The experience of hospitalization in childhood can often lead to traumatic consequences. Various practices (play, art therapy, music therapy, etc.) are used to help children cope with this process. In recent years, attention has been drawn to nature-based approaches in addition to existing practices. Within the scope of this approach, this study was planned in a parallel group (experimental-control) randomized controlled experimental design to determine the effect of garden activities on anxiety levels and psychosocial symptoms of hospitalized children aged 6-12 years. Hypotheses of the study H1: The gardening activities program applied to hospitalized children; H1a: There is an effect on children's anxiety. H1b: There is an effect on psychosocial symptoms of children. In this direction, the population of the study will consist of children between the ages of 6-12 in the children's ward of University Research and Application Hospital. The sample size determined as a result of G\*power analysis was found as control (18) and intervention (18). The research will be conducted between September 2024 and June 2025. 'Child Descriptive Information Form', "Child Follow-up Form", "Child Anxiety Scale-Conditioning" and "Psychosocial Symptoms Diagnostic Scale for Hospitalized Children" will be used for data collection. The data collection process consists of three stages: pre-intervention period, intervention period and post-intervention period. Children in the intervention group will have three sessions of gardening activities within the scope of the 'Gardening Activities Program' during their hospitalization. Children in the control group will receive services within the scope of the routine treatment and nursing care protocol of the clinic during hospitalization.
The age of the children is between 6-12 years old
Hospitalization due to an acute medical diagnosis
Hospitalization for at least 3 days
Approval of the child's participation in the session by the responsible doctor
Hospitalization for more than 7 days
No previous hospitalization experience
High-risk drug use
Having a chronic disease that suppresses the immune system
Parallel
Garden Activities Program
Other interventionWhen we look at the studies evaluating the effect of gardening activities on hospitalized children; it is seen that mostly children's opinions about therapeutic gardens are included and studies involving active gardening activities are limited. Shao et al. (2020) gave hospitalized children a task about garden plants and made them full this task through active participation and mobile games. However, it is seen that the gardening activity applied in this study was limited to a 5-minute task. The most important difference of our study from these studies is that a standardized gardening activity program will be applied to hospitalized children during their hospitalization and the active participation of the child will be ensured.
Clinical routine treatment and nursing care protocol
Other interventionWithin the scope of the clinic routine treatment and nursing protocol; the decision to hospitalize the child, orientation to the clinic, execution of hospitalization paperwork, room placement, invasive intervention and treatment procedures are carried out. Treatment and care hours are revised according to individual order characteristics; 08.00-20.00, 08.00-16.00-00.00, 06.00-12.00-18.00-00.00 are planned considering the time order. 13.00-15.00 are the visiting hours. The child is not allowed to leave the clinic except for any medical purpose. No intervention will be applied to the control group of this study until the discharge process takes place.
Changes in children's anxiety as a result of the implementation of the Garden Activity Programme
Child Anxiety Scale-Dispositional (CAS-D): The Child Anxiety Scale-State (CAS-D) is shaped like a thermometer with a bulb at the bottom and horizontal lines with intervals going upwards. To measure the child's state anxiety, the child is asked to tick 'what he/she is feeling at the moment'. The score can range from 0-10. A high scale score indicates that the child's anxiety is increasing.
Changes in children's psychosocial symptoms as a result of the implementation of the Garden Activity Program
Psychosocial Symptoms Diagnostic Scale for Hospitalized Children: The scale consists of 24 items and five sub-dimensions (anxiety, hopelessness, communication difficulties, anger and aggression, regression). The scale has a 3-point likert-type scale, 'never: 0, sometimes: 1, often: 2'. The score obtained from the scale varies between 0-48. A high scale score indicates that the child hospitalized in the clinic has psychosocial problems.
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