The Study of the Impacts of Bibliotherapy on The Enhancement of Nourocism of Children Suffering from Cancer (A Case Study of Kashani Children)

Introduction
Stories read or heard by children have a profound impact on their thoughts and emotions, helping them better understand and resolve problems (Elyasi, citing Poluski, 1396:44). Children’s literature refers to a collection of literary and artistic texts and works aimed at children and adolescents under 15 years of age. Stories, narratives, and tales have the power to captivate readers for hours and transport them away from the real world (Elyasi, 1396:36). According to the World Health Organization, cancer is a disease that can affect any part of the body and comes in many forms (WHO, 2020). Today, cancer is one of the leading causes of death worldwide. According to the latest statistics in 2020, 10 million people die from this chronic disease each year (Ferlay et al., 2020). Bibliotherapy (poetry therapy and storytelling) is particularly important in the treatment of children with life-threatening illnesses such as cancer. The essential pattern of storytelling includes elements that can be used to create a compelling and effective story.
Research Method
This research employes quasi-experimental method and is a pre-test, post-test study with a control group. In this design, the subjects have been randomly selected and assigned to different groups. Before the independent variable is implemented, the selected subjects in both groups are measured and assessed through a pre-test. In this study, the pre-test plays a role in applying statistical control, comparison, and ultimately measuring the amount of change caused by the experiments (Delavar, 1394:15). The sample of this study consists of children with cancer whom the researcher recruited over two months using three questionnaires and two stages of bibliotherapy. The set of tools used to collect data in this research includes the following three:
_ Children’s hope scale
_ Spence children’s anxiety scale (SCAS)
_ A questionnaire on the child’s illness level completed by the physician
In this research, the criterion for measuring and determining the sample size was the interview with physicians, specialists, psychologists, and social workers. Therefore, based on the research objective, the questionnaires were prepared, and the research findings were provided. According to the approval of the group of experts, at a 95% confidence level and a study power of 80%, as well as a 20% probability of dropout among respondents in the later stages, a total of 30 child patients were included in the storytelling and poetry therapy group and 30 in the control group. Finally, to analyze the research data, SPSS version 22 software and repeated measure analysis of variance were used.
Research Findings
This study examined the effects of storytelling and poetry therapy sessions on children with cancer aged 8 to 12 years. The indicators of effectiveness in this study include hope, anxiety, and emotional expression. The results showed that storytelling and poetry therapy sessions had a positive impact on the level of hope for life, reducing anxiety and fear, and expressing emotions in children. It is also possible that the effect of drug treatments and the improvement of children’s physical condition may increase. Initially, the physical condition of children in the control and experimental groups was evaluated by a physician. Then, the children in the training group participated in 15 storytelling and poetry therapy sessions. After the end of the treatment sessions, both groups of children were reassessed, and their psychological and physical conditions were examined.
Conclusion
According to the results obtained from the hope variable, the significance level is 0.319 in the control group. In the continuation of the research process, after conducting storytelling and poetry therapy sessions, the level of hope was assessed again among the children in the control group using the prepared questionnaire. The results showed that there was no significant difference in this group over this period. The test results in the experimental group showed a significance level of 0.004. This means that in the experimental group, i.e., children who attended storytelling and poetry therapy sessions, there were noticeable and increasing changes in the direction of increasing children’s hope. Regarding the anxiety variable, children were initially divided into control and experimental groups. The level of anxiety and fear of children in the control group was first calculated. After conducting storytelling and poetry therapy sessions, the level of anxiety of these children was reassessed. The test results showed a significance level of 0.573. These results indicate that the level of anxiety and fear of these children did not change. Also, the level of anxiety and fear of children in the experimental group was measured twice. First, before the beginning of the storytelling therapy sessions and after the end of these sessions, the level of anxiety of the children was assessed and recorded. The test results showed a significance level of 0.000; therefore, children in the experimental group experienced a decrease in anxiety, fear, and stress during storytelling and poetry therapy sessions. Regarding the variable of emotional expression, children were divided into the control and experimental groups. The level of emotional expression and its ability in the children of this group were first measured before the implementation of the therapy sessions. After the end of the storytelling and poetry therapy sessions, the level of emotional expression of the children in the control group was measured again using the same questionnaire. The test results showed a significance level of 0.637. The test results showed a significance level of 0.002. After the end of the storytelling and poetry therapy sessions, the physical condition and the level of treatment response to their bodies were reassessed using the research questionnaire. The results showed an average positive increase in the children’s mental and physical state. According to the results of the analysis of variance test, the significance level was determined to be 0.000. This number indicates a significant difference between the physical condition of children before and after the storytelling therapy sessions.