The effectiveness of mandala drawing in reducing psychological symptoms, anxiety and depression in hospitalised adolescents with cancer: A randomised controlled trial.

OBJECTIVE: This study aimed to evaluate the effectiveness of individual mandala drawing methods on psychological symptoms, anxiety and depression in hospitalised adolescents with cancer. METHODS: A randomised controlled trial design with repeated measures was conducted. The study was carried out in a paediatric haematology and oncology clinic in Turkey. The study protocol is registered at ClinicalTrials.gov NCT04297982. The study sample consisted of 60 hospitalised adolescents aged between 12 and 17. Participants were randomly assigned to receive two 1- to 2-h mandala drawing sessions (intervention group, n = 30) or routine care only (control group, n = 30). Each adolescent was assessed using the Hospital Anxiety and Depression Scale and the Memorial Symptom Assessment Scale (Psychological subscale) questionnaires and was evaluated at baseline and after 5 days. RESULTS: The anxiety and depression scores significantly decreased in the intervention group, compared with the control group, after 5 days of intervention, F(1, 57) = 28.9, p < 0.01, η2 = 0.337. Similarly, the psychological symptoms scores significantly decreased in the intervention group, compared with the control group, F(1, 57) = 69.7, p < 0.001, η2 = 0.550). CONCLUSION: The individual mandala activity intervention was effective in reducing on psychological symptoms, anxiety and depressive symptoms in adolescents with cancer.

Examining the expectations of healing care environment of hospitalized children with cancer based on Watson's theory of human caring.

AIM: To describe the expectations of children with cancer about the healing care environment during hospitalization based on Watson's Theory of Human Caring. DESIGN: A descriptive qualitative research design was used in this study. METHODS: Data were collected between December 2019 and February 2020 from purposively selected children with cancer in a paediatric haematology and oncology clinic at a university hospital in Turkey. Twelve participants (7 females and 5 males) aged 10-17 were recruited to carry out individual semi-structured interviews. All interviews were recorded via a digital audio recorder and transcribed verbatim. The content analysis method was used to analyse the data. FINDINGS: As a result of the analysis, three main themes with related sub-themes were identified that revealed the expectations of children with cancer: 'healing care behaviors', 'creating the physical environment of the hospital' and 'support from the social environment'. CONCLUSION: Watson's Theory of Human Caring may be a useful and applicable guide for drawing a conceptual framework of the expectations of children with cancer regarding a healing care environment. The study revealed these children's need for humanistic, compassionate, honest and problem-focused care. In addition, participants wished for improvements in the physical environment. They also stated that they feel lonely and need social support from their family, peers and society. IMPACT: This study presents a comprehensive picture of the expectations regarding a healing care environment (caring behaviours and physical and social aspects) of hospitalized children with cancer undergoing treatment. The qualitative findings generated by our study have the potential to facilitate these children's healthy adjustment to the hospital environment and procedures during hospitalization. Knowledge acquired through this study may be used to shape nursing care, enhance the healing care environment, and ensure that hospital design and setting are acceptable to and appropriate for paediatric patients.

The experiences of adolescents receiving cancer treatment in Turkey: A qualitative study.

OBJECTIVE: The adolescents with cancer usually receive intensive chemotherapy in the hospital. Their experiences of the process can affect their lives. This study aimed to describe the experiences of hospitalised adolescents receiving cancer treatment. METHODS: This study was conducted using a descriptive qualitative research design. Data were collected from 12 adolescents receiving cancer treatment in the paediatric haematology/oncology clinic at a university hospital in Turkey. Adolescents participated in one session of individual, unstructured mandala drawing. Individual interviews were then conducted using a semi-structured interview guide. The interviews, researcher observations and document analysis methods were used to produce and analyse data. Interview transcripts of the study were analysed using the content analysis method. RESULTS: Two main themes with related sub-themes each were obtained: being an adolescent with cancer, with the sub-themes of changes in health, restriction of freedom and feeling lonely; and coping with cancer with the sub-themes of psychological growth and hope for healing. CONCLUSION: Adolescents felt lonely and as though their freedom was restricted while they were hospitalised. Participants also noticed changes in their perspective on life and experienced psychological growth. Most of them hoped for healing and prayed to cope with cancer.