The Importance of the Instructions in the Use of Draw-and-Write Techniques for Understanding Children’s Health and Illness Concepts

Ligia Lima, Marina Serra de Lemos


Aim: The present study aims to test whether different instructions, when using draw-and-write data collection techniques, can be especially suited for understanding specific aspects of children’s conceptions about health and illness. Method: This is a mixed-method study and participants were 209 schoolchildren, aged 10 to 12 years, who were asked to draw-and-write following one of two different instructions (A or B) that were related to the concepts of health and illness. Texts were examined through content analysis based on a previously validated coding system (inter-rater agreement of 93%). Results: Findings suggest that the instruction “what does it mean to you to be sick and what does it mean to you to be healthy?” allows a more direct access to experiences and feelings, and that the instruction “draw and write about what a sick person is and what a healthy person is” is more adequate to elicit children’s knowledge and perceptions. Conclusion: The study suggests that to elicit children’s concepts of health and illness, relevant for health education and health promotion interventions, the draw-and-write instructions should be phrased in impersonal general terms. In contrast, for clinical interventions, the instruction should be targeted to the child’s direct experience of being ill.


draw-and-write; concepts of health and illness; children; eliciting instruction; health education; clinical practice