Hospitalization in Pediatric Oncology and Child Development: Cognitive and Affective Interface

Abstract

Diagnosing and treating childhood cancer requires children to develop coping strategies, indicating the need for understanding their perception and cognitive organization. Thus, this study aimed to understand how participants perceive the process of hospitalization and treatment for childhood neoplasia according to Piaget’s stages of cognitive and affective development. This is a qualitative study conducted with a convenience sample of five children aged between 4 and 9 years, diagnosed with Leukemia and treated at a pediatric oncology outpatient clinic in a hospital in Baixada Santista, São Paulo, Brazil. Data were collected using semi-structured interviews, Piagetian proofs, and thematic drawing-and-story procedure and analyzed in the light of Bardin’s Thematic Content Analysis (1988), Piaget’s theory, and Trinca’s theory (2002), respectively. Two children (4 and 6 years old) were characterized as preoperative and three (8 and 9 years old) as concrete operative. The discourse of preoperative children included high levels of symbolism regarding the suffering arising from hospitalization and the effects of treatment, while concrete-operative children demonstrated mastery of the notion of cause and consequence and logical thinking. A qualitative comparison between Piagetian Proofs and drawings showed consistency between the types of evaluation. All participants show an understanding of their current condition and treatment, presenting different forms of coping. They also highlighted an optimistic position regarding the prospects for healing, regardless of their cognitive development stage.

Keywords:
Pediatric oncology; Piagetian theory of cognitive development; Hospitalization; Thematic drawing-and-story procedure