Students’ views about disease concept: Drawing and writing technique

Creating a healthy society is possible with healthy individuals. Whether the individuals are healthy or not depends on various individual and behavioral properties and especially the due importance given to health and disease (Tekin, 2007). Health which was defined in 1948 by World Health Organization (WHO) and is still valid nowadays is below: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Disease concept is defined in various ways. For instance, disease means “Cells, tissues or body organs of human beings can’t function properly or the functioning of these is impaired” (Berker, 2008, p.75). Disease means “physiological tasks cannot be performed or mental health deteriorates as a result of the emergence of a number of changes in organism” (Sert, Kibaroğlu, Şenyüz and Ünsal, 2008, p.1). Or disease reveals itself with the changes in physical, mental or social functions as it is conceptualized as a state which ruins the flow of usual conditions and daily life (Candansayar and Coşar, 2001). In brief, disease can be defined as the state of physical, mental or social not well-being.

Although individuals define health and disease concepts in various ways, a collective consciousness has to be created. The thoughts individuals have about the disease concept affect their behaviors related to health and disease, their health consciousness and their risk perceptions (Piko and Bak, 2006). Therefore, it is important to determine individuals’ ideas about disease.

First we must define concept before determining individuals’ views about disease. Concept is ‘an abstract and general notion of an object or a thought in mind’ (Turkish Language Association). As concept is defined in various researches, it has been defined as ‘the abstract units in the thought system of individuals’ (Saka and Ayas, 2002); as the generalization of the similarities with reference to the similarities and differences that state the common properties of different objects and phenomena (Yörek, 2007). Concepts that facilitate interpersonal communication also take place in mind as schemata. These schemata called image is personal and everybody can form various images related to a particular concept (Atasoy, Kadayıfçı and Akkuş, 2007). Learning the ideas individuals develop about a concept is also quite important in terms of the new experiences that will be developed related to that concept.

How abstract concepts such as health and disease are explained in mind is quite important for determining the ideas about these concepts. In order to determine students’ views about disease and causes and treatment of the disease, the cognitive structures of the students have to be revealed (Vacik, Nagy and Jessee, 2001). The place in which knowledge is structured and learning process is actualized cognitively for students is human memory. In the researches on cognitive psychology, it is stated that human memory consists of two memories as ‘short term memory’ or working memory and ‘long term memory’ (Baddeley, 1992). It is thought that cognitive structure develops in the long term memory of the students. Cognitive structure is represented with words, concepts, rules and abstract ideas and their meanings, their implications, relations among them and organized figures (Tulving, 1993). In the process of developing this structure; properties such as students’ knowledge, experiences, how students organize the knowledge, their perceptions, their ideas and their interaction with environment are actively used (Bağcı Kılıç, 2001; Dikmenli, 2010a; Dikmenli, 2010b; Durmuş, 2001; Şimşek, 2004).

Alternative techniques such as questionnaire, interview, concept map, fortune lines, word association and drawing and writing are used in order to determine the students’ thoughts, comprehension or attitude towards a particular topic (Bahar, Özel, Prokop and Uşak, 2008; White and Gunstone, 1992). The drawing and writing is a technique which is used to find out the students’ learning in depth. This technique is a very useful technique to acquire natural and high quality data about students’ thoughts, comprehension and attitudes which remained hidden in the research process (Pridmore and Bendelow, 1995; White and Gunstone, 1992). Drawing technique is more efficient since it is easily internalized and it is more effective in comparison with the techniques such as writing and behavior scales which focus on thought, comprehension and attitude changes since it is more useful in terms of time and provides various data (Atasoy, Kadayıfçı and Akkuş, 2007). Moreover, it is preferred because of the fact that it is an enjoyable technique and it is an activity in which children at all ages participate (Backett-Milburn and McKie, 1999).

Some of the works by drawing and writing technique are related to these subjects; cell division (Dikmenli, 2010a); heart (Bahar et al., 2008); passive smoking (Woods, Springett, Porcellato and Dugdill, 2005); happiness and sadness (Jolley, Fenn and Jones, 2004); violence (Yurtal and Artut, 2008); germ (Saka and Ayas, 2002); health (Çetin et al., 2013); disease, health (Piko and Bak, 2006); healthy school (Macgregor, Currie and Wetton, 1998); health education (Backett-Milburn and McKie, 1999); water cycle, environment (Dove, Everett and Preece, 1999); environment (Taşkın and Şahin, 2008); internet (Ersoy and Türkan, 2009); air pollution (Pluhar, Piko, Kovacs and Uzzoli, 2009).

When we have a look at the literature concerning the thoughts of the individuals about disease concept and the meanings given to disease concept, it is clearly seen that there are a lot of researches on this subject. Some of these researches were conducted by explanation and/or drawing techniques (Natapoff, 1978; Onyango-Ouma, Aagaard-Hansen and Jensen, 2004; Piko and Bak, 2006). In researches, disease is defined in various concepts: Asthenia, pollution, terrible, patient, being sad (Natapoff, 1978); pain, feeling bad, fatigue, headache, sore throat, sad, angry (Onyango-Ouma et al., 2004); bacteria, virus, cigarette, alcohol, air pollution (Piko and Bak, 2006); being unhealthy, inadequacy of sanitary measures and inadequacy in carrying out the things considered necessary (Boruchovitch and Mednick, 1997). On the other hand, it has been observed that these concepts are mostly drawn in the drawings related to the disease concept: Dead fish, snake, bicycle, dirty environment, contaminated food, dirty dishes (Onyango-Ouma et al., 2004); cigarette, polluted air, car, chicken pox, bacteria, dirty water (Piko and Bak, 2006).

As a result, even if there are many studies about drawing and explanations as stated above, any study concentrating on describing of drawing and writing about illness has not come across in Turkey. Therefore this study has been conducted to determine thoughts of ninth grade students towards illness concept by means of drawing and writing technique. The results of the study were considered to be significant in contributing knowledge to the literature.

Purpose of the Study

The purpose of this study was to determine ninth grade students’ views about disease concept by a drawing and writing technique.

Three research questions guided this study:

1. What are the students’ explanations about disease concept?

2. What are the students’ drawings about disease concept?

3. Do the students’ explanations and drawings about disease concept support each other or not?