Here’s how storytelling reduces pain and stress in hospitalized children
Children in intensive care units (ICUs) experienced physiological and emotional benefits after participating in storytelling study – new research suggests.
The study was published in the Proceedings of the National Academy of Sciences, the official scientific journal of the National Academy of Sciences in the United States.
It was produced by the Golden Institute for Research and Education (IDOR) and the Federal University of ABC (UFABC). The study was led by Guilherme Brockington, PhD, of UFABC, and Jorge Moll, MD, PhD, of IDOR.
“In storytelling, something happens that we call ‘narrative transport’. The child, through fantasy, can experience sensations and thoughts which transport him to another world, a place different from the hospital room and therefore far from the aversive conditions of hospitalization, ”said Guilherme Brockington , PhD, and lead author of the study.
Storytelling is an age-old practice of humanity. Legends, religions and social values have spanned millennia through orality and writing. Today’s best-selling film scripts and novels captivate audiences through the same mechanism: listening to a good story is passing from one reality to another.
This movement, driven by the imagination, can create empathy for events and characters that fluctuate based on each individual’s interpretation.
“ Until now, the positive evidence for storytelling has relied on ‘common sense’ and taken at face value, in which interaction with the child can distract, entertain, and relieve psychological pain. But it lacked a solid scientific basis, especially with regards to the underlying physiological mechanisms, ”explained Dr Moll.
Given the psychological and biological processes that occur during and after listening to a story, the study’s investigators came up with the idea to seek scientific evidence of the effects of storytelling on critically hospitalized children.
A total of 81 children were selected, aged 2 to 7 years old and with similar clinical conditions, such as breathing problems caused by asthma, bronchitis or pneumonia.
The children were admitted to the intensive care unit at Rede D’Or Sao Luiz Jabaquara Hospital, Sao Paulo, Brazil, and were randomly divided into two groups: 41 of them participated in a group in which storytellers read children’s stories for 25 to 30 minutes, while in a control group, 40 children were told riddles given by the same professionals and for the same length of time.
To compare the effects of the two interventions, saliva samples were taken from each participant before and after each session to analyze the oscillations of cortisol and oxytocin – hormones related to stress and empathy, respectively.
In addition, the children took a subjective test to assess the level of pain they felt before and after participating in the activities. They also performed a free word association task by relating their impressions on 7 cards illustrated with elements of the hospital context (nurse, doctor, hospital, medicine, patient, pain and book).
The results were positive for all groups, as both interventions reduced cortisol level and increased oxytocin production in all children analyzed, while the feeling of pain and discomfort was also reduced, according to the evaluation of the children themselves.
However, one significant difference was that the positive results of children in the storytelling group were twice as good as those in the riddles group. These results led the researchers to conclude that narrative activity was significantly more effective.
Another strong point of this study is that it was not performed in an artificial environment, but rather in the routine of the pediatric intensive care unit. The storytelling was done individually; the child chose which story. From the books on offer, we have chosen titles available in regular bookstores and without predefined emotional bias, so that the story does not influence the child’s reaction to the activity so much, ”said Dr Brockington.
Although the storytelling was already adopted in many children’s hospitals, this is the first time that we have been presented with solid evidence of its physiological and psychological impacts. This helps to see activity as an effective and inexpensive therapeutic method, which can make a big difference in the quality of life of children in intensive care units.
“I consider this study to be one of the most important in which I have participated, because of its simplicity, its thoroughness and its potential direct impact on practices in hospitals, aimed at alleviating human suffering. and highly safe intervention, it can potentially be implemented across the public system, once larger studies have verified its reproducibility and effectiveness. We intend to expand and replicate it in other settings and patient groups and to support volunteerism dedicated to the noble activity of storytelling, now with stronger scientific evidence, ”Dr Moll pointed out. .
The emotional impacts of storytelling were also revealed in the results of the free word association test, performed at the end of each intervention. Children in the storytelling group reported more positive emotions than those in the control group, when exposed to the words of the hospital, nurse and doctor.
For example, the children in the control group responded to the map by drawing a hospital saying, “This is where people go when they are sick”. Children in the storytelling group reported for the same map that “this is the place where people go to get better.”
For the illustrations of a nurse and a doctor, the same pattern was observed. The children in the control group remarked: “It is the wrong woman who comes to give me an injection”, while those who were told the stories said sentences such as: “It is the woman who comes to heal me. “.
Although the research benefited from the support of volunteer storytellers trained from the Brazilian non-profit association “Viva e Deixe Viver”, the authors claim that storytelling is an activity that can be practiced in the same way by parents and children. educators, thus offering children a space to participate in the choice of the book and to interact with the story.
In addition to reducing anxiety and stress, the activity helps strengthen the bonds between the child, the narrator and other people in the environment.
The authors also noted that the results of this storytelling research indicate additional potential applications for children with environmental stress, such as pandemic disruption.
Storytelling by parents, relatives and friends can be a simple and effective way to improve a child’s well-being and is accessible to all families.
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