van der Ziel Sterre, Hogendoorn Elske, Jorge Brian A, van Dijk Marijn W G, van Vliet Michel J, Rosmalen Judith G M
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Nieuwenhuis Institute for Educational Sciences, University of Groningen, Groningen, the Netherlands.
Child Care Health Dev. 2025 Mar;51(2):e70069. doi: 10.1111/cch.70069.
Young children frequently experience physical symptoms, such as common cold, vaccination pain or a playground injury. Picture books about physical symptoms and illness are a source of information for young children. This study assessed the nature and causes of and responses to physical symptoms depicted in Dutch children's picture books.
A systematic search for Dutch picture books for children between the ages of 2 and 8 years about physical symptoms or illness was conducted in public library catalogues in the Netherlands, with terms such as 'pain' and 'doctor'. Only picture books with a fictional storyline, in which the main character experienced symptoms or illness, were included. A content analysis was conducted by two independent reviewers.
Fifty-five books met the inclusion criteria. The most common symptoms were injuries (29%), cold symptoms (21%), fatigue/malaise (14%) and fever (11%). Causes were mostly unknown (41%), due to accidents (38%) or infections (18%). Accidents were always caused by the main character. In 89% of the picture books, remedies were necessary to resolve the symptoms, including bandages (36%), bedrest (33%), medical interventions (33%) or medication (27%). Fifty-six percent of the books depicted seeking medical care. Four themes regarding the morals of the stories were identified: the seemingly scary hospital or doctor, the responsibility of the main character to engage in coping strategies, the importance of social contacts, and illness gains after possible unpleasantness of symptoms.
The picture books about physical symptoms and illness in our sample depicted various symptoms, limited causes and a range of responses. Physical symptoms and illness were rarely normalized in the stories, often requiring medical intervention rather than spontaneous resolution.
幼儿经常出现身体症状，如普通感冒、疫苗接种疼痛或在操场受伤。关于身体症状和疾病的图画书是幼儿的信息来源。本研究评估了荷兰儿童图画书中描绘的身体症状的性质、原因及应对方式。
在荷兰公共图书馆目录中系统搜索面向2至8岁儿童的关于身体症状或疾病的荷兰语图画书，使用“疼痛”和“医生”等词汇。仅纳入具有虚构故事情节且主角经历症状或疾病的图画书。由两名独立评审员进行内容分析。
55本书符合纳入标准。最常见的症状是受伤（29%）、感冒症状（21%）、疲劳/不适（14%）和发烧（11%）。病因大多不明（41%），因意外（38%）或感染（18%）所致。意外总是由主角引起。在89%的图画书中，需要采取治疗措施来缓解症状，包括包扎（36%）、卧床休息（33%）、医疗干预（33%）或药物治疗（27%）。56%的书描绘了寻求医疗护理的情节。确定了关于故事寓意的四个主题：看似可怕的医院或医生、主角采取应对策略的责任、社会交往的重要性以及症状可能带来不适后的疾病收获。
我们样本中关于身体症状和疾病的图画书描绘了各种症状、有限的病因和一系列应对方式。故事中身体症状和疾病很少被正常化，通常需要医疗干预而非自行缓解。
