Background. Several studies have reported an association between chronic pain and reduction of cognitive abilities of adults living in Western cultures. No literature could be found on the relationship between chronic pain and cognition among Middle Eastern adults. Objective. To compare four of the most commonly reported cognitive domains [memory, attention, processing speed, and executive functioning] among Middle Eastern adults with and without chronic pain. Methods. This matched group comparative study included 69 community residing and functionally independent Middle Eastern adults. Forty participants had chronic pain and 29 were pain-free. We administered five standardized cognitive assessments that are independent of culture and language to measure variable tasks of memory, attention, processing speed, and executive functioning. The study was conducted in a rehabilitation research setting with a controlled environment. Results. Evidence of decreased cognitive processing was found in patients with chronic pain. The chronic pain participants performed significantly worse than the pain-free participants on the cognitive measures of long-term memory, selective attention, processing speed, and executive functioning. Conclusion. The effect of Middle Eastern culture on the cognitive abilities of patients with chronic pain was negligible. Despite the wide variations between Eastern and Western cultures, the performance of our Middle Eastern participants in this study was consistent with performance of Western adults reported in previous studies.

Background Living with a life threatening/limiting condition changes and challenges children’s play. The environment is known to support participation in play, yet there is a lack of evidence highlighting its specific factors contributing to children’s play. In this study, we investigated the perspectives of children living with life threatening/limiting conditions with regards to the environmental factors that are related to their engagement in play whilst receiving inpatient healthcare. Methods Twenty-seven children took part in this study. Participants were aged between 5y and 11y, diagnosed with life threatening/limiting conditions and were receiving care at either a children’s hospital or hospice in either Kuwait or the UK. Children were asked to rank-order a Q set according to their perceived importance. The used Q set comprised of social and physical environmental factors. The data were analysed using factor analysis and content analysis. Findings Two shared viewpoints were identified which represented children from both countries. For factor1, the children’s need for social connectivity guided their answers regarding the environmental factors. For factor2, although children considered being surrounded by others important, their selections of the play conditions directed their play. For both factors, children had relatively little concern for outdoor and the type of play to engage in, with the exception of arts and crafts play activities which were deemed important. Conclusions Play settings are important to support rich, social play experiences and opportunities that match children’s play preferences. Children living with life threatening/limiting conditions in Kuwait and the UK have relatively similar play needs.

Background. Play, which is fundamental to children’s lives, can be utilised to enrich their daily experience. However, the available knowledge regarding the impact of play on children with attention deficit hyperactivity disorder (ADHD) is limited. Therefore, this study is aimed at investigating mothers’ perspectives on their children with ADHD in Kuwait regarding their play preferences, the impact of play on ADHD behaviours, and the strategies used to regulate their children’s ADHD symptoms. Methods. Eight mothers of children aged five to ten years old with ADHD were recruited via purposive sampling. Their perspectives were qualitatively explored through one-week diaries of their children’s routines followed by semistructured interviews. The data were analysed using thematic analysis. Results. Four themes emerged: (1) play characteristics for children with ADHD, (2) play preferences, (3) play settings and their impact on ADHD symptoms, and (4) mothers’ values, understanding, and influence on play. Children were found to spend most of their playtime in indoor settings, largely playing video games. The mothers acknowledged the positive influence on their children of outdoor play and the deleterious effect of video games. However, they undervalued the contribution of play to their children’s development. Their strategies for regulating the types of play that diminish their children’s ADHD behaviours were less well understood. The weather and mothers’ other responsibilities were the main barriers. Conclusions. Understanding the play of children with ADHD revealed the requirement for more opportunities for different types of play, with more consideration of those that positively manage ADHD behaviours.

Children living with palliative care needs are less engaged in play, despite its importance in their lives. The environment may have a crucial role in supporting these children’s play. Understanding the importance and impact of environmental factors on children’s play is essential to being able to support their participation in play. Data were collected from caregivers (mostly parents) of children living with life-threatening/limiting conditions, who were between 5 and 11 years old. Thirty-nine participants were recruited from two children hospitals and two hospices in Kuwait and in the United Kingdom. The participants’ perspectives were explored using Q methodology. By-person factor analysis was used to explore the ranking of each statement. Content analysis was used to analyse the participants’ verbal comments. The most important environmental factors were the need for others to share play and get assistance to facilitate play. However, this is not always possible as these conditions, the life-threatening/limiting conditions, may be socially isolating. Children also experience limitations in accessing play resources that match their abilities and meet their play needs. Being aware and responsive to children’s play needs is essential for building appropriately supportive play environments for children living with life-threatening/life-limiting conditions.

Background: Play is central to children’s lives. Children living with palliative care needs experience disruption in their play. In this study, we sought to discover the characteristics and patterns of children’s play when receiving care in children’s hospital wards and hospices in Kuwait and the United Kingdom. Methods: A qualitative nonparticipatory observation design was used. Thirty-one children were observed, between the ages of 5 and 11 years, all diagnosed with life-limiting or life-threatening conditions and receiving palliative care. The data were analysed using content analysis. Results: The children’s illnesses were negatively impacting their ability to have typical play for their age and development. The children’s interactive play was with grown-ups and very rarely with other children. This was associated with isolation precautions, the child’s need for assistance and a lack of play resources that match children’s physical and cognitive abilities. This gave rise to their engagement in more sedentary, solitary play. The findings of the study did not indicate significant cultural differences between the two countries. Conclusion: Children living with palliative care needs may be socially isolated due to their illnesses and their play participation can be limited. Understanding the influencing factors that determine these children’s play is essential for implementing effective modifications to enhance their play routines.