Abstract
This study assessed the disease experiences in children and adolescents with cancer through an art-based assessment. It used a longitudinal qualitative research design with inductive content analysis. The study included twenty children (6-17 years old) diagnosed with cancer from the Hospital de Especialidades Pediatricas, Maracaibo, Venezuela. The art-based assessment program consisted of 7 individual sessions in which self-image, family relationships, disease perception, child's experiences at the hospital, concerns about the disease and treatment, and positive feelings were evaluated through art exercises. Two main categories emerged from the analysis: (1) Cognitive Dimension, related to awareness and concerns regarding the disease and treatment, as well as patients' ability to take responsibility for their health, and (2) Emotional Dimension, which covers the positive emotional states, such as fighting spirit, affection towards others, happiness, and hope, along with the negative emotional states which include sadness, anxiety-fear, and anger. The results of this research support previous findings indicating that art-based assessment is a valid and effective tool to evaluate thoughts and emotions in children and adolescents with cancer.
References
Aguilar, B. (2017). The Efficacy of Art Therapy in Pediatric Oncology Patients: An Integrative Literature Review. Journal of Pediatric Nursing, 36, 173-178. https://doi.org/10.1016/j.pedn.2017.06.015
Allemani, C., Matsuda, T., Di Carlo, V., Harewood, R., Matz, M., Nikšić, M.,…CONCORD Working Group. (2018). Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet, 391 (10125), 1023–75. https://doi.org/10.1016/S0140-6736
Angell, C., & Alexander, J. (2015). ¨Draw, write, and tell¨. A literature review and methodological development on the "draw and write" research method. Journal of Early Childhood Research, 13 (1), 17-28
Altay, N., Kilicarslan-Toruner, E., & Sari, Ç. (2017). The effect of drawing and writing technique on the anxiety level of children undergoing cancer treatment. European Journal of Oncology Nursing, 28, 1-6. https://doi.org/10.1016/j.ejon.2017.02.007
Anderzén-Carlsson, A., Kihlgren, M., Svantesson, M., & Sorlie, V. (2010). Parental handling of fear in children with cancer; caring in the best interests of the child. Journal of Pediatric Nursing, 25(5), 317-326. https://doi.org/10.1016/j.pedn.2008.10.004
Best, M., Aldridge, L., Butow, P., Olver, I., & Webster, F. (2015). Conceptual analysis of suffering in cancer: a systematic review. Psycho-Oncology, 24, 977-986.
Björk, M. (2008). Living with childhood cancer - Family members' experiences and needs. [Doctoral dissertation]. Lund: Department of Health Sciences, Faculty of Medicine. Lund University, Sweden. Retrieved from https://portal.research.lu.se/ws/files/4069139/1148900.pdf
Björk, M., Wiebe, T., & Hallstrom, I. (2009). An everyday struggle-Swedish families'lived experiences during a child's cancer treatment. Pediatric Nursing, 24(5), 423-432. https://doi.org/10.1016/j.pedn.2008.01.082
Cayrou, S., Dickes, P., Gauvain-Piquard, A., & Roge, B. (2003). The mental adjustment to cancer (MAC) Scale: French replication and assessment of positive and negative adjustment dimensions. Psycho-Oncology, 12, 8-23. https://doi.org/10.1002/pon.634
CIOMS, OMS & OPS (2016). Pautas éticas internacionales para la investigación relacionada con la salud con seres humanos. Retrieved from https://cioms.ch/wp-content/uploads/2017/12/CIOMS-EthicalGuideline_SP_INTERIOR-FINAL.pdf
Cordova, M., Giese-Davis, J., Kronnenwetter, C., Chang, V., McFarlin, S., & Spiege, D. (2003). Mood disturbance in community cancer support groups. The role of emotional suppression and fighting spirit. Psychosomatic Research, 55(5), 461-467. https://doi.org/10.1016/S0022-3999(03)00510-5
Corman, L. (1961). Le Test du Dessin de Famille. Paris: Presses Universitaires de France.
Curran, L., Sharpe, L., & Bulow, P. (2017). Anxiety in the context of cancer: A systematic review and development of an integrated model. Clinical Psychology Review, 56, 40-54. https://doi.org/10.1016/j.cpr.2017.06.003
Darcy, L., Enskar, K., & Bjork, M. (2019). Young children's experiences of living an everyday life with cancer - A three year interview study. European Journal of Oncology Nursing, 1-9. https://doi.org/10.1016/j.ejon.2018.12.007
Donalek, J. (2005). The interview in qualitative research. Urologic Nursing, 124-125.
Dua, P., & Heiland, M. (2017). Cancer-related hair loss: a selective review of the alopecia research literature. Psycho-Oncology, 26, 438–443. https://doi.org/10.1002/pon.4039.
Einberg, E., Nygren, J., Svedberg, P., & Enskark, K. (2015). "Through my eyes": health-promoting factors described by photographs taken by children with experience of cancer treatment. Child: care, health and development, 42(1), 76-86. https://doi.org/10.1111/cch.12285
Enskar, K., Knutsson, S., Huus, K., Granlund, M., Darcy, L., & Bjork, M. (2014). A literature review of the results from nursing and psychological research within Swedish pediatric oncology. Nursing and Care, 3(6), 1-11. https://doi.org/10.4172/2167-1168.1000217
Escribano, J. (1977). Test de la Figura Humana (Psicodiagnostico a priori de normalidad y patologia). Graficas Uguina.
Ferlay, J., Ervik, M., Lam, F., Colombet, M., Mery, L., Piñeros, M.,… Bray, F. (2018). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Retrieved from https://gco.iarc.fr/today, accessed 30 March 2020.
Filová, A., & Sikorová, L. (2015). Evaluating the needs of children with cancer. Central European Journal of Nursing and Midwifery, 6 (1), 224-230. https://doi.org/10.15452/CEJNM.2015.06.0007
Gantt, L. (2011). The Case for Formal Art Therapy Assessments. Art Therapy Journal, 21(1), 18-29. https://doi.org/10.1080/07421656.2004.10129322
Gibson, F., Aldiss, S., Horstman, M., Kumpunen, S., & Richardson, A. (2010). Children and young people's experience of cancer care: A quality research study using participatory methods. International Journal of Nursing Studies, 47(11), 1397-1407. https://doi.org/10.1016/j.ijnurstu.2010.03.019
Graneheim, U., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105-112. https://doi.org/10.1016/j.nedt.2003.10.001
Husson, O., & Zebrack, B. (2017). Perceived impact of cancer among adolescents and young adults: Relationship with health‐related quality of life and distress. Psycho‐Oncology, 26, 1307–1315. https://doi.org/10.1002/pon.4300
IAAP & IUPsyS (2008). Universal Declaration of Ethical Principles for Psychologists. Available from the International Union of Psychological Science Web site: https://www.iupsys.net/about/governance/universal-declaration-of-ethical-principles-for-psychologists.html
Im-Ryung, K., Juhee, C., Eun-Kyung, C., In, G. K., Young, H., Sung, . . . Jung-Hyun, Y. (2012). Perception, attitudes, preparedness and experience of chemotherapy-induced alopecia among breast cancer patients: a qualitative study. Asian Pacific Journal of Cancer Prevention, 13(4), 1383–1388. https://doi.org/10.7314/apjcp.2012.13.4.1383
Leibring, I., & Anderzén-Carlsson, A. (2019). Fear and coping in children 5–9 years old treated for Acute Lymphoblastic Leukemia - A longitudinal interview study. Journal of Pediatric Nursing, 46, e29–e36. https://doi.org/10.1016/j.pedn.2019.02.007
Machover, K. (1953). The Human Figure Drawings of children. Journal of Projective Techniques, 17, 85-91. https://doi.org/10.1080/08853126.1953.10380466
Malchiodi, C. (1998). Understanding children's drawings. The Guilford Press.
Malchiodi, C. (1999). Medical art therapy with children. Jessica Kingsley Publishers.
Malchiodi, C. (2005). Expressive Therapies. Guilford.
Marcus, J. (2012). Psychosocial issues in pediatric oncology. The Ochsner Journal, 12, 211–215.
Phillippi, J., & Lauderdale, J. (2017). A guide to field notes for qualitative research: context and conversation. Qualitative Health Research. 28(3), 381-388. https://doi.org/10.1177/1049732317697
Pinheiro, I. (2015). Hospital psychological assessment with the drawing of the human figure: A contribution to the care to oncologic children and teenagers. Scientific Research Publishing Inc, 6(4), 484-500. http://dx.doi.org/10.4236/psych.2015.64046
Rollins, J., Drescher, J., & Kelleher, M. (2012). Exploring the ability of a drawing by proxy intervention to improve quality of life for hospitalized children. Arts & Health, 4(1), 55-69. https://doi.org/10.1080/17533015.2011.564194
Ruhe, K., Badarau, D., Brazzola, P., Hengartner, H., Elger, B., & Wangmo, T. (2016). Participation in pediatric oncology: views of child and adolescent patients. Psycho-Oncology, 25, 1036–1042. https://doi.org/10.1002/pon.4053
Sadruddin, M., & Hameed Ur Rehman, M. (2013). Understanding the perceptions of children battling cancer about self and others through drawing. South Asian Journal of Cancer, 2(3), 113-118. https://doi.org/10.4103/2278-330x.114100
Soanes, L., Hargrave, D., Smith, L., & Gibson, F. (2009). What are the experiences of the child with a brain tumor and their parents? European Journal of Oncology Nursing, 13(4), 255-261. https://doi.org/10.1016/j.ejon.2009.03.009
Stegenga, K., & Ward-Smith, P. (2009). On Receiving the diagnosis of cancer: The adolescent perspective. Journal of Pediatric Oncology Nursing, 26(2), 75-80. https://doi.org/10.1177/1043454208328767
Swartzman, S., Sani, F., & Munro, A. (2017). The role of social support, family identification, and family contraints in predicting posttraumatic stress after cancer. Psycho-Oncology, 26, 1330-1335. https://doi.org/10.1002/pon.4304
Tahmasebi, Z., Maghsoudi, J., & Talakoub, S. (2017). The effect of painting on depression in children with cancer undergoing chemotherapy. Iranian Journal of Nursing and Midwifery Research, 22(2), 102-105. https://doi.org/10.4103/ijnmr.ijnmr_242_15
Tilton-Weaver, L., Vitunski, E., & Galambos, N. (2001). Five images of maturity in adolescence: what does "grown up" mean?. Journal of Adolescence, 24(2), 143-158. https://doi.org/10.1006/jado.2000.0381
Torres, V., Darezzo, M., Machado, F., Bravo, L., Adlard, K., Secola, R., & Fernandes, A. (2019). Frequency, severity, and distress associated with physical and psychosocial symptoms at home in children and adolescents with cancer. Journal of Pediatric Health Care, 33(4), 404-414. https://doi.org/10.1016/j.pedhc.2018.11.007
Williamson, H., Harcourt, D., Halliwell, E., Frith, H., & Wallace, M. (2010). Adolescents' and parents' experiences of managing the psychosocial impact of appearance change during cancer treatment. Journal Pediatric Oncology Nurse, 27(3), 168-175. https://doi.org/10.1177/1043454209357923
Woodgate, R., Degner, L., & Yanofsky, R. (2003). A different perspective to approaching cancer symptoms in children. Journal of Pain and Symptom Management, 26(3), 800-817. https://doi.org/10.1016/s0885-3924(03)00285-9
Yuen, A., Ho, S., & Chan, C. (2014). The mediating roles of cancer-related rumination in the relationship between dispositional hope and psychological outcomes among childhood cancer survivors. Psycho-Oncology, 23, 412–419. https://doi.org/10.1002/pon.3433
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2022 Olimpia Petzold, Darius Razavi