Creative arts intervention (CAT) is an effective strategy for easing the anxiety pediatric patients with cancer experience, especially in their first year of cancer treatment. These findings were published in Cancer Nursing.

Children with cancer often experience symptom distress, including high levels of pain and nausea, as well as anxiety that can decrease their quality of life (QOL). Some research indicates that CAT can help; however, more research is needed due to the mixed quality of evidence.

A group of researchers set out to add to the body of research on CAT in pediatric oncology by examining the association between QOL symptom subscales and creative arts therapy over time in children aged 3 to 17 who were in their first year of cancer treatment.

Continue Reading

In a retrospective secondary analysis of prospective data, the researchers analyzed data from children who participated in CAT at a large pediatric cancer center between 2014 and 2019. A total of 267 observations of 2 groups of patients was analyzed: a CAT group that included 65 participants and a non-CAT group that included 18 participants. They explored the CAT relationship with the Pediatric Quality of Life Inventory (PedsQL) symptoms subscales.

The intervention consisted of CAT sessions as a part of planned cancer therapy that occurred approximately every 2 to 3 weeks, based on chemotherapy cycles. The therapy included dance, movement with articles such as parachutes, yoga breathing and poses, singing, listening to music, drawing, working with clay, and other arts activities.

Procedural anxiety, such as the anxiety associated with needlesticks, is one of the most distressing experiences children with cancer report. In this study, feelings of procedural anxiety declined in the CAT group but increased in the non-CAT group over time, although the effect of CAT diminished by age of the patient.

“Creative arts therapy may be an intervention to improve the burdensome symptom of procedural anxiety in children with cancer,” the researchers wrote. However, “pain and nausea were not significantly improved with CAT and may be better targeted with other interventions.”

These results support considering creative arts interventions as part of a repertoire of symptom management strategies. “Nurses can suggest creative interventions such as drawing before a stressful ‘poke,’ playing music in the treatment room, or dancing in the halls to physically process anxiety before a procedure,” suggested the researchers.

Study limitations include a selection bias in that the children who participated may have already had an interest in art or improving QOL. The study also was skewed toward younger children, which suggests that future research should focus on exploring incentives to increase adolescent patients’ participation.


Raybin JL, Zhou W, Pan Z, Hendricks-Ferguson VL, Jankowski C. Creative arts therapy among children with cancer: symptom assessment reveals reduced anxiety. Cancer Nurs. Published online January 10, 2023. doi:10.1097/ncc.0000000000001186