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Creative Arts Therapy Among Children With Cancer: Symptom Assessment Reveals Reduced Anxiety
Jennifer L Raybin1, Wenru Zhou, Zhaoxing Pan
1Author Affiliations: Oregon Health & Sciences University, Schools of Nursing and Medicine, Pediatric Hematology Oncology, Doernbecher Children's Hospital (Dr Raybin); College of Nursing and School of Medicine, University of Colorado Anschutz Medical Campus (Drs Raybin, Pan, and Jankowski); Colorado School of Public Health-Biostatistics and Informatics (Ms Zhou); and Trudy Busch Valentine School of Nursing, Saint Louis University (Dr Hendricks-Ferguson), Missouri.
Background:
Symptom distress is related to decreased quality of life (QOL) among children with cancer, with high levels of pain, nausea, and anxiety reported. Creative arts therapy (CAT) has been related to improved QOL and symptoms in pediatric oncology, but the quality of evidence is mixed.
Objective:
This article aims to examine the QOL symptom subscales in relation to CAT over time in children during the first year of cancer treatment.
Methods:
A secondary analysis of prospective data was performed with linear mixed modeling on 267 observations with predictors of 2 groups: No CAT (n = 18) vs CAT (n = 65). The covariate of time (6 months) was used to explore the CAT relationship with the Pediatric Quality of Life Inventory (PedsQL) symptom subscales (pain and hurt, nausea, procedural anxiety, treatment anxiety, worry, cognitive problems, perceived physical appearance, and communication).
Results:
Children (n = 83) were between 3 and 17 years old (M = 6), 51.2% female, and 32% minority. All tumor types were represented: liquid (37.3%), solid (24.1%), and central nervous system (38.6%). Reduced child report of procedural anxiety was significantly related to receiving CAT with a medium magnitude of association (adjusted effect size = 0.58, P = .01).
Conclusion:
Creative arts interventions were associated with a longitudinal improvement in anxiety in children with cancer. Further work is needed to target interventions to the appropriate specific burdensome symptoms.
Implication For Practice:
Pediatric oncology nurses can advocate for CAT as an effective intervention to ameliorate the burdensome procedural anxiety experienced by patients.
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