introduction of group and individual play stimulation programs. Brief guideline prompts were also created.

Therapists

Training Package for Nurses

Training

Brief training included all the aspects from the training package for nurses. The training was for two days.

Nurses

Infection Control Standard Operating Procedure (SOP)

Infection Control

Guidelines on ways to disinfect and sanitize the toys based on the use and type of disease. It also consisted of the checklist that trainees had to use before and after using the toys.

Trainees

Exposure to the Intervention

Group sessions

Intervention

Maximum five to six participants from different age groups. Children younger than 2 years to receive interventions from manual for 40 min children older than 2 years for fifty minutes.

Children aged newborn to six years, parents and trainees.

Individual sessions

Intervention

Play interventions from the manual on the bedside for parents and children between 20 to 50 min.

Children aged newborn to six years, parents and trainees.

Training

Training

Training

Trainees who were enrolled in post-graduate psychology programs were hired. They were given training from the training package of nurses. Training was for two days with observations.

Trainees

Supervision

Supervision

The session was held once a week in which cases were discussed, grievances and feedback from the observation checklist were shared.

Trainees and investigators

Intervention Implementation Measures

Mental Status Examination

Instrument

Demographic information and before and after intervention observation on motor skills, communication, mood, attention and multiple choices on theme of play and transition out of session. The scale was completed by trainee before and after intervention.

Children

Individual Family Behaviour Checklist

Instrument

Likert-type scale observational tool that looks into parental behaviour with children during hospitalization. The scale was completed by the trainee after intervention.

Parents, grandparents, uncles and aunts.

Individual Behaviour Checklist

Instrument

Likert type scale observation tool that looks at the behaviour of children when hospitalised.  The scale was completed by the trainee after intervention.

Children

Group Session Follow-up Form

Observation Form

Goals of therapy, observation based on multiple choice on the themes of play, pro-social behaviour and transition out of session. This form was to be completed by the trainees after the session.

Children

Family Feedback Form

Survey

Likert type scale with seven questions that constituted satisfaction with the program, challenges faced and impact of intervention increasing positive behaviour. This form was to be completed by the parents in the last session.

Parents

Quarterly Meeting Record Sheet

Record form

Intervention progress, objectives and solutions to problems. This form was to be completed by the investigators.

Investigators

Supervision Observation Checklist

Observation Form

Dichotomous questions under the domains of organization, structure of the session, core conditions, boundary setting, interaction with individuals, cooperation and strength and weaknesses. This form was completed by the investigators.

Trainees