The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalised with cancer

Aims.  To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. Background.  There has been an increase in the use of therapeutic play intervention to help ch...

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Published inJournal of clinical nursing Vol. 20; no. 15-16; pp. 2135 - 2143
Main Authors Li, William HC, Chung, Joyce OK, Ho, Eva KY
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.08.2011
Wiley Subscription Services, Inc
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Abstract Aims.  To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. Background.  There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer. Design.  A non‐equivalent control group pretest–post‐test, between‐subject design was employed. Method.  Hong Kong Chinese Children (8–16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14‐month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions. Results.  The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children’s anxiety scores between the two groups on day 7. Conclusion.  The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care. Relevance to clinical practice.  The findings heighten the awareness in healthcare professionals that play is a very important part of children’s life and that they need play even when they are ill.
AbstractList To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer.AIMSTo examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer.There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer.BACKGROUNDThere has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer.A non-equivalent control group pretest-post-test, between-subject design was employed.DESIGNA non-equivalent control group pretest-post-test, between-subject design was employed.Hong Kong Chinese Children (8-16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14-month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions.METHODHong Kong Chinese Children (8-16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14-month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions.The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children's anxiety scores between the two groups on day 7.RESULTSThe results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children's anxiety scores between the two groups on day 7.The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care.CONCLUSIONThe study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care.The findings heighten the awareness in healthcare professionals that play is a very important part of children's life and that they need play even when they are ill.RELEVANCE TO CLINICAL PRACTICEThe findings heighten the awareness in healthcare professionals that play is a very important part of children's life and that they need play even when they are ill.
To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer. A non-equivalent control group pretest-post-test, between-subject design was employed. Hong Kong Chinese Children (8-16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14-month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions. The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children's anxiety scores between the two groups on day 7. The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care. The findings heighten the awareness in healthcare professionals that play is a very important part of children's life and that they need play even when they are ill.
Aims.  To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. Background.  There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer. Design.  A non‐equivalent control group pretest–post‐test, between‐subject design was employed. Method.  Hong Kong Chinese Children (8–16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14‐month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions. Results.  The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children’s anxiety scores between the two groups on day 7. Conclusion.  The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care. Relevance to clinical practice.  The findings heighten the awareness in healthcare professionals that play is a very important part of children’s life and that they need play even when they are ill.
To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer. A non-equivalent control group pretest-post-test, between-subject design was employed. Hong Kong Chinese Children (8-16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14-month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions. The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children's anxiety scores between the two groups on day 7. The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care. The findings heighten the awareness in healthcare professionals that play is a very important part of children's life and that they need play even when they are ill.
Aims.  To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong Chinese children hospitalised with cancer. Background.  There has been an increase in the use of therapeutic play intervention to help children cope with the stress of hospitalisation. However, it is not clear whether therapeutic play is an appropriate psychological intervention for Chinese children hospitalised with cancer. Design.  A non‐equivalent control group pretest–post‐test, between‐subject design was employed. Method.  Hong Kong Chinese Children (8–16 years of age), admitted to a paediatric oncology ward for the treatment of cancer during a 14‐month period, were invited to participate in the study. Of the 122 children, 70 formed the control group receiving routine nursing care and 52 in the experimental group receiving therapeutic play interventions. Results.  The results showed that children in the experimental group reported statistically significant fewer depressive symptoms than children in the control group on day 7. The results, however, find no differences in children’s anxiety scores between the two groups on day 7. Conclusion.  The study provides empirical evidence to support the effectiveness of therapeutic play, using virtual reality computer games, in the psychological preparation of children hospitalised with cancer, thus charting a path towards promoting holistic and quality care. Relevance to clinical practice.  The findings heighten the awareness in healthcare professionals that play is a very important part of children’s life and that they need play even when they are ill.
Clinical trial research in Hong Kong examining the impact of virtual reality-based play therapy on the mental health of hospitalised 8-16 year olds undergoing cancer treatment. Pre-test post-test depression and anxiety scores were compared for children receiving normal care plus 30 minute virtual reality computer games daily and with a control group receiving usual care only. [(BNI unique abstract)] 30 references
Author Ho, Eva KY
Li, William HC
Chung, Joyce OK
Author_xml – sequence: 1
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  surname: Li
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  organization: Authors:William HC Li, PhD, Assistant Professor, School of Nursing, The University of Hong Kong; Joyce OK Chung, MPH, Teaching Consultant, School of Nursing, The University of Hong Kong; Eva KY Ho, BNurs, Research Nurse, School of Nursing, The University of Hong Kong, Hong Kong, China
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  givenname: Joyce OK
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  fullname: Chung, Joyce OK
  organization: Authors:William HC Li, PhD, Assistant Professor, School of Nursing, The University of Hong Kong; Joyce OK Chung, MPH, Teaching Consultant, School of Nursing, The University of Hong Kong; Eva KY Ho, BNurs, Research Nurse, School of Nursing, The University of Hong Kong, Hong Kong, China
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  givenname: Eva KY
  surname: Ho
  fullname: Ho, Eva KY
  organization: Authors:William HC Li, PhD, Assistant Professor, School of Nursing, The University of Hong Kong; Joyce OK Chung, MPH, Teaching Consultant, School of Nursing, The University of Hong Kong; Eva KY Ho, BNurs, Research Nurse, School of Nursing, The University of Hong Kong, Hong Kong, China
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References Weissman MM, Orvaschel H & Padian N (1980) Children's symptom and social functioning self-report scales: comparison of mothers' and children's reports. The Journal of Nervous and Mental Disease 168, 736-740.
Whitsett SF, Gudmundsdottir M, Davies B, McCarthy P & Friedman D (2008) Chemotherapy-related fatigue in childhood cancer: correlates, consequences and coping strategies. Journal of Pediatric Oncology Nursing 25, 86-96.
Vessey JA & Mahon MM (1990) Therapeutic play and the hospitalized child. Journal of Pediatric Nursing 5, 328-533.
Barkmann C, Erhart M & Schulte-Markwort M (2008) The German version of the Centre for Epidemiological Studies Depression Scale for Children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents - results of the BELLA study. European Child and Adolescent Psychiatry 17, 116-124.
Steele E, Grimmer K, Thomas B, Mulley B, Fulton I & Hoffman H (2003) Virtual reality as a pediatric pain modulation technique: a case study. CyberPsychology and Behavior 6, 633-638.
Lazarus RS & Folkman S (1984) Stress, Appraisal and Coping. Springer, New York.
Polit DF & Beck CT (2008) Nursing Research: Generating and Assessing Evidence for Nursing Practice, 8th edn. Lippincott Williams & Wilkins, Philadelphia, PA.
Li HCW, Lopez V & Lee TLI (2007) Psychoeducational preparation of children for surgery: the important of parental involvement. Patient Education and Counseling 65, 34-41.
Dejong M & Fombonne E (2006) Depression in paediatric cancer: an overview. Psycho-Oncology 15, 553-566.
Williams PD, Schmideskamp J, Ridder EL & Williams AR (2006) Symptom monitoring and dependent care during cancer treatment in children. Cancer Nursing 29, 188-197.
Stam H, Grootenhuis MA, Caron HN & Last BF (2006) Quality of life and current coping in young adult survivors of childhood cancer: positive expectations about the further course of the disease were correlated with better quality of life. Psycho-Oncology 15, 31-43.
Li HCW & Chung OK (2009) Enhancing the efficacy of psychoeducational interventions for paediatric patients in a randomized controlled trial: methodological considerations. Journal of Clinical Nursing 18, 3013-3021.
Langeveld NE, Langeveld NE, Grootenhuis MA, Voute PA, Haan RJ & Bos CVD (2004) Quality of life, self-esteem and worries in young adult survivors of childhood cancer. Psycho-Oncology 13, 867-881.
Hicks MD & Lavender R (2001) Psychosocial practice trends in pediatric oncology. Journal of Pediatric Oncology Nursing 18, 143-153.
Li HCW, Wong EML & Lopez V (2008) Factorial structure of the Chinese version of the State Anxiety Scale for Children (short form). Journal of Clinical Nursing 17, 1762-1770.
Matziou V, Perdikaris P, Galanis P, Dousis E & Tzoumakas K (2008) Evaluating depression in a sample of children and adolescents with cancer in Greece. International Nursing Review 55, 314-319.
Penkman L, Scott-Lane L & Pelletier W (2006) A psychosocial program for pediatric oncology patients: a pilot study of 'The Beaded Journey.' Journal of Psychosocial Oncology 24, 103-115.
LeVieux-Anglin L & Sawyer EH (1993) Incorporating play interventions into nursing care. Pediatric Nursing 19, 459-463.
Kizony R, Katz N & Weiss PL (2003) Adapting an immersive virtual reality system for rehabilitation. Journal of Visualization and Computer Animation 14, 261-268.
Li HCW & Lopez V (2007) Development and validation of a short form of the Chinese version of the State Anxiety Scale for Children. International Journal of Nursing Studies 44, 566-573.
Becher Y & Sing AWN (1997) A New Chapter in Paediatric Health Care: A Research Report to Evaluate Hospital Play Services in Hong Kong. Playright Children's Playground Association Ltd., Hong Kong.
Li HCW, Chung OK & Chiu SY (2010) The impact of cancer on children's physical, emotional and psychosocial well-being. Cancer Nursing 33, 47-54.
Schultheis MT & Rizzo AA (2001) The application of virtual reality technology in rehabilitation. Rehabilitation Psychology 46, 296-311.
Cooper SE & Blitz JT (1985) A therapeutic play group for hospitalized children with cancer. Journal of Psychosocial Oncology 3, 23-37.
O'Connor G & Drennan C (2003) Optimising patient care: meeting the needs of the paediatric oncology patient. Journal of Diagnostic Radiography and Imaging 1, 33-38.
Dowling JS, Hockenberry M & Gregory RL (2003) Sense of humor, childhood cancer stressors and outcomes of psychosocial adjustment, immune function and infection. Journal of Pediatric Oncology Nursing 20, 271-292.
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Cohen J (1992) A power primer. Psychological Bulletin 112, 155-159.
Weiss PL, Bialik P & Kizony R (2003) Virtual reality provides leisure time opportunities for individuals with physical and intellectual disabilities. CyberPsychology and Behavior 6, 335-342.
Radloff LS (1977) A CES-D scale: a self-report depression scale for research in the general population. Apply Psychology Measurement 1, 385-401.
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2006; 15
1997
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2008
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2001; 46
1993; 19
2006; 24
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Vessey JA (e_1_2_11_27_1) 1990; 5
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References_xml – reference: Li HCW & Lopez V (2007) Development and validation of a short form of the Chinese version of the State Anxiety Scale for Children. International Journal of Nursing Studies 44, 566-573.
– reference: Barkmann C, Erhart M & Schulte-Markwort M (2008) The German version of the Centre for Epidemiological Studies Depression Scale for Children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents - results of the BELLA study. European Child and Adolescent Psychiatry 17, 116-124.
– reference: Cohen J (1992) A power primer. Psychological Bulletin 112, 155-159.
– reference: O'Connor G & Drennan C (2003) Optimising patient care: meeting the needs of the paediatric oncology patient. Journal of Diagnostic Radiography and Imaging 1, 33-38.
– reference: Whitsett SF, Gudmundsdottir M, Davies B, McCarthy P & Friedman D (2008) Chemotherapy-related fatigue in childhood cancer: correlates, consequences and coping strategies. Journal of Pediatric Oncology Nursing 25, 86-96.
– reference: Vessey JA & Mahon MM (1990) Therapeutic play and the hospitalized child. Journal of Pediatric Nursing 5, 328-533.
– reference: Langeveld NE, Langeveld NE, Grootenhuis MA, Voute PA, Haan RJ & Bos CVD (2004) Quality of life, self-esteem and worries in young adult survivors of childhood cancer. Psycho-Oncology 13, 867-881.
– reference: Weissman MM, Orvaschel H & Padian N (1980) Children's symptom and social functioning self-report scales: comparison of mothers' and children's reports. The Journal of Nervous and Mental Disease 168, 736-740.
– reference: Li HCW, Chung OK & Chiu SY (2010) The impact of cancer on children's physical, emotional and psychosocial well-being. Cancer Nursing 33, 47-54.
– reference: Weiss PL, Bialik P & Kizony R (2003) Virtual reality provides leisure time opportunities for individuals with physical and intellectual disabilities. CyberPsychology and Behavior 6, 335-342.
– reference: Dowling JS, Hockenberry M & Gregory RL (2003) Sense of humor, childhood cancer stressors and outcomes of psychosocial adjustment, immune function and infection. Journal of Pediatric Oncology Nursing 20, 271-292.
– reference: LeVieux-Anglin L & Sawyer EH (1993) Incorporating play interventions into nursing care. Pediatric Nursing 19, 459-463.
– reference: Armstrong TSH (2000) The developing role of play preparation in paediatric anaesthesia. Pediatric Anaesthesia 10, 1-4.
– reference: Lazarus RS & Folkman S (1984) Stress, Appraisal and Coping. Springer, New York.
– reference: Stam H, Grootenhuis MA, Caron HN & Last BF (2006) Quality of life and current coping in young adult survivors of childhood cancer: positive expectations about the further course of the disease were correlated with better quality of life. Psycho-Oncology 15, 31-43.
– reference: Penkman L, Scott-Lane L & Pelletier W (2006) A psychosocial program for pediatric oncology patients: a pilot study of 'The Beaded Journey.' Journal of Psychosocial Oncology 24, 103-115.
– reference: Li HCW, Wong EML & Lopez V (2008) Factorial structure of the Chinese version of the State Anxiety Scale for Children (short form). Journal of Clinical Nursing 17, 1762-1770.
– reference: Steele E, Grimmer K, Thomas B, Mulley B, Fulton I & Hoffman H (2003) Virtual reality as a pediatric pain modulation technique: a case study. CyberPsychology and Behavior 6, 633-638.
– reference: Williams PD, Schmideskamp J, Ridder EL & Williams AR (2006) Symptom monitoring and dependent care during cancer treatment in children. Cancer Nursing 29, 188-197.
– reference: Polit DF & Beck CT (2008) Nursing Research: Generating and Assessing Evidence for Nursing Practice, 8th edn. Lippincott Williams & Wilkins, Philadelphia, PA.
– reference: Li HCW & Chung OK (2009) Enhancing the efficacy of psychoeducational interventions for paediatric patients in a randomized controlled trial: methodological considerations. Journal of Clinical Nursing 18, 3013-3021.
– reference: Matziou V, Perdikaris P, Galanis P, Dousis E & Tzoumakas K (2008) Evaluating depression in a sample of children and adolescents with cancer in Greece. International Nursing Review 55, 314-319.
– reference: Becher Y & Sing AWN (1997) A New Chapter in Paediatric Health Care: A Research Report to Evaluate Hospital Play Services in Hong Kong. Playright Children's Playground Association Ltd., Hong Kong.
– reference: Schultheis MT & Rizzo AA (2001) The application of virtual reality technology in rehabilitation. Rehabilitation Psychology 46, 296-311.
– reference: Cooper SE & Blitz JT (1985) A therapeutic play group for hospitalized children with cancer. Journal of Psychosocial Oncology 3, 23-37.
– reference: Radloff LS (1977) A CES-D scale: a self-report depression scale for research in the general population. Apply Psychology Measurement 1, 385-401.
– reference: Dejong M & Fombonne E (2006) Depression in paediatric cancer: an overview. Psycho-Oncology 15, 553-566.
– reference: Kizony R, Katz N & Weiss PL (2003) Adapting an immersive virtual reality system for rehabilitation. Journal of Visualization and Computer Animation 14, 261-268.
– reference: Hicks MD & Lavender R (2001) Psychosocial practice trends in pediatric oncology. Journal of Pediatric Oncology Nursing 18, 143-153.
– reference: Li HCW, Lopez V & Lee TLI (2007) Psychoeducational preparation of children for surgery: the important of parental involvement. Patient Education and Counseling 65, 34-41.
– volume: 18
  start-page: 143
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  end-page: 153
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  article-title: Therapeutic play and the hospitalized child
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  year: 1977
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  article-title: A CES‐D scale: a self‐report depression scale for research in the general population
  publication-title: Apply Psychology Measurement
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  article-title: Depression in paediatric cancer: an overview
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Snippet Aims.  To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong...
Aims.  To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong...
To examine the effectiveness of therapeutic play, using virtual reality computer games, in minimising anxiety and reducing depressive symptoms in Hong Kong...
Clinical trial research in Hong Kong examining the impact of virtual reality-based play therapy on the mental health of hospitalised 8-16 year olds undergoing...
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SubjectTerms Adaptation, Psychological
Adolescent
Cancer
Child
children
Childrens health
Computer & video games
Happiness
Hong Kong
Humans
Neoplasms - psychology
nurses
nursing
Play and Playthings
psychological
therapeutic play
Therapy
User-Computer Interface
virtual reality
Title The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalised with cancer
URI https://api.istex.fr/ark:/67375/WNG-7PHF8L2C-2/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1365-2702.2011.03733.x
https://www.ncbi.nlm.nih.gov/pubmed/21651633
https://www.proquest.com/docview/884546778
https://www.proquest.com/docview/877406182
https://www.proquest.com/docview/888157667
Volume 20
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