Bibliotherapy Outcomes In Preschoolers With Infectious Diseases: A Two-Site Comparison Of Dengue Hemoragic Fever And Acute Respiratory Infection Cases

Abstract

Background: Hospitalization in preschool children, especially due to infectious diseases such as Dengue Haemorrhagic Fever (DHF) and Acute Respiratory Tract Infection (ARI), frequently triggers anxiety that affects psychological well-being and the recovery process. Bibliotherapy, a non-pharmacological intervention using age-appropriate picture storybooks, has been applied to reduce anxiety. However, its effectiveness may differ depending on the illness and individual response. Research Objective: To compare the effectiveness of bibliotherapy in reducing anxiety levels among hospitalized preschool children with DHF and ARI. Methods: This comparative case study with a qualitative approach involved four children aged 4–7 years: two diagnosed with DHF at Dr. Soedirman General Hospital, Kebumen, and two diagnosed with ARI at Majenang General Hospital. Bibliotherapy sessions were conducted for three consecutive days, one 20-minute session per day, using picture storybooks. Anxiety levels were assessed through behavioral observation and the Spence Children’s Anxiety Scale (SCAS) Parent Report. Results: The findings showed differences between the two groups. Children with DHF demonstrated a more significant reduction in anxiety within the first two days, whereas children with ARI showed a slower decrease, with improvements observed on days two and three. Moreover, children with DHF exhibited positive emotional expressions earlier than those with ARI. Conclusion: Bibliotherapy appears to be more effective in reducing anxiety levels more rapidly in preschool children hospitalized with DHF compared to those with ARI