The Leisure Engagement Scale©: A Therapeutic Recreation Outcome Measure for Children Undergoing Bone Marrow Transplantation

Authors

  • Valerie Lazzara Mould Nationwide Children's Hospital
  • Heather Sotak Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio
  • Mary Chadbourne Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio
  • Victoria Green (Warner) Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio
  • Anne Gonzales Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio
  • Ben Reader Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, Ohio
  • Joseph Stanek Division of Hematology, Oncology, and Bone Marrow Transplantation, Nationwide Children's Hospital, Columbus, Ohio

DOI:

https://doi.org/10.18666/TRJ-2025-V59-I3-12813

Keywords:

Cancer, Pediatrics, Outcome Measure, Acute Care, Therapeutic Recreation, Bone Marrow Transplant

Abstract

Children and young adults with cancer experience an array of debilitating side effects due to antineoplastic treatments that impair participation in daily activities and decrease quality of life. Recreational therapists provide interventions to rehabilitate the impacts of bone marrow transplantation (BMT). To track progress and monitor health status of individuals undergoing BMT, an outcome measure was created. The purpose of this study was to describe the Leisure Engagement Scale© (LES) and demonstrate its face validity. A retrospective cohort study was performed to assess the scores of the LES. The LES is a recreational therapist-administered, 4-point scale with items examining readiness for session, emotional presentation, leisure education, and socialization. Linear mixed models were used to analyze the change in scores over time. A total of 572 sessions were recorded in 57 individuals who had a median age of 5.9 (IQR: 1.8-12.33) years. The LES was performed in all sessions. Scores demonstrated an expected decline in all items from evaluation (86%) to nadir (70%; p<.0001), followed by a rebound at discharge (84%; p<.0001). Correlations demonstrated a mild positive relationship among variables. The LES was able to track readiness for session, emotional presentation, leisure education, and socialization throughout the individual’s admission and face validity suggests that all areas of the LES measure different constructs that are weakly related. Future research and practice should investigate the interrater reliability of the LES and expand use clinically for other populations. 

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Published

2025-07-23

Issue

Vol. 59 No. 3 (2025)

Section

Research Papers

License

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