Impact of Therapeutic Storytelling on Fear, Screen Time, and Parental Stress Among Hospitalized Children

Primary outcomes

1. The Scale Of Fear In Children Against Nursing Interventions And Used Materials

   Time frame: At baseline (prior to the intervention) and immediately after completion of the 3-day intervention period.

   Fear levels are assessed using the Fear of Children Against Nursing Interventions and Used Materials Scale (FCANIM), a 18-item instrument developed to evaluate children's fear of nursing procedures and commonly used medical materials. The scale consists of two subdimensions: (1) fear of frequently encountered materials and (2) fear of less frequently encountered materials. Each item includes a visual representation of a nursing intervention or medical material (e.g., stethoscope, thermometer). Children rate their level of fear for each image using a five-point Likert-type scale illustrated with facial expressions representing increasing levels of fear. Total scores range from 18 to 90. Higher scores indicate higher levels of fear toward nursing interventions and medical materials, while lower scores indicate lower fear levels. The internal consistency of the scale is high, with Cronbach's alpha coefficients ranging from 0.89 to 0.93 for the subdimensions and 0.94 for the total scale.

2. Problematic Media Use Measure

   Time frame: At baseline (prior to the intervention) and immediately after completion of the 3-day intervention period.

   Problematic media use is assessed using the 9-item Problematic Media Use Scale - Short Form (PMUS-SF). The scale evaluates problematic use of screen-based media devices, including television, computers, tablets, and smartphones.

   Items are rated on a 5-point Likert scale based on the frequency of screen-use behaviors. The total score is calculated by summing the item scores and dividing by nine. Final scores range from 1 to 5. Higher scores indicate higher levels of problematic media use, whereas lower scores indicate lower levels of problematic media use. The original scale demonstrated high internal consistency (Cronbach's alpha = 0.92). In the present study, Cronbach's alpha was 0.78 at pre-test and 0.80 at post-test.

3. Parental Stress Scale

   Time frame: At baseline (prior to the intervention) and immediately after completion of the 3-day intervention period.

   Parental stress is assessed using the 16-item Parental Stress Scale (PSS). The scale consists of four subdimensions: parental stressors, loss of control, satisfaction, and rewards. Items are rated on a 5-point Likert-type scale. Total scores range from 16 to 80. Higher scores indicate higher levels of parental stress, whereas lower scores indicate lower levels of parental stress. In the Turkish validation study, Cronbach's alpha coefficients for the subscales ranged between 0.70 and 0.76, and 0.81 for the total scale score. In the present study, Cronbach's alpha was 0.73 at pre-test and 0.76 at post-test.