The Perception of Nurses From Children With Intellectual Disabilities Using the Drawing Method: A Qualitative Study.
Mahinur Durmus, Havva Kaçan, Mehmet Kanak
PMID 41797729WHAT IT FOUND
Children with mild intellectual disabilities mostly drew nurses as smiling women but associated them with large, red syringes.
Some omitted facial features or placed themselves far from the nurse. The drawings reflect anxiety about injections and unfamiliar media images, not a lack of understanding.
Key findings
01Children predominantly associated nurses with syringes, often drawing them larger than other figures and in red, which the authors link to anxiety.
02Most children depicted nurses as smiling female figures, but a minority drew them without facial features, which some children described as avoiding interaction.
03The drawing method is not recommended as a routine clinical assessment tool, but understanding these perceptions can help nurses anticipate fears about injections.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in a single province in Turkey, so the findings may not apply to other cultural contexts. Participants had only mild intellectual disabilities; perceptions may differ significantly for children with moderate or severe disabilities. The interpretation of drawing elements (like colour and size) as signs of anxiety is subjective and based on theoretical frameworks, not direct measurement of the child's emotional state. Some children drew nurse caps with Red Cross symbols, suggesting media influence rather than direct experience, which complicates the link between drawings and actual healthcare encounters.
Declared interests
The authors declare no conflicts of interest. The study was approved by the Social and Human Sciences Ethics Committee.
The easy way to misread this
Do not use the drawings as a diagnostic tool to assess a child's psychological state or cognitive ability. The authors explicitly state that these are descriptive observations of social representations, not clinical indicators, and that the absence of facial features in a drawing does not mean the child has a thinking problem.