The Importance of the Instructions in the Use of Draw-and-Write Techniques for Understanding Children’s Health and Illness Concepts

Abstract

Aim: The present study aims to test whether different instructions, when using draw-and-write data collection techniques, can be especially suited for understanding specific aspects of children's conceptions about health and illness. Method: This is a mixed-method study and participants were 209 schoolchildren, aged 10 to 12 years, who were asked to draw-and-write following one of two different instructions (A or B) that were related to the concepts of health and illness. Texts were examined through content analysis based on a previously validated coding system (inter-rater agreement of 93%). Results: Findings suggest that the instruction "what does it mean to you to be sick and what does it mean to you to be healthy?" allows a more direct access to experiences and feelings, and that the instruction "draw and write about what a sick person is and what a healthy person is" is more adequate to elicit children's knowledge and perceptions. Conclusion:The study suggests that to elicit children's concepts of health and illness, relevant for health education and health promotion interventions, the draw-and-write instructions should be phrased in impersonal general terms. In contrast, for clinical interventions, the instruction should be targeted to the child's direct experience of being ill.

‘A smile stands for health and a bed for illness’: Graphic cues in children’s drawings

“…However, researchers have warned that the wording of the drawing instructions may provoke different representations. For example, the prompt to draw what health/illness means to the child elicits his or her experiences of the two situations, while the instruction to draw a healthy/ill person seems to tap into his or her perceptions (Lima and De Lemos, 2014; Renslow and Maupin, 2017). Irrespective of the drawing instruction, within this research tradition content analysis is generally used to describe the main thematic categories that emerge from children’s drawing representations (Mouratidi et al, 2016; Piko and Bak, 2006; Zaloudikova, 2010).…”

Draw-and-write technique elicits children’s perceptions of health in the USA and Guatemala

“…The ability to compare results across studies is uncertain, however, given the variation in methodology and analysis (Backett-Milburn and McKie, 1999). As Lima and de Lemos (2014) demonstrate, the phrasing of the prompt is determinant of the results. Comparing child responses to the personal prompt of ‘draw what it means to you to be healthy/sick’ to those given the general prompt of ‘draw a sick/healthy person’, they found that although both prompts elicited similar themes, the former elicited emotional and personal experiences of health and illness, while the latter elicited more knowledge-based understandings of personal preventative behaviour.…”

Pensando en la salud de niños y niñas, el aporte desde las representaciones sociales

“…Los autores concluyen que los niños no piensan en abstracciones, sino que piensan en realidades; es así como salud se representa desde la acción, el movimiento, la alimentación, la felicidad y la enfermedad desde la inactividad, la terapia y las experiencias personales. Otros estudios corroboran dichos hallazgos, en los cuales niños y niñas relacionan la salud a la adherencia a prácticas saludables, sentimientos positivos y funcionabilidad; mientras que la enfermedad se representa desde los problemas o síntomas específicos, compromiso de la funcionalidad y sentimientos negativos (Cromack, Bursztyn y Rangel, 2009;Lima y de Lemos, 2014).…”