Harnessing Children's Picture Books to Socialize Children About Pain and Injury: A Qualitative Study

Sarah B Wallwork; Sue Nichols; Abbie Jordan; Melanie Noel; Victoria J Madden; G Lorimer Moseley

doi:10.1016/j.jpain.2024.03.016

Harnessing Children's Picture Books to Socialize Children About Pain and Injury: A Qualitative Study

J Pain. 2024 Apr 3:104520. doi: 10.1016/j.jpain.2024.03.016. Online ahead of print.

Authors

Sarah B Wallwork¹, Sue Nichols², Abbie Jordan³, Melanie Noel⁴, Victoria J Madden⁵, G Lorimer Moseley¹

Affiliations

¹ IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
² Education Futures, University of South Australia, Adelaide, South Australia, Australia.
³ Department of Psychology & Centre for Pain Research, University of Bath, Bath, United Kingdom.
⁴ Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
⁵ IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Pain Unit, Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa; HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

PMID: 38580100
DOI: 10.1016/j.jpain.2024.03.016

Abstract

Pain experiences are common during childhood (eg, "everyday" pain, vaccine injections) and are powerful opportunities for children to learn about pain and injury. These experiences likely inform fundamental and life-long beliefs about pain. There is scant research investigating the sociocultural contexts in which children learn about pain and injury. One unexplored context is the shared reading of picture books (eg, between parents/caregivers and children). In this study, we investigated whether shared reading of picture books that included depictions of pain and/or injury prompted parent/caregiver-child interactions. If interactions were observed, we explored what those interactions entailed. Twenty parents/caregivers (8 men, 12 women) and their children (n = 27; 10 boys, 17 girls) were recruited from libraries in South Australia. Parent/caregiver-child families chose from 8 books (7 fiction, 1 nonfiction) with varying amounts of pain/injury-related content. Shared reading interactions were video recorded, transcribed, and analyzed alongside analysis of the picture books using reflexive thematic analysis. Pain/injury-related interactions were observed between parents/caregivers and children during shared reading of picture books. Qualitative analyses generated 1 main theme and 3 subthemes. Findings identified that shared reading presented an opportunity for children's understanding of pain and injury to be socialized through discussion of characters' experiences. This included teaching children about pain and injury, as well as promoting empathy and emotional attunement toward characters who were depicted as being in pain. Finally, parents/caregivers often responded with observable/expressed amusement if pain/injury was depicted in a light-hearted or unrealistic way. Overall, shared reading of picture books presents an untapped opportunity to socialize children about pain and injury. PERSPECTIVE: Shared reading of picture books that have depictions of pain and/or injury can prompt parent/caregiver-child interactions about pain and injury. These interactions present critical opportunities that can be harnessed to promote children's learning of adaptive pain-related concepts and behaviors during a critical developmental period.

Keywords: Pain education; pediatric pain; picture books; shared reading; thematic analysis.