Acciones educativas para reducir la ansiedad derivada de la hospitalización infantil: una revisión panorámica de la literatura
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INTRODUCCIÓN. La hospitalización pediátrica puede provocar riesgos tanto a nivel clínico como educativo. Los menores hospitalizados suelen exhibir estados de ansiedad asociados a su enfermedad o al propio ingreso. Desde las aulas hospitalarias se protege y promueve el bienestar psicológico de los escolares hospitalizados y se desarrollan actuaciones educativas que redundan en el ajuste académico y psicosocial de estos. El objetivo de esta revisión panorámica de la literatura es analizar la diversidad de acciones educativas basadas en la evidencia que se desarrollan en las aulas hospitalarias dirigidas a reducir los niveles de ansiedad de los escolares hospitalizados. MÉTODO. Se realizó una revisión panorámica de la literatura siguiendo el protocolo PRISMA. Las bases de datos utilizadas fueron Dialnet, ERIC, Medline, PubMed, Scielo, Scopus y Web of Science. Se incluyeron estudios cuantitativos aleatorizados y cuasi-experimentales desde 2013-2023. RESULTADOS. Se han evaluado 23 estudios (11 cuasi-experimentales y 12 aleatorizados) que incluyen a 1.578 menores con edades entre los 3 y los 12 años. Existe una amplia heterogeneidad de acciones educativas para reducir la ansiedad infantil en el contexto hospitalario: actividades lúdicas (basadas en juegos y con animales), expresivas-artísticas y digitales. Todas han demostrado ser eficaces para aminorar los estados de ansiedad infantil derivados del ingreso y permanencia hospitalaria. DISCUSIÓN. Se sugieren nuevos estudios evaluativos que apliquen una metodología mixta para conocer en profundidad las singularidades del contexto, la de los propios menores hospitalizados, así como las de su entorno familiar e interpersonal. Asimismo, se anima a emprender futuros estudios evaluativos sobre el impacto del acompañamiento educativo y de los dispositivos pedagógicos en el desarrollo académico y salud mental de los menores hospitalizados.
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Ahmadipour, M., Sattari, H., y Nejad, M. A. (2022). Incidence and risk factors related to anxiety of children and adolescents before elective surgery. European journal of translational myology, 32(2), 10449. https://doi.org/10.4081/ejtm.2022.10449
Aguilera-Pérez, P. y Whetsell, M. V. A (2007). La ansiedad en niños hospitalizados. Aquichan, 7(2), 207-218. https://acortar.link/K0KGZj
Arksey, H., y O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Aromataris, E., Lockwood, C., Porritt, K., Pilla, B., Jordan, Z. (2024). JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-24-01
Bagur, S., y Verger, S. (2022). Educación inclusiva y pedagogía hospitalaria: las actitudes docentes promotoras de la inclusión. Revista Brasileira de Educação Especial, 28, e0140. https://doi.org/10.1590/1980-54702022v28e0140
Barash, M.S., Orlin, I., Jacob, T., Kushnir, G., Rawashdeh, L., Nachmias, E.R., Meire, N., y Pilar, G. (2023). Medical clowns improve sleep and shorten hospitalization duration in hospitalized children. Scientific Reports, 14(1), 2347. https://doi.org/10.1038/s41598-024-52943-2
Barker, T.H., Stone, J.C, Sears, K., Klugar, M., Tufanaru, C., Leonardi-Bee J, Aromataris, E., y Munn, Z. (2023). The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evidence Synthesis, 21(3), 494–506. https://doi.org/10.11124/jbies-22-00430
Barker, T.H., Habibi, N., Aromataris, E., Stone, J.C., Leonardi-Bee, J., Sears, K, Hasanoff, S., Klugar, M., Tufanaru, C., Moola, S., y Munn, Z. (2024). The revised JBI critical appraisal tool for the assessment of risk of bias quasi-experimental studies. JBI Evidence Synthesis, 22(3), 378-88. https://doi.org/10.11124/jbies-23-00268
Barnett, T., Tollit, M., Ratnapalan, S., Sawyer, S. M, Kelaher, M. (2023). Education support services for improving school engagement and academic performance of children and adolescents with a chronic health condition. Cochrane Database Systematic Reviews, 2(2). https://doi.org/10.1002/14651858.CD011538.pub2
Branson, S.M., Boss, L., Padhye, NS., Trötscher, T., Ward, A. (2017). Effects of animal-assisted activities on biobehavioural stress responses in hospitalized children: A randomized controlled study. Journal of Pediatric Nursing, 36, 84-91. https://doi.org/10.1016/j.pedn.2017.05.006
Benigno, V., y Fante, C. (2020). Hospital school teachers’ sense of stress and gratification: an investigation of the Italian context. Continuity in Education, 1(1), 37-47. https://doi.org/10.5334/cie.14
Boff, L.M., McGuire, A. L., y Raphael, J. L. (2021). Hospital-based education for hospitalized children: current practice and future direction. Hospital Pediatrics, 11(5), e75–e77. https://doi.org/10.1542/hpeds.2020-004556
Castañeda, C., González, T., Morales, V., Rosado, L., y May, S. (2015). Factores sociodemográficos y hospitalarios relacionados con el nivel de ansiedad en familiares con pacientes pediátricos. Enfermería Universitaria, 12(3), 120-109. https://doi.org/10.1016/j.reu.2015.07.005
Castro-Ibáñez, C. (2023). Estudiantes que se educan en escuelas de hospital. Una mirada desde la filosofía, economía y tecnología. Revista Electrónica Educare, 27(3), 535-549. https://doi.org/10.15359/ree.27-3.17242
Catalán-Díez, J. y de la Vega, L.F. (2022). Propuesta para el desarrollo de un perfil del docente hospitalario en Chile. TRANCES. Revista de transmisión del conocimiento educativo y de la salud, 14(4), 222- 253. https://filosofia.uchile.cl/publicaciones/189911/propuesta-para-eldesarrollo-de-un-perfil-del-docente-hospitalario.
Cohen-Yatziv, L. y Regev, D. (2019). The effectiveness and contribution of art therapy work with children in 2018 -what progress has been made so far? A systematic review. International Journal of Art Therapy, 24(3), 100–112. https://doi.org/10.1080/17454832.2019.1574845
Colwell, C.M., Edwards, R., Hernandez, E., y Brees, K. (2013). Impact of music therapy interventions (listening, composition, orff-based) on the physiological and psychosocial behaviors of hospitalized children: a feasibility study. Journal of Pediatric Nursing, 28(3), 249-57. https://dx.doi.org/10.1016/j.pedn.2012.08.008
Commodari, E. (2010). Children staying in hospital: A research on psychological stress of caregivers. Italian journal of paediatrics, 36(1), 1-9. https://doi.org/10.1186/1824-7288-36-40
Da Silva Santa, I.N., Schveitzer, M.C., Dos Santos, M.L.B.M., Ghelman, R., Filho, V.O. (2021). Music interventions in pediatric oncology: Systematic review and meta-analysis. Complementary Therapies Medicine., 59, 102725. https://doi.org/10.1016/j.ctim.2021.102725
Dalei, S.R., Nayak, G.R., Pradhan, R. (2020). Effect of art therapy and play therapy on anxiety among hospitalized preschool children. Journal of Biomedical Sciences, 7(2), 71-76. https://doi.org/10.3126/jbs.v7i2.34006
Davidson, B., Sathya, N., y Venkatesan, L. (2017). Effectiveness of play therapy upon anxiety among hospitalised children. International Journal of Advance Research, Ideas and Innovations in Technology, 3(5), 441-444. https://acortar.link/xVUUMp
De Mula-Fuentes, B., Quintana, M., Rimbau, J., Martínez-Mejías, A., Úriz, M., Rivera-Pérez, C., y Garolera, M. (2017). Anxiety, hospital fears and conducta and behavioral alterations during pediatric hospitalization. Actas Españolas de Psiquiatría, 46(2), 42-50. https://acortar.link/YljqKn
Dehghan, Z., Reyhani, T., Mohammadpour, V., y Zahra, S. (2017). The effectiveness of dramatic puppet and therapeutic play in anxiety reduction in children undergoing surgery: A randomized clinical trial. Iranian Red Crescent Medical Journal, 19(3), 1-8. https://acortar.link/jJx4OX
Díaz-Rodríguez, M., Alcántara-Rubio, L., Aguilar-García, D., Pérez-Muñoz, C., Carretero-Bravo, J., y Puertas-Cristóbal, E. (2021). The effect of play on pain and anxiety in children in the field of nursing: A systematic review. Journal of Pediatric Nursing, 61, 15–22. https://doi.org/10.1016/j.pedn.2021.02.022
Didehbani, N., Allen, T., Kandalaft, M., Krawczyk, D. y Chapman, S. (2016). Virtual reality social cognition training for children with high functioning autism. Computers in human behavior, 62, 703-711. https://doi.org/10.1016/j.chb.2016.04.033
Dinç, F., Kurt, A., y Yıldız, D. (2023). Hospital classroom experiences of hospitalized school-age pediatric oncology patients: A qualitative study. Journal of Pediatric Nursing, 73, e220–e226. https://doi.org/10.1016/j.pedn.2023.09.014
Evans, D. (2002). The effectiveness of music as an intervention for hospital patient: a systematic literature review. Journal of Advanced Nursing, 37(1), 8-18. https://doi.org/10.1046/j.1365-2648.2002.02052.x
Facchini, M., y Ruini, C. (2021). The role of music therapy in the treatment of children with cancer: A systematic review of literature. Complementary Therapies in Clinical Practice, 42, 101289. https://doi.org/10.1016/j.ctcp.2020.101289
Feng, Y., Lin, Y., Zhang, N., Jiang, X., y Zhang, L. (2021). Effects of animal-assisted therapy on hospitalized children and teenagers: A systematic review and meta-analysis. Journal of Pediatric Nursing, 60, 11-23. https://doi.org/10.1016/j.pedn.2021.01.020
Fernández A. y López I. (2006). Transmisión de emociones, miedo, y estrés infantil por hospitalización. International Journal Clinic and Heath Psychology, 6(3), 631–45. https://acortar.link/HzAau5
Fernández-García, Paula, Vallejo-Seco, Guillermo, Livacic-Rojas, Pablo E., y Tuero-Herrero, Ellián. (2014). Validez estructurada para una investigación cuasi-experimental de calidad: se cumplen 50 años de la presentación en sociedad de los diseños cuasi-experimentales. Anales de Psicología, 30(2), 756-771. https://dx.doi.org/10.6018/analesps.30.2.166911
Francischinelli, A. G. B., Almeida, F. de A., y Fernandes, D. M. S. F. (2012). Routine use of therapeutic play in the care of hospitalized children: nurses’ perceptions. Acta Paulista de Enfermagem, 25(1), 18-23. https://doi.org/10.1590/S0103-21002012000100004
Franck, L.S., Wray, J., Gay C., Dearmun, A.K., Lee, K., y Cooper, B.A. (2015). Predictors of parent post traumatic stress symptoms after child hospitalization on general pediatric wards: a prospective cohort study. International Journal of Nursing Studies, 52(1), 10-21. https://doi.org/10.1016/j.ijnurstu.2014.06.011
García-Parra, M., Negre, F., y Verger, S. (2021). Educational programs to build resilience in children, adolescent or youth with disease or disability: A systematic review. Eduacation Sciencies, 11(9), 464. https://doi.org/10.3390/educsci11090464
García-Peñalvo, F. J. (2022). Desarrollo de estados de la cuestión robustos: Revisiones sistemáticas de literatura. Education in the Knowledge Society (EKS), 23, e28600. https://doi.org/10.14201/eks.28600
Godino-Iáñez, M.J., Martos-Cabrera, M.B., Suleiman-Martos, N., Gómez-Urquiza, J.L., Vargas- Román, K., Membrive-Jiménez, M.J., y Albendín-García, L. (2020). Play therapy as an intervention in hospitalized children: A systematic review. Healthcare (Basel), 8(3), 239. https://doi.org/10.3390/healthcare8030239
Golan, G., Tighe, P., Dobija, N., Perel, A., y Keidan, I. (2009). Clowns for the prevention of preoperative anxiety in children: a randomized controlled trial. Pediatric Anesthesia, 19(3), 262-266. https://doi.org/10.1111/j.1460-9592.2008.02903.x
Goren, K., Cen, Y., Montemurri, V., Moodley, D., Sutton, A., Ahmed, A., Alphonsus, L., Denezis, P., Fleming, C., Guertin, H., Hyland, K., Kalim, A., Kim, H.H., Krause, S., Liang, A., Maclean, E., Neocleous, P., Patel, A., Pritchard, S., … Marcotte, E. (2023). The impact of music, play, and pet therapies in managing pain and anxiety in paediatric patients in hospital: a rapid systematic review. Paediatrics & Child Health, 28(4), 218-224. https://doi.org/10.1093/pch/pxad010
Gútiez-Cuevas, P., y, Muñoz-Garrido, V. (2021). Aulas hospitalarias: diferentes actuaciones. Una realidad de inclusión educativa. Revista de Educación Inclusiva, 13-25. https://acortar.link/HadIEA
Hakim, A., Hosseini, S.S., Tashakori, A., y Ghanbari, S. (2023). The effect of non-verbal music on anxiety in hospitalized children. BMC Pediatrics, 23(1), 279. https://doi.org/10.1186/s12887-023-04101-2
Hart, J. (2010) Art therapy and cancer care. Alternative and Complementary Therapies, 16(3), 140- 144. https://doi.org/10.1089/act.2010.16306
Hen, M. (2023). Art therapy for children in short-term hospitalization. Continuity in Education, 4(1), 83–95. https://doi.org/10.5334/cie.63.
Hen, M., y Gilan-Shochat, M. (2022). Exploring the unique professional identity of hospital teachers. Continuity in Education, 3(1), 115–126. https://doi.org/10.5334/cie.46
Herrera-Floro, T. (2016). Ansiedad en la hospitalización del paciente pediátrico. Revista de enfermería y salud mental, 4, 15-21. https://acortar.link/DiUGz9
Hinic, K., Kowalski, M.O., Holtzman, K., y Mobus, K. (2019). The effect of a pet therapy and comparison intervention on anxiety in hospitalized children. Journal of Pediatric Nursing, 46, 55-61. https://doi.org/10.1016/j.pedn.2019.03.003
Huhtala, S., Palomaa, A., Tuomikoski, A. y Pölkki, T. (2024). Effectiveness of distraction-based interventions for relieving anxiety, fear, and pain in hospitalized children during venous blood sampling: a systematic review protocol. JBI Evidence Synthesis, 22 (5), 889-895. https://doi.org/10.11124/jbies-22-00057
Johnson, A.A., Berry, A., Bradley, M., Daniell, J.A., Lugo, C., Schaum-Comegys, K., Villamero, C., Williams, K., Yi, H., Scala, E., y Whalen, M. (2021). Examining the effects of music-based interventions on pain and anxiety in hospitalized children: An integrative review. Journal of Pediatric Nursing, 60, 71-76. https://doi.org/10.1016/j.pedn.2021.02.007
Kapkin, G. (2020). Effect of therapeutic play methods on hospitalized children in Turkey: Systematic review. Erciyes Medical Journal, 42(2), 127-131. https://doi.org/10.14744/etd.2019.94940
Karppinen, S. (2022). Outdoor education in a Finnish hospital school: Let’s open the doors and take a forest walk. Journal of Outdoor and Environmental Education, 25(1), 47-60. https://doi.org/10.1007/s42322-021-00093-8
Kasem Ali Sliman R, Meiri N y Pillar G (2023). Medical clowning in hospitalized children: A meta-analysis. World Journal of Pediatrics, 19(11), 1055-1061. https://dx.doi.org/10.1007/s12519-023-00720-y
Keehan, S. (2021). Continuing education in Irish hospital schools: provision for and challenges for teachers. Continuity in Education, 2(1), 42-59. https://doi.org/10.5334/cie.25
Kishor, H., y Kale, A. (2022). A study to assess the effectiveness of origami therapy on anxiety towards hospitalization among children admitted in pediatric wards of selected hospitals from Sangli, Mirajand Kupwad corporation area. Journal of Pharmaceutical Negative Results, 13(8), 1169-1173. https://doi.org/10.47750/pnr.2022.13.S08.145
Kool, R. y Lawver, T. (2010). Play therapy considerations and applications for the practitioner. Psychiatry, 7, 19–24. PMC2989834
Koller, D., y Gryski, C. (2008). The life threatened child and the life enhancing clown: towards a model of therapeutic clowning. Evidence-based Complementary and Alternative Medicine, 5(1), 17–25. https://doi.org/10.1093/ecam/nem033
Lawrence, E. J., y Lazer, J. (2024). Effective reduction of anxiety in hospitalised children through bibliotherapy. Acta Paediatrica, 113(6), 1349–1355. https://doi.org/10.1111/apa.17154
Li, W., Kwan. J.O., Yan, K., y Chau, B.M. (2016). Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatrics, 36, 1-9. https://doi.org/10.1186/s12887-016-0570-5
Litke, J., Pikulska, A., y Wegner, T. (2012). Management of perioperative stress in children and parents. Part I--the preoperative period. Anaesthesioly Intensive Therapy, 44(3), 165–9. https://acortar.link/60xYUD
Ludgério, M. J. B., Pontes, C. M., Dos Santos, B. L. C., Macedo, E. C., de Lavor Coriolano Marinus, M. W., y Leal, L. P. (2023). Pedagogical practices developed with children through hospital classes: An integrative literature review. Journal of Pediatric Nursing, 72, e10–e18. https://doi.org/10.1016/j.pedn.2023.05.014
Molina Garuz, M. C. (2020). Pedagogía hospitalaria. Claves teóricas y enfoques para la práctica. Octaedro
Mousumi, P., Niyati, D., y Purmina, S. (2020). Effectiveness of play therapy during hospitalization in reducing anxiety among 6-12 years children in the selected tertiary hospital at Bhubaneswar. Journal of Advanced Research in Psychology & Psychoterapy, 3(3), 8-14. https://doi.org/10.24321/2581.5822.202008
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., y Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1). https://doi.org/10.1186/s12874-018-0611-x
Muñoz-Violant, S., Violant-Holz, V. y Rodríguez, M., J. (2023). Factors of well-being of youth with complex medical conditions from the experience of hospitalization and convalescence: A pilot study. PLoS One, 18(5). https://doi.org/10.1371/journal.pone.0285213
Nerm, W., y Funmilayo, V. (2021). Effectiveness of hospital play interventions programin reducing anxiety and negative emotions among hospitalized children in Ras Al-Khaimah, United Arab Emirates. JournalsPub. International Journal of Nursing Science Practice and Research, 7(2), 41-50. https://acortar.link/W0glO3
Orhan, E., y Yıldız, S. (2017). The effects of pre-intervention training provided through therapeutic play on the anxiety of pediatric oncology patients during peripheral catheterization. International Journal of Caring Sciences, 10(3), 1533–1544. https://acortar.link/te1QFp
Padila, J.A., Bagus, M., Sartika, A., y Oktaviyani, Y. (2022). Educational play snakes and stairs can overcome anxiety in children‘s hospitalization. Journal of Nursing and Health, 3(1), 1-6. https://doi.org/10.31539/josing.v3i1.3775
Page, M., McKenzie, J., Bossuyt, P., Boutron, I., Hoffman, T, Mulrow, C., Shamseer, L., Tetzlaff, J.M., Akl, E.A.; Brennan, S, Chou, R., Glanville, J., Grimshaw, J.M., Hróbjartsson, A., Lalu, M., Li, T., Loder, E., Mayo-Wilson, E ... Moher, D. (2021). Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología, 74(9), 790-799. https://doi.org/10.1016/j.recesp.2021.06.016
Palomares-Ruíz, A., y Sánchez-Navalón, B. (2016). Percepciones del profesorado y de los padres del paciente sobre la pedagogía hospitalaria. Bordón. Revista De Pedagogía, 68(4), 137–153. https://doi.org/10.13042/Bordon.2016.38618
Patel, K., y Ravindra, H.N. (2014). A study to assess the effectiveness of play therapy on anxiety among hospitalized children. Journal of Nursing and Health Science, 3(5), 17-23. https://doi.org/10.9790/1959-03531723
Patil, P. P., Karale, R., Mohite, V. R., y Naregal, P. (2021). Effectiveness of art therapy on level of stress and anxiety among paediatric oncology patients. Sri Lanka Journal of Child Health, 50(3), 459. https://doi.org/10.4038/sljch.v50i3.9696
Ramdaniati S., y Hermaningsih S, M. (2016). Comparison study of art therapy and play therapy in reducing anxiety on pre-school children who experience hospitalization. Open Journal of Nursing, 6(1),46–52. https://doi.org/10.4236/ojn.2016.61005
Ranamagar, B., y Karki, S. (2021). The effectiveness of handicrafts on anxiety reduction among hospitalised children in paediatric ward of Dhulikhel hospital. Journal of Nepal Paediatric Society, 41(3), 432–438. https://doi.org/10.3126/jnps.v41i3.36115
Rennick, J.E., Dougherty, G., Chambers, C., Stremler, R., Childerhose, J.E., y Stack, D.M.(2014). Children’s psychological and behavioral responses following pediatric intensive care unit hospitalization: the caring intensively study. BMC Pediatrics, 14, 1–11. https://doi.org/10.1186/1471-2431-14-276
Reyes-Laredo, F., Martín-Rubio, M. E., y Daza-Navarro, P. (2018). El papel del docente en un aula hospitalaria de oncología pediátrica. Revista Andina de Educación, 1(1), 3–11. https://doi.org/10.32719/26312816.2018.1.1
Rismala, D., Lestari, A., y Velyana, D. (2020). The effect of therapy containing puzzle on decreasing anxiety of hospitalized children aged 3-6 years. Proceedings of the 1st International Conference on Science, Health, Economics, Education and Technology. Advances in Health Sciences Research, 27. https://doi.org/10.2991/ahsr.k.200723.105
Romero, K., y Alonso, L. (2007). Un modelo de práctica pedagógica para las aulas hospitalarias: el caso del Hospital Universitario de Los Andes. Revista de Pedagogía, 28(83), 407-441. https://www.redalyc.org/pdf/659/65908304.pdf
Ruiz, G., y García- Álvarez, A. G. (2016). Music education at hospital schools in Spain and Sweden: Paths between governing and knowledge. European Education, 48(4), 258-273. https://doi.org/10.1080/10564934.2016.1239297
Ryan, K. S. (2011). Play and playfulness among hospitalized children: A mixed method analysis [Tesis Doctoral, The Texas Woman’s University]. http://hdl.handle.net/11274/144
Sáez, D.J., y Chico, P. (2021). Aplicación de la realidad virtual en niños oncológicos hospitalizados sometidos a procedimientos invasivos: un estudio de casos. Psicooncología. 18(1), 157-172. https://dx.doi.org/10.5209/psic.74537
Saharan, P. (2017). Assess the effectiveness of play interventions on anxiety among hospitalized children in selected hospital of Yamuna Nagar, Haryana: An experimental study. International Journal of Advance Research and Development. 2(11), 88-94. https://acortar.link/wN96zy
Sarman, A., y Günay, U. (2023). The effects of goldfish on anxiety, fear, psychological and emotional well-being of hospitalized children: A randomized controlled study. Journal of Pediatric Nursing, 68, e69–e78. https://doi.org/10.1016/j.pedn.2022.11.012
Serradas, M. (2016). La pedagogía hospitalaria como promotora de conductas resilientes. Serendipia.
Revista de Cooperación Interfacultades, 9(5),70-95. https://acortar.link/SPdJSR
Sofia, M., y Aranha, P.R. (2023). Effectiveness of game-based learning on anxiety and postoperative self-efficacy among children undergoing surgery. Journal of Health and Allied Sciences, 13(1), 83–89. https://doi.org/10.1055/s-0042-1749179
Soniya, S.A., y Solomon, R.J. (2019). Effectiveness of play therapy on anxiety among hospitalized preschool children. Asian Journal of Nursing Education and Research, 9(2), 193. https://doi.org/10.5958/2349-2996.2019.00040.5
Spielberger, C. D., Gonzalez-Reigosa, F., Martinez-Urrutia, A., Natalicio, L. F., y Natalicio, D. S. (1971). The state-trait anxiety inventory. Revista Interamericana de Psicologia/Interamerican journal of psychology, 5(3 y 4).
Spielberger, C. D., Goursch, R. L. y Lushene, R. E. (2023). Cuestionario de ansiedad estado rasgo, STAIC. (10ª ed.). (Adaptación española G. Buela-Casal, A. Guillén-Riquelme y N. Seisdedos-Cubero.TEA Ediciones. (Trabajo original publicado en 1970).
Sridharan, K. y Sivaramakrishnan, G. (2016). Therapeutic clowns in pediatrics: a systematic review and meta-analysis of randomized controlled trials. European Journal of Pediatrics, 175(10), 1353-60. https://dx.doi.org/10.1007/s00431-016-2764-0
Tan, J., Yin, H., Meng, T., y Guo, X. (2021) Effects of sandplay therapy in reducing emotional and behavioural problems in school-age children with chronic diseases: A randomized controlled trial. Nursing Open. 8(6), 3099-3110. https://doi.org/10.1002/nop2.1022
Thosar, N. R., Bane, S. P., Deulkar, P. V., Deshpande, M. A., y Gupta, S. (2022). Effectiveness of two different behavior modification techniques for anxiety reduction in children. Cureus, 14(8), e28141. https://doi.org/10.7759/cureus.28141
Tobias da Silva, S.G., Santos, M.A., Freitas, C.M., Cintra, E.B., Viera, F., y Rossato, L.M. (2017). Influence of therapeutic play on the anxiety of hospitalized school-age children: Clinical trial. Revista Brasileira de Enfermargem. 70(6), http://dx.doi.org/10.1590/0034-7167-2016-0353
Tollit, M. A., Sawyer, S. M., Ratnapalan, S., y Barnett, T. (2015). Education support services for improving school engagement and academic performance of children and adolescents with a chronic health condition. Cochrane Database of Systematic Reviews, (2), 3-21. https://doi.org/10.1002/14651858.cd011538
Tomberli, L., Vagnoli, L., Amore, E., Maffei, F., Smorti, A., y Ciucci, E. (2023). How to become a teacher in the hospital: acquiring knowledge and skills through experience. Journal of Education for Teaching, 50(3), 525–537. https://doi.org/10.1080/02607476.2023.2296449
Uggeri, M., Capurso, M., Dennis, J., Janssen, E., Merkt, A., Schmeider, I., y Patel, D. (2015). Learning at home and in the hospital. The institutional environments of Home and Hospital Education (HHE) in Europe. http://www.lehoproject.eu/en/toolkit/158-the-institutional-environments-ofhome-and-hospital-education-hhe-in-europe-1
Verdejo, C., Tapia-Benavente, L., Schuller-Martínez, B., Vergara-Merino, L., Vargas-Peirano, M., y Silva-Dreyer, A. M. (2021). What you need to know about scoping reviews. Medwave, 21(2), e8144–e8144. https://doi.org/10.5867/medwave.2021.02.8144
Vollmer, T., y Koppen, G. (2021). The Parent–Child Patient Unit (PCPU): Evidence-based patien room design and parental distress in pediatric cancer centers. International Journal of Environmental Research and Public Health, 18(19), 9993. https://doi.org/10.3390/ijerph18199993
Waite, T. C., Hamilton, L., y O’Brien, W. (2018). A meta-analysis of animal assisted interventions targeting pain, anxiety, and distress in medical settings. Complementary Therapies in Clinical Practice, 33, 49–55. https://doi.org/10.1016/j.ctcp.2018.07.006
Wantanakorn, P., Harintajinda, S., Chuthapisith, J., Anurathapan, U., y Rattanatamrong, P. (2018). A new mobile application to reduce anxiety in pediatric patients before bone marrow aspiration procedures. Hospital Pediatrics, 8(10), 643–50. https://doi.org/10.1542/hpeds.2018-0073
Warnock, H. M. (1978). Special educational needs. Report of the committee of enquiry into the education of the handicapped children and young people. HMSO.
Zamani, M., Sigaroudi, A.E., Pouralizadeh, M., y Kazemnejad, E. (2022). Effect of the Digital Education Package (DEP) on prevention of anxiety in hospitalized children: a quasi-experimental study, BMC Nursing, 21(1), 1-8. https://doi.org/10.1186/s12912-022-01113-8
Zimmermann, A., Bonifácio, A. R., Nascimento, R. do y Kibrit, S. Z. (2017). Pedagogia hospitalar favorecendo a continuidade escolar da criança hospitalizada. Doxa: Revista Brasileira de Psicologia e Educação, 19(1), 62–66. https://doi.org/10.30715/rbpe.v19.n1.2017.10820