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Children's Perceptions of Pictures Intended to Measure Anxiety During Hospitalization
Stefan Nilsson1, Josefine Holstensson2, Cajsa Johansson3
1Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
This study validated visual scales for assessing childhood hospital anxiety. Recommended pictures improve understanding of emotional states for young patients, aiding in better care and recovery.
Area of Science:
- Child Psychology
- Medical Sociology
- Pediatric Healthcare
Background:
- Childhood anxiety during hospitalization negatively impacts recovery and future healthcare experiences.
- Assessing anxiety in young children and those with communication disabilities requires specialized tools.
- The short version of the State scale of the State-Trait Anxiety Inventory (S-STAI) was previously adapted into a visual format.
Purpose of the Study:
- To validate visual representations of emotions and quantitative scale steps ('a lot' - 'some' - 'a little') for the S-STAI.
- To evaluate pictures for a qualitative scale ('good/like' - 'in between/so-so' - 'bad/dislike') within the same instrument.
- To identify and recommend optimal pictures for assessing childhood anxiety in hospital settings.
Main Methods:
- 103 children aged 5-8 years participated.
- Children matched facial expression pictures to emotional categories (Tense/Nervous, Worried/Afraid, Calm/Relaxed, Happy/Content).
- Children selected preferred pictures for quantitative and qualitative scale steps.
Main Results:
- Children understood both the quantitative and qualitative scales and differentiated between positive and negative emotions.
- Older children (7-8 years) more accurately selected pictures corresponding to specific scale steps.
- The study identified effective visual representations for assessing childhood anxiety.
Conclusions:
- The validated visual scales are suitable for assessing anxiety in young children and those with communicative disabilities.
- Recommended pictures enhance the accurate assessment of emotional states during hospitalization.
- Improved anxiety assessment can lead to better patient care and outcomes.
Abstract:
Many children experience anxiety during a hospital stay, which can have an adverse impact on their recovery and response to future hospital care. To facilitate assessment of anxiety in young children and children with communicative disabilities, the short S-STAI (short version of the State scale of the State-Trait Anxiety Inventory), has previously been adapted to a visual format. The aims of the present study were (a) to validate the pictures used to represent emotions and the steps of a quantitative scale ('a lot' - 'some' - 'a little'), including to determine whether any of them should be replaced, and (b) to assess different pictures to be used for a qualitative scale ('good/like' - 'in between/so-so' -'bad/dislike') in the same instrument. A total of 103 children aged 5-8 years were asked to choose verbal labels for pictures of facial expressions intended to represent emotions, match those pictures with the emotional categories used in the short S-STAI (Tense/Nervous, Worried/Afraid, Calm/Relaxed, and Happy/Content) and indicate their preferences for pictures intended to represent the steps of a quantitative scale and a qualitative one. The children understood both scales and the differences between positive and negative emotions in the short S-STAI. The older children (aged 7 and 8) significantly more often chose a picture for each step of the scales that was intended to represent that particular step. The article discusses implications for the choice of pictures representing emotional states in the short S-STAI and presents recommended pictures.