Children Draw And Tell: Insights from a Study of Stress in the Hospital

Wechter, Susan M.

Saturday, 16 November 2013

Susan M. Wechter, PhDc, RN, PPCNP-BC
College of Nursing, University of New Mexico, Albuquerque, NM

Learning Objective 1: Discuss the results of a qualitative interpretive descriptive study regarding children's perceptions of stress in the hospital.

Learning Objective 2: Identify the multi-faceted meaning of stress through a child's voice.

Specific Aims/Background: The purpose of this study is to explore the perceptions of stress for the hospitalized school-age child, age 7-9 years, through a draw and tell technique. Over 3 million children are hospitalized every year and 42% of these children are 6 years of age and older (1). Since the 1960’s, it has been well-known that hospitalization can be an extremely traumatic and stressful experience for children (2) and elicits feelings of fear, uncertainty, insecurity, pain and discomfort affecting a child’s healing, behavior and health outcomes (3). The psychosocial impact of hospitalization has not been remedied, and not fully explored from a child’s perspective. Given the current complex technological nature of hospital environments it is critical to resume the study of children in a hospital setting. This study is sensitized to the theoretical frameworks of Magnusson's (4) Developmental Science, Vessey's (5) Child's Psychosocial Responses to Hospitalization; and Kolcaba’s (6) modified Comfort Theory.

Methods: Data is collected through a child-centered ‘draw and tell’ technique (7) eliciting the child’s views of their hospitalization experience. An interpreted child drawing is recognized as a powerful communication tool that promotes rapport building, emotional expression and empowerment of the child research participant (8). Interpretive description framework is applied (9). A constant comparison method is utilized with repeated immersion and thoughtful clinical tests, as data collection and analysis occur simultaneously.

Results: The results of this study are interpreted themes regarding children’s perceptions of stress during hospitalization. Exploring the meaning of stress for the hospitalized child and what they perceive as remedies to this stress, leads to congruent nursing care and psychosocial support of the child in the hospital.

Implications: Discovering the meaning of stress from a child’s voice launches a research trajectory addressing the remedies of the psychosocial trauma for this population.

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