Inventing a story in the context of hospital pediatrics: Strategies and experiences of hospitalized children

Background: Hospitalization represents a stressful experience for children, with repercussions on their emotional, cognitive, and relational well-being. Assessing hospitalized children's internal experiences remains challenging due to the limited availability of appropriate tools and the intrusive nature of standardized tools. This study pro- poses the use of invented story narration as an ecological and non-invasive approach to explore the mental states of hospitalized children. Methods: Participants included 88 children (mean age = 9.34 years) from pediatric and surgical wards and 15 healthcare professionals. Children completed a spontaneous oral narrative task, freely inventing and telling a story without prompts, time limits, or evaluative feedback. Narratives were audio-recorded, transcribed, and an- alyzed for narrative structure, cohesion, and psychological lexicon across eight internal states categories. Healthcare professionals completed a feasibility questionnaire assessing the usefulness and applicability of the task within the hospital context. Results: Professionals considered the narrative task useful for gaining insight into children's internal experiences and improving communication and quality of care. Findings revealed a predominance of socio-relational and physiological terms, followed by cognitive and volitional states, whereas emotional and moral expressions were less frequent. The narratives highlighted the centrality of the body and interpersonal relationships, reflecting the concrete and interdependent nature of children's hospital experiences. Conclusion: The study supports the feasibility and clinical–educational value of invented stories as a respectful and participatory tool for accessing the internal world of hospitalized children. Practical implication: Practical implications include the implementation of invented narrative stories to personal- ize pediatric care and facilitate emotional expression during recovery. © 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).