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Wu TJ, Sheih CSM, Jou ST, Lee CY, Yu TY, Liu CY, Chen CW. Effects of bibliotherapy on emotional distress, coping strategies, and resilience in adolescents with cancer: A pilot randomized controlled trial. Eur J Oncol Nurs 2025; 76:102900. [PMID: 40381380 DOI: 10.1016/j.ejon.2025.102900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2025] [Revised: 05/06/2025] [Accepted: 05/08/2025] [Indexed: 05/20/2025]
Abstract
PURPOSE This study investigated the effects of interactive versus reading bibliotherapy using picture books on emotional distress, coping strategies, and resilience among adolescents with cancer. METHODS In this multicenter pilot randomized controlled trial with qualitative interviews, 27 patients aged 10-19 years diagnosed with leukemia or osteosarcoma within the past two years and undergoing treatment were randomly assigned to interactive bibliotherapy (n = 14) or reading bibliotherapy (n = 13). Each participant completed two sessions with picture books, 1-2 weeks apart. Emotional distress, coping strategies, and resilience were measured at baseline (T0), immediately post-intervention (T1), and at a one-month follow-up (T2). Interviews at T2 explored intervention effects and participant feedback. RESULTS At one-month follow-up, the experimental group showed significantly lower negative affect than the comparison group. No significant differences were found in positive affect, coping strategies, or resilience. Participants reported interactive bibliotherapy promoted support, emotional connection, and inner strength, while the comparison group experienced brief relaxation and distraction. Picture books resonated with illness experiences and were suitable during chemotherapy. Participants recommended more frequent sessions. CONCLUSIONS This study provided preliminary evidence that interactive bibliotherapy was more effective than reading bibliotherapy in alleviating emotional distress. Picture books may represent a promising psychological intervention for adolescents undergoing cancer treatment. TRIAL REGISTRATION www. CLINICALTRIALS gov, NCT05510635.
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Affiliation(s)
- Tsai-Jung Wu
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chen Su-May Sheih
- Department of Library and Information Science, National Taiwan University, Taipei, Taiwan
| | - Shiann-Tarng Jou
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Chih-Ying Lee
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ting-Yen Yu
- Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chieh-Yu Liu
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chi-Wen Chen
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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McKeon L, Gildersleeve J, Mullens AB. The Strategies of Picture Books as a Mode of Health Communication for Young Children with Coeliac Disease. CHILDREN (BASEL, SWITZERLAND) 2025; 12:530. [PMID: 40426709 PMCID: PMC12110137 DOI: 10.3390/children12050530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2025] [Revised: 04/12/2025] [Accepted: 04/16/2025] [Indexed: 05/29/2025]
Abstract
Background/Objectives: Coeliac disease, a chronic and lifelong health condition, is one of the most common autoimmune diseases. However, it is also one of the most under-recognised conditions, and emotionally and cognitively appropriate materials are especially lacking for young children and their families who are coping with this disease. Effective health communication is essential for educating and supporting children living with coeliac disease as well as their families and communities. Picture books can serve as useful and accessible educational and health promotion tools, promoting adaptive coping strategies for dealing with a potentially traumatic condition. Methods: This study aimed to fill a critical gap in the literature by examining a range of picture books (n = 9) aimed at children three to eight years of age diagnosed with coeliac disease. Reflective thematic and structural narrative analyses were applied to explore strategies and themes used in these books and how they align with the current literature on developing coping through children's narratives. Results: Four themes were developed and measured against an existing model of coping narratives to find a more specific model that recognises the specific concerns of coeliac disease. The four themes found were Information Provision; Promotion of CD Management; Anxiety and Hypervigilance Reduction, with two subthemes of Validating Feelings and Reducing Concerns; and Community and Connection. Conclusions: The findings have likely implications for the following applications: incorporation into clinician training (as a therapeutic and health promotion intervention), support within schools, authors of similar books for children coping with chronic illness, and coping approaches for individuals/families to promote health literacy/support regarding living with coeliac disease.
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Affiliation(s)
- Lydia McKeon
- School of Psychology and Wellbeing, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia; (L.M.); (A.B.M.)
| | - Jessica Gildersleeve
- School of Humanities and Communication, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Amy B. Mullens
- School of Psychology and Wellbeing, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia; (L.M.); (A.B.M.)
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Slater R, Walker S, Eccleston C, Bellieni C, Hirekodi T, Carbajal R, Smart L, Laughey W, Cobo MM, Friedrichsdorf S. Moments that matter: childhood pain treatment shapes pain for life-we can do better every time in every child. BMC Med 2025; 23:64. [PMID: 39901139 PMCID: PMC11792334 DOI: 10.1186/s12916-025-03869-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 01/14/2025] [Indexed: 02/05/2025] Open
Abstract
BACKGROUND Needle procedures, such as vaccinations, blood draws, and intravenous cannulation, are the most frequent source of childhood pain, causing fear and reducing the uptake of medical procedures. Every child has the right to expect pain relief, and we have evidence-based tools to reduce needle procedure-related pain. Therefore, the lack of analgesic provision for needle pain is not justified. We argue that better informed and motivated healthcare professionals and families can advocate for appropriate pain relief in every child, every time. OBSERVATIONS Engaging communication campaigns are needed to educate our healthcare professionals. Evidence-based modalities such as topical anaesthesia, sucrose or breastfeeding, comfort positioning, and age-appropriate distractions should be available for every child during needle procedures. However, high-quality information is not enough to change behaviour-healthcare professionals need to be motivated, encouraged, and inspired. Parents and carers should be empowered to advocate for their children and be aware that their child has the right to receive pain relief during these procedures. CONCLUSIONS AND RELEVANCE: This is a call to action-we need collaboration between academics, healthcare professionals, industry and charities, to expedite behavioural change and parental advocacy through high-quality communication strategies. Effective pain management in infants and children can play a crucial role in promoting the uptake of vaccinations and medical procedures and can influence future attitudes to pain.
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Affiliation(s)
- Rebeccah Slater
- Department of Paediatrics, University of Oxford, Oxford, UK.
| | - Suellen Walker
- Developmental Neurosciences Department, UCL GOS Institute of Child Health, UCL, London, UK
| | - Christopher Eccleston
- Centre for Pain Research, The University of Bath, Bath, UK
- Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Psychology, The University of Helsinki, Helsinki, Finland
| | - Carlo Bellieni
- Department of Pediatrics, University of Siena, Siena, Italy
| | - Tanvi Hirekodi
- School of Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Ricardo Carbajal
- Pediatric Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau- Sorbonne Université, INSERM U1153, Paris, France
| | | | - William Laughey
- Reckitt Health Care UK Ltd, Hull, UK
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - Maria M Cobo
- Department of Paediatrics, University of Oxford, Oxford, UK
- Colegio de Ciencias Biologicas y Ambientales, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Stefan Friedrichsdorf
- Division of Pediatric Pain, Palliative Care & Integrative Medicine, University of California San Francisco, San Francisco, USA
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Abdi F, Karamoozian A, Lotfilou M, Gholami F, Shaterian N, Niasar AA, Aghapour E, Jandaghian-Bidgoli M. Effect of play therapy and storytelling on the anxiety level of hospitalized children: a randomized controlled trial. BMC Complement Med Ther 2025; 25:23. [PMID: 39856674 PMCID: PMC11761729 DOI: 10.1186/s12906-025-04767-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 01/16/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND Children are anxious when hospitalized due to being away from home and undergoing treatment.This anxiety has an effect on their disease process, treatment, growth and development.Children's anxiety has an effect on parents' anxiety and can lead to lower level of cooperation among the children and their parents with the treatment team.the present study aimed to compare the effect of play therapy and storytelling on the anxiety of hospitalized children. METHODS A randomized controlled trial study with a three-group design (play therapy, storytelling and control) was conducted in 75 children aged 3 to 10 years admitted to Imam Ali Alborz Hospital of Karaj, Iran between 2022-2023.The data before and after the intervention were collected by the Spence children's anxiety scale and the face tool for anxiety assessment and analyzed by the Mixed effect model statistical method. RESULTS There is a statistically significant difference between the anxiety score of the children for whom storytelling was used and control group. Also, among the two therapies of storytelling and play therapy, only storytelling therapy has a significant effect on reducing children's anxiety.Regarding the time of measuring the anxiety score(the first, second, third day after the intervention), it was found that as this time increases, the children's anxiety decreases significantly.morever, the children's gender, age, and history of hospitalization are influencing factors. CONCLUSION Play therapy and storytelling play an effective role in controlling the anxiety of hospitalized children, although storytelling had a greater role in reducing the anxiety of hospitalized children than play therapy. It is suggested to provide the necessary conditions and facilities for the implementation of these methods in children's inpatient departments. TRIAL REGISTRATION https://irct.behdasht.gov.ir/ ,IRCT20220704055367N1,13/7 /2022.
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Affiliation(s)
- Fatemeh Abdi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Karamoozian
- Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Lotfilou
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Gholami
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Negin Shaterian
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Abasi Niasar
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ehsan Aghapour
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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de Souza DM, Maia EBS, Ferrer APS, Rocha JCA, da Silva MLLM, Barber ROLB, Rossato LM. The effect of instructional therapeutic play on acceptance behavior of nasal lavage in hospitalized children. J Pediatr Nurs 2025; 80:e144-e150. [PMID: 39674703 DOI: 10.1016/j.pedn.2024.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 12/05/2024] [Accepted: 12/06/2024] [Indexed: 12/16/2024]
Abstract
PURPOSE To evaluate the effect of instructional therapeutic play on acceptance of nasal lavage in children hospitalized for respiratory conditions. DESIGN AND METHODS This quasi-experimental study was conducted at a teaching hospital. For the therapeutic play session, disposable gloves filled with compressed air and designed to resemble a human face, syringes, and saline solution ampoules were used. Children's acceptance behaviors were assessed before, immediately after, and 6 h after the therapeutic play session. The data were subjected to descriptive and inferential statistical analyses. RESULTS Children (N = 42) aged 3-6 years, 50 % female, with a hospitalization duration of 0.2-9 days, showed increased acceptance of nasal lavage (p = 0.01), with the child self-administering the saline solution (p = 0.01), and with reduction of all resistance behaviors to nasal lavage (p < 0.05). CONCLUSIONS Instructional therapeutic play was effective as an educational intervention for the acceptance of nasal lavage in hospitalized children. PRACTICE IMPLICATIONS This study demonstrates the potential of using instructional therapeutic play, innovating the field of pediatric nursing, and expanding the international knowledge frontier of this subject. In the future, there is a need for clinical trials with control groups, larger and more heterogeneous samples, and implementation studies.
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Affiliation(s)
| | | | | | | | | | - Rebecca Ortiz La Banca Barber
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, CA, United States of America
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