Representation of Pain and Injury in Children's Picture Books—A Content Analysis

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-08-13 DOI:10.1002/ejp.70102

Dur-E-Nayab Mehar, Sue Nichols, Abbie Jordan, G. Lorimer Moseley, Melanie Noel, Sarah B. Wallwork

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Abstract

Background

Pain and injury experiences are common throughout childhood (e.g., minor injuries, vaccine injections) and provide important and frequent opportunities for children to learn about pain. Sociocultural contexts, such as reading picture books, may also provide critical opportunities for children to learn about pain/injury. This study aimed to investigate the representation of pain and injury in children's literature.

Methods

We systematically screened for pain/injury representations in children's picture books, freely available from public libraries in South Australia. A content analysis of pain/injury representations was conducted on all included books.

Results

Two hundred and fifty-four picture books were screened until 50 books with pain/injury representations were identified. There were 63 pain (i.e., subjective experience) and 43 injury (i.e., associated with tissue damage) representations. ‘Minor’ pains/injuries were frequently represented (n = 69; 86%), whereas ‘procedural’ (e.g., vaccine injections) (n = 1; 1%) and ‘chronic’ pain (n = 2; 3%) were not. Gender differences were observed where boy characters experienced more pain/injury incidents (n = 42; 53%) than girl characters (n = 23; 28.8%). Behavioural responses to pain/injury also differed, with girl characters being portrayed to experience more emotional responses (e.g., crying; n = 7; 77.8%) than boy characters (n = 2; 22.2%). Other characters present during pain/injury experiences were more likely to be passive bystanders (i.e., did not respond; n = 109; 59.6%) than active responders (n = 51; 27.6%) to characters experiencing pain.

Conclusions

While the type of pain/injury representations in picture books seem consistent with young children's everyday pain/injury experiences (i.e., ‘minor’ pains/injuries), gendered stereotypes and dominant societal perspectives around pain and injury appear to be reinforced.

Significance Statement

Shared reading of children's picture books provides an important sociocultural context for children to learn about pain and injury. In this study, we investigated how pain and injury are represented in children's picture books. We found that pain/injury incidents were consistent with young children's common pain/injury experiences; however, observing characters often lacked prosocial behaviours (e.g., helping, providing comfort) and gendered stereotypes were common. These findings have similarities to pain representations in children's popular TV/movies, speaking to the pervasiveness of these messages across children's media.

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儿童绘本中疼痛与伤害的表现——内容分析

疼痛和损伤经历在整个童年时期都很常见（例如，轻伤，疫苗注射），并为儿童提供了重要和频繁的了解疼痛的机会。社会文化背景，如阅读绘本，也可能为儿童提供了解疼痛/伤害的重要机会。本研究旨在探讨疼痛与伤害在儿童文学中的表现。方法系统筛选南澳大利亚公共图书馆免费提供的儿童绘本中关于疼痛/损伤的描述。对所有纳入的书籍进行疼痛/损伤表征的内容分析。结果共筛选254本绘本，筛选出50本具有疼痛/损伤表现的绘本。有63种疼痛（即主观体验）和43种损伤（即与组织损伤相关）表征。“轻微”疼痛/损伤经常出现(n = 69；86%)，而“程序性”（例如疫苗注射）(n = 1；1%)和“慢性”疼痛(n = 2；3%)没有。观察到性别差异，男孩角色经历了更多的疼痛/伤害事件(n = 42；53%)比女孩角色(n = 23；28.8%)。对疼痛/伤害的行为反应也有所不同，女孩角色被描绘成经历更多的情绪反应(例如，哭泣；n = 7；77.8%)大于男孩(n = 2；22.2%)。在疼痛/伤害经历中出现的其他角色更有可能是被动的旁观者(即没有反应；n = 109；59.6%)高于积极应答者(n = 51；27.6%)的角色正在经历痛苦。虽然绘本中疼痛/损伤表征的类型似乎与幼儿的日常疼痛/损伤经历（即“轻微”疼痛/损伤）一致，但围绕疼痛和损伤的性别刻板印象和主流社会观点似乎得到了强化。儿童绘本的共享阅读为儿童了解疼痛和伤害提供了一个重要的社会文化背景。在这项研究中，我们调查了疼痛和伤害是如何在儿童绘本中呈现的。我们发现疼痛/损伤事件与幼儿常见的疼痛/损伤经历一致；然而，观察角色通常缺乏亲社会行为（例如，提供帮助，提供安慰），性别刻板印象很常见。这些发现与儿童流行电视/电影中的疼痛表现相似，说明这些信息在儿童媒体中无处不在。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.