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与肿瘤血液科儿童分组创作童话故事。

Invented fairy tales in groups with onco-haematological children.

作者信息

Margherita G, Martino M L, Recano F, Camera F

机构信息

Department of Humanistic Studies, Federico II University, Naples, Italy.

出版信息

Child Care Health Dev. 2014 May;40(3):426-34. doi: 10.1111/cch.12076. Epub 2013 May 14.

Abstract

BACKGROUND

The impact of an onco-haematological illness for children is a traumatic event that opens to pain, hospitalizations and interrupts the continuity of daily life. It is difficult for the child to make meaning, to share the pain or ask a question related to the illness because, often, the parents or doctors cannot find a way to communicate in a suitable way for the child who remains in a situation of 'unspoken', where, fear, anxiety and pain cannot find a space to express.

METHODS

The present research-intervention uses the methodology of invented fairy tales in groups with onco-haematological children, in the hospital, in order to explore the organization of the meanings at the base of the tales co-constructed by the participants underlying weaknesses and strengths of the invented fairy tales in groups intervention. The invented fairy tales in groups is used as a tool, such as a play, to express, share and support the experience of the illness of children. Forty-nine children participated to the invented fairy tales in groups in an onco-haematological hospital. Within a quali-quantitative framework we performed a thematic analysis of elementary context, cluster analysis, on the fairy tales considered as a unique narrative corpus of the thought of the group.

RESULTS

The analysis shows four thematic clusters: fantasy as search for a meaning, 29.71%, the group as a space for illusions, 27.90%, the illness as a family problem, 25.72%, anchoring reality, 16.67%. The results highlighted three main carriers of sense: the representation of illness/the relational world/the representation of the institution.

CONCLUSIONS

The use of invented-fairy-tales groups allowed the onco-haematological children to tell and share the experience of illness through a different way, which let them express symbolically their pain. The invented fairy tale in groups becomes a mediator of psychic processes which offer new solutions while improving interpersonal relationships/communication between the participants in group.

摘要

背景

儿童患上肿瘤血液疾病是一个创伤性事件,会带来痛苦、住院治疗,并打断日常生活的连续性。孩子很难理解疾病的意义、分享痛苦或询问与疾病相关的问题,因为父母或医生常常找不到适合孩子的沟通方式,孩子处于“无法言说”的状态,恐惧、焦虑和痛苦找不到表达的空间。

方法

本研究干预采用为肿瘤血液科住院儿童开展小组创作童话的方法,以探索参与者共同构建的故事背后意义的组织方式,以及小组干预中创作童话的潜在优缺点。小组创作童话被用作一种工具,比如一种游戏,来表达、分享和支持儿童的疾病体验。49名儿童参与了肿瘤血液科医院的小组创作童话活动。在定性-定量框架内,我们对基本情境进行了主题分析,对被视为小组思维独特叙事语料库的童话进行了聚类分析。

结果

分析显示了四个主题聚类:幻想即寻找意义,占29.71%;小组即幻想空间,占27.90%;疾病即家庭问题,占25.72%;锚定现实,占16.67%。结果突出了三个主要的意义载体:疾病表征/关系世界/机构表征。

结论

使用小组创作童话的方式让肿瘤血液科儿童能够通过一种不同的方式讲述和分享疾病体验,使他们能够象征性地表达痛苦。小组创作童话成为心理过程的调解者,在改善小组成员间的人际关系/沟通的同时提供新的解决方案。

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