PEDIATRIC PHYSICAL EXAMINATION: DEVELOPMENT AND VALIDATION OF EDUCATIONAL MATERIAL FROM THE PERSPECTIVE OF SCHOOL-AGED CHILDREN

• Grant number: 25/13027-1
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2025
• End date: August 31, 2026
• Field of knowledge: Health Sciences - Nursing - Pediatric Nursing
• Principal Investigator: Edmara Bazoni Soares Maia
• Grantee: Gabrielle Souza Ferreri
• Host Institution: Escola Paulista de Enfermagem (EPE). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Introduction:The physical examination is a recurring procedure in the lives of children in healthcare settings, often perceived as stressful due to factors such as unfamiliarity, bodily exposure, and the use of medical instruments. Studies indicate that, even though it is non-invasive, the physical exam can generate fear, anxiety, and lasting impacts on the child's interactions with healthcare professionals. Despite its high frequency, this topic remains underexplored in the scientific literature. For a child to understand the need for the examination, healthcare professionals must practice effective communication, build rapport with the child and their family, and demonstrate sensitivity in respecting the child's developmental stage while ensuring their right to information in accessible language. In this regard, the Child-Centered Care framework emphasizes the importance of active listening and children's participation in decisions about their health. Health literacy is a fundamental resource in this process, promoting children's empowerment by offering information appropriate to their level of understanding. Among the possible strategies, playful interventions-such as storytelling-stand out for their role in reducing stress, supporting comprehension, and making the care environment more welcoming. Objectives: To understand the experience of school-aged children undergoing physical examinations in healthcare settings and to develop and validate a children's storybook about this procedure. Method: The study will be conducted in two phases: the first with a qualitative approach, and the second, methodological. Participants in the first phase will be school-aged children enrolled in the 4th grade of elementary school, in both morning and afternoon shifts. Data collection will occur through a focus group using the photoelicitation technique, which incorporates photographs as prompts in interviews to promote reflection between image and verbal expression. At the end of the session, the children will be invited to narrate, in the form of a story, their experience of being examined by a healthcare professional. This material will serve as the basis for developing the educational resource. In the second phase, the storybook will be developed and its content and images will be validated by a group of experts using the Health Educational Content Validation Instrument (IVCE). Subsequently, validation with the target audience will take place through in-person reading sessions with the children who participated in the initial phase, in order to gather their opinions and identify evidence of validity based on the response process. Expert evaluations will be analyzed using the IVCE, with the Content Validity Ratio calculated and agreement defined as a ratio equal to or greater than 0.80. The children's responses will be recorded on forms and analyzed qualitatively.