Telling stories to children doesn’t just put them to sleep at night. It also helps reduce pain and stress. This is shown by a new study, carried out by the D’Or Institute for Research and Education (IDOR), Brazil. For the first time, a study shows that storytelling is able to bring physiological and emotional benefits to children hospitalized in intensive care units. The study was published in the journal Proceedings of the National Academy of Sciences.
During the telling of a story, something happens that researchers call “narrative transport.” The child, through fantasy, can experience sensations and thoughts that transport him to another world, a place different from the hospital room, and therefore far from the conditions of hospitalization.
The story is an immemorial practice of humanity. Legends, religions and social values have passed through the millennia through orality and writing. Many blockbuster movies and novels captivate audiences through the same mechanism. To listen to a good story is to pass from one reality to another. This movement, carried by the imagination, can create empathy for events and characters that fluctuate according to each person’s interpretation.
So far, positive storytelling evidence has been based on “common sense” and taken at face value, that interaction with the child can distract, entertain and alleviate psychological suffering. But it lacked a solid scientific basis, especially regarding the underlying physiological mechanisms. Considering the psychological and biological processes that occur during and after listening to a story, the study’s researchers came up with the idea of looking for scientific evidence of the effects of storytelling on seriously hospitalized children.
A total of 81 children between the ages of two and seven with similar clinical conditions, such as breathing problems caused by asthma, bronchitis or pneumonia, were admitted to the intensive care unit at Rede D Hospital. ‘Or São Luiz Jabaquara, in São Paulo, Brazil. They were randomly divided into two groups: Forty-one of them participated in a group in which storytellers read children’s stories for 25 to 30 minutes, while in a control group, 40 children saw each other tell riddles proposed by the same professionals and for the same duration.
Storytelling stimulates the production of feel-good hormones
To compare the effects of the two interventions, saliva samples were collected from each participant before and after each session to analyze cortisol and oxytocin oscillations. A hormones related to stress and empathy, respectively. In addition, the children took a subjective test to assess the level of pain they felt before and after participating in the activities. They also carried out a free word association task by reporting their impressions of seven cards illustrated by elements of the hospital context (nurse, doctor, hospital, medicine, patient, pain and book).
The results were positive for all groups, since both interventions reduced the level of cortisol and increased the production of oxytocin in all the children analyzed, while the sensation of pain and discomfort was also reduced, according to the evaluation of the children themselves. However, a significant difference was that the positive results of the children in the “tales” group were twice as high as those in the “riddles” group. These results led the researchers to conclude that narrative activity was significantly more effective.
Better quality of life for hospitalized children
Another strength of this study is that it was not performed in an artificial environment, but rather as part of the routine of the pediatric intensive care unit. The storytelling activity was carried out individually; the child chose the story that would be told to him. Among the proposed books, the researchers chose titles available in ordinary bookstores and without predefined emotional bias, so that the story did not influence the child’s reaction after the activity as much. Although storytelling was already adopted in many children’s hospitals, this is the first solid evidence of its physiological and psychological impact. The researchers see this activity as an effective and inexpensive therapeutic method that can make a big difference in the quality of life of children hospitalized in intensive care units.
As it is an inexpensive and very safe intervention, it can potentially be implemented in all pediatric hospitals, once larger studies have verified its reproducibility and effectiveness.
Children change words and relationships
The emotional impact of storytelling was also revealed by the results of the free word association test performed at the end of each intervention. Children in the story group reported more positive emotions than those in the control group when exposed to the words hospital, nurse, and doctor. For example, children in the control group responded to the card depicting a hospital by saying, “This is where people go when they are sick.” Children in the storytelling group responded for the same card with, “This is where people go to get better.”
For the illustrations of a nurse and a doctor, the same pattern was observed. The children in the control group said, “It’s the bad woman who comes to give me an injection”, while those who were told the stories said phrases such as: “It’s the woman who comes to heal me . »
Although the research was supported by volunteer storytellers trained by a Brazilian nonprofit, the researchers say storytelling is an activity that can also be practiced by parents and educators, providing a space for children to participate. choosing the book and interacting with the story. In addition to reducing anxiety and stress, the activity strengthens the bonds between the child, the narrator and the other people present in the environment.
The authors also noted that the results of this storytelling research point to other potential applications for children under environmental stress, such as the disruptions caused by the pandemic. Storytelling by parents, relatives and friends can be a simple and effective way to improve a child’s well-being and is accessible to all families.
Guilherme Brockington et al., “Storytelling increases oxytocin and positive emotions and decreases cortisol and pain in hospitalized children,” PNAS (2021). Proceedings of the National Academy of Sciences