Talking to children and adolescents with cancer about spirituality is a challenge. This study aimed to develop and evaluate a conversation model for a spiritual approach with children and adolescents with cancer. It was a methodological study with a systematic approach in three stages: (a) review of the literature for the selection of photographs and guiding questions, (b) using an expert committee to evaluate photographs and preselected questions, and (c) cognitive interview with children and adolescents to test the methodology. The expert committee evaluated and selected 20 photos and their respective guiding questions. Fifteen children and adolescents hospitalized with cancer tested the spirituality conversation model and expressed feelings, values, beliefs, fears, and the meaning they give to life and illness. The implementation of the conversation model can contribute both to the clinical practice, facilitating care for the spiritual dimension of pediatric patients, and to qualitative research on spirituality involving children.
AlvarengaW. de A.de CarvalhoE. C.CaldeiraS.VieiraM.NascimentoL. C. (2017). The possibilities and challenges in providing pediatric spiritual care. Journal of Child Health Care, 21(4), 435-445.https://doi.org/10.1177/1367493517737183
2.
Arruda-ColliM. N. F.PerinaE. M.SantosM. A. (2015). Experiences of Brazilian children and family caregivers facing the recurrence of cancer. European Journal of Oncology Nursing, 19(5), 458-464. https://doi.org/10.1016/j.ejon.2015.02.004
3.
BartonK. S.TateT.LauN.TaliesinK. B.WaldmanE. D.RosenbergA. R. (2018). “I’m not a spiritual person”: How hope might facilitate conversations about spirituality among teens and young adults with cancer. Journal of Pain and Symptom Management, 55(6), 1599-1608. https://doi.org/10.1016/j.jpainsymman.2018.02.001
Damsma BakkerA.van LeeuwenR. R.RoodbolP. F. (2018). The spirituality of children with chronic conditions: A qualitative meta-synthesis. Journal of Pediatric Nursing, 43, e106-e113. https://doi.org/10.1016/j.pedn.2018.08.003
7.
de Moura SouzaV.FrizzoH. C. F.de PaivaM. H. P.BoussoR. S.da Silva SantosÁ. (2015). Spirituality, religion and personal beliefs of adolescents with cancer. Revista Brasileira de Enfermagem, 68(5), 791-796. https://doi.org/10.1590/0034-7167.2015680504i
8.
DionigiA.GremigniP. (2017). A combined intervention of art therapy and clown visits to reduce preoperative anxiety in children. Journal of Clinical Nursing, 26(5-6), 632-640. https://doi.org/10.1111/jocn.13578
9.
DraytonN. A.WaddupsS.WalkerT. (2019). Exploring distraction and the impact of a child life specialist: Perceptions from nurses in a pediatric setting. Journal for Specialists in Pediatric Nursing, 24(2), Article e12242. https://doi.org/10.1111/jspn.12242
10.
EbmeierC.LoughM. A.HuthM. M.AutioL. (1991). Hospitalized school-age children express ideas, feelings, and behaviors toward God. Journal of Pediatric Nursing, 6(5), 337-349. https://doi.org/10.5555/uri:pii:088259639190052U
11.
EpsteinI.StevensB.McKeeverP.BaruchelS. (2006). Photo elicitation interview (PEI): Using photos to elicit children’s perspectives. International Journal of Qualitative Methods, 5(3), 1-11. https://doi.org/10.1177/160940690600500301
HannaK. M.JacobsP. (1993). The use of photography to explore the meaning of health among adolescents with cancer. Issues in Comprehensive Pediatric Nursing, 16(3), 155-164. https://doi.org/10.3109/01460869309078272
HayD.NyeR. (2006). The spirit of the child (Revised ed.). Jessica Kingsley.
16.
HydeB. (2008). Weaving the threads of meaning: A characteristic of children’s spirituality and its implications for religious education. British Journal of Religious Education, 30(3), 235-245. https://doi.org/10.1080/01416200802170169
17.
KamperR.Van CleveL.SavedraM. (2010). Children with advanced cancer: Responses to a spiritual quality of life interview. Journal for Specialists in Pediatric Nursing, 15(4), 301-306. https://doi.org/10.1111/j.1744-6155.2010.00253.x
18.
Kantrowitz-GordonI.AltmanM. R.VandermauseR. (2016). Prolonged distress of parents after early preterm birth. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(2), 196-209. https://doi.org/10.1016/j.jogn.2015.12.004
19.
LeiteA. C. A. B.AlvarengaW. de A.MachadoJ. R.LuchettaL. F.BancaR. O. LaSparapaniV. de C.NerisR. R.Cartagena-RamosD.Fuentealba-TorresM.NascimentoL. C. (2019). Children in outpatient follow-up: perspectives of care identified in interviews with puppet. Revista Gaúcha de Enfermagem, 40. https://doi.org/10.1590/1983-1447.2019.20180103
20.
LiberatiA.AltmanD. G.TetzlaffJ.MulrowC.GøtzscheP. C.IoannidisJ. P. A.ClarkeM.DevereauxP. J.KleijnenJ.MoherD. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine, 6(7), Article e1000100. https://doi.org/10.1371/journal.pmed.1000100
21.
LimaN. N. R.BarbosadoNascimentoV.de CarvalhoS. M. F.NetoM. L. R.MoreiraM. M.BrasilA. Q.JuniorF. T. C.de OliveiraG. F.ReisA. O. A. (2013). Spirituality in childhood cancer care. Neuropsychiatric Disease and Treatment, 9, 1539-1544. https://doi.org/10.2147/NDT.S42404
22.
MalcomN. L. (2011). Images of heaven and the spiritual afterlife: Qualitative analysis of children’s storybooks about death, dying, grief, and bereavement. OMEGA: Journal of Death and Dying, 62(1), 51-76. https://doi.org/10.2190/OM.62.1.c
23.
MarquesE. P.GarciaT. M. B.AndersJ. C.da LuzJ. H.RochaP. K.de SouzaS. (2016). Playful activities in health care for children and adolescents with cancer: The perspectives of the nursing staff. Escola Anna Nery: Revista de Enfermagem, 20(3), 1-8. https://doi.org/10.5935/1414-8145.20160073
24.
MichelatG. (1987). Sobre a Utilização da Entrevista Não-Diretiva em Sociologia [On the Use of the Non-Directive Interview in Sociology]. In ThiollentM. (Ed.), Crítica metodológica, investigação social e enquete operária (pp. 191-212). Editora Polis.
25.
MoriartyM. W. (2011). A conceptualization of children’s spirituality arising out of recent research. International Journal of Children’s Spirituality, 16(3), 271-285. https://doi.org/10.1080/1364436X.2011.617730
26.
MurrayL.NashM. (2017). The challenges of participant photography: A critical reflection on methodology and ethics in two cultural contexts. Qualitative Health Research, 27(6), 923-937. https://doi.org/10.1177/1049732316668819
27.
NascimentoL.C.AlvarengaW.CaldeiraS.MicaT.OliveiraF.PanR.SantosT.CarvalhoE.VieiraM. (2016). Spiritual Care: The Nurses’ Experiences in the Pediatric Intensive Care Unit. Religions, 7(3), 27. https://doi.org/10.3390/rel7030027
28.
NascimentoL. C.OliveiraF. C. S.de, MorenoM. F.SilvaF. M. da. (2010). Spiritual care: an essential component of the nurse practice in pediatric oncology. Acta Paulista de Enfermagem, 23(3), 437–440. https://doi.org/10.1590/S0103-21002010000300021
29.
PadgettD. K.SmithB. T.DerejkoK.-S.HenwoodB. F.TideringtonE. (2013). A picture is worth . . . ? Photo elicitation interviewing with formerly homeless adults. Qualitative Health Research, 23(11), 1435-1444. https://doi.org/10.1177/1049732313507752
30.
PolitD. F.BeckC. T. (2018). Essentials of nursing research: Praising evidence for nursing practice (9th ed.). Wolters Kluwer.
31.
RibeiroP. C. P. S. V. (2008). The spirituality in the chronical sick patient as a strategy of coping: Narrative of life history. Revista Referência, 2(7), 21-31.
32.
RobertR.StavinohaP.JonesB. L.RobinsonJ.LarsonK.HicklenR.SmithB.PerkoK.KochK.FindleyS.WeaverM. S. (2019). Spiritual assessment and spiritual care offerings as a standard of care in pediatric oncology: A recommendation informed by a systematic review of the literature. Pediatric Blood & Cancer, 66(9), e27764. https://doi.org/10.1002/pbc.27764
33.
RossariÚ. V. S.da MottaM. G. C. (2009). Uso da fotografia como método de coleta de informações: estudo qualitativo com adolescentes com cancer [Use of photography as a method of information collection: A qualitative study with adolescents with cancer]. Revista Gaúcha Enfermagem, 30(3), 500-507. http://seer.ufrgs.br/RevistaGauchadeEnfermagem/article/view/7671
34.
RothL.ThomasT. (2013). Spirit books: Promoting conversation with picture books. International Journal of Children’s Spirituality, 18(4), 351-368. https://doi.org/10.1080/1364436X.2013.858664
35.
SelmanL.YoungT.VermandereM.StirlingI.LegetC. (2014). Research priorities in spiritual care: An international survey of palliative care researchers and clinicians. Journal of Pain and Symptom Management, 48(4), 518-531. https://doi.org/10.1016/j.jpainsymman.2013.10.020
36.
SpositoA. M. P.de MontignyF.SparapaniV. de C.LimaR. A. G.de, Silva-RodriguesF. M.PfeiferL. I.NascimentoL. C. (2016). Puppets as a strategy for communication with Brazilian children with cancer. Nursing & Health Sciences, 18(1), 30–37. https://doi.org/10.1111/nhs.12222
37.
TaylorE. J.PetersenC.OyedeleO.HaaseJ. (2015). Spirituality and spiritual care of adolescents and young adults with cancer. Seminars in Oncology Nursing, 31(3), 227-241. https://doi.org/10.1016/j.soncn.2015.06.002
38.
TetiM.MurrayC.JohnsonL.BinsonD. (2012). Photovoice as a community-based participatory research method among women living with HIV/AIDS: Ethical opportunities and challenges. Journal of Empirical Research on Human Research Ethics, 7(4), 34-43. https://doi.org/10.1525/jer.2012.7.4.34
39.
TilbrookA.DwyerT.Reid-SearlK.ParsonJ. A. (2017). A review of the literature: The use of interactive puppet simulation in nursing education and children’s healthcare. Nurse Education in Practice, 22(January), 73-79. https://doi.org/10.1016/j.nepr.2016.12.001
40.
TorreD.MurphyJ. (2015). A different lens: Changing perspectives using Photo-Elicitation Interviews. Education Policy Analysis Archives, 23(111), https://epaa.asu.edu/ojs/article/view/2051/1689
41.
Van CleveL.MuñozC. E.RiggsM. L.BavaL.SavedraM. (2012). Pain experience in children with advanced cancer. Journal of Pediatric Oncology Nursing, 29(1), 28-36. https://doi.org/10.1177/1043454211432295
42.
WeathersE.McCarthyG.CoffeyA. (2016). Concept analysis of spirituality: An evolutionary approach. Nursing Forum, 51(2), 79-96. https://doi.org/10.1111/nuf.12128
43.
WienerL.BattlesH.MamalianC.ZadehS. (2011). ShopTalk: A pilot study of the feasibility and utility of a therapeutic board game for youth living with cancer. Supportive Care in Cancer, 19(7), 1049-1054. https://doi.org/10.1007/s00520-011-1130-z
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