Symbols of Hope on Pediatric Oncology Ward: Children's Perspective Using Photovoice

Children picturing their own worlds: Using photovoice to amplify children's voice in sociological research

This research note highlights an emerging transdisciplinary research method-photovoice-and why it is particularly suited for sociological studies of children and youth. Traditional social science data collection methods can be limited in their ability to capture both the depth and breadth of childhood experiences and children's perceptions of their experiences. We describe an emerging method, photovoice, that is used more frequently in other disciplines, and its suitability for sociologically studying youth and children. We describe the limitations of traditional social science methods and how photovoice can help overcome some of these limitations. Photovoice engages participants as lived experts who contribute to both the data collection and analysis in an individual and collective manner. Through taking photos and discussing their meaning, participants can share abstract feelings and discuss sensitive topics in an imaginative format and express themselves creatively. We describe how previous research has used photovoice to work with youth from vulnerable circumstances and those who have experienced trauma as well as demonstrate how photovoice is well situated to bolster the tenets of sociological research.

Children's perspective of hope in living with leukemia: A qualitative study using drawing

PURPOSE

This study aimed to explore children's perspective of hope in living with leukemia through the utilization of drawing-based interview technique.

DESIGN AND METHODS

This qualitative study was conducted at the Children's Medical Center in Tehran with the participation of children aged 6 to 12 diagnosed with leukemia. The children were asked to prepare a drawing about hope then interviews were conducted face-to-face with each child after completing the drawing. Data analysis was conducted using the qualitative content analysis.

RESULTS

In the collection of a total of 20 drawings from school-age children with leukemia, each drawings has different metaphors symbolizing hope. Five themes emerged including positive thinking, embracing the sanctuary of maternal affection and collective caring, the ethereal glow of joy, the melody of resilient soul, and navigating the way back to home.

CONCLUSION

Hope from the child's perspective can be achieved in simple, possible and accessible ways, making it easier for the family, community and healthcare system to inspire hope in their lives with Leukemia.

PRACTICE IMPLICATION

Health providers in pediatric oncology can integrate hope-based care interventions related to the factors influencing children's perspectives.

A picture of hope: From the perspective of adolescents with cancer-A phenomenological-visual qualitative study

This study aims to investigate the phenomenon of hope in adolescents diagnosed with cancer and examine adolescents' lived experiences of hope. The study was conducted between November 2022 and March 2023. The study used a phenomenological-visual qualitative research design with 20 adolescents in the pediatric oncology ward. The purposive sampling method was used in the study. Data were collected using "Descriptive Characteristic Form," "Semi-structured Interview Form," "Drawing Technique," and "Mutual Storytelling Technique". The adolescents were instructed, "Let us draw our hopes," and asked to draw pictures. Each adolescent was interviewed about the drawings and asked four semi-structured questions. Audio recordings of the interviews were made and transcribed. A hermeneutic phenomenological approach was used in the analysis of the data. Two main themes and four subthemes were identified in the study. Metaphorical and conceptual context was included in the theme of symbolizing and linking hope. Two subthemes, facilitators and barriers, were identified in the main theme of rooting hope. The study sheds light on hope experiences in adolescents receiving cancer treatment and guides healthcare professionals.

Opportunities for play in paediatric healthcare environments: a scoping review

Play spaces are important components of paediatric healthcare environments. They provide children with critical opportunities to experience the social, emotional, and developmental benefits of play while in healthcare settings for appointments or hospitalizations. These spaces can help to mitigate stress, provide a sense of normalcy in unfamiliar environments, and facilitate social engagement for children and their families. Given the benefits of play spaces in paediatric healthcare settings, it is important to understand how these spaces can be designed to enhance children's inclusion and quality of care. The aim of this scoping review was to explore the current understanding of paediatric play space design. Using search terms related to children, health care, and play space, six interdisciplinary databases were searched over a 30-year period. The search found 2,533 records from which eighteen were included for review. Findings suggest that although it is well-documented that play spaces offer valuable social and emotional benefits, little is known about the specific design features that can and should be incorporated to enhance play opportunities and ensure that they benefit all children and families. Further, the literature mostly considers play spaces in the context of designated play or recreational rooms. Scholars are encouraged to consider how play opportunities can be incorporated into the designs of paediatric healthcare environments beyond the boundaries of these rooms. Future studies should also consider the diversity of play space users, including children of varying ages and abilities, to create more accessible and inclusive paediatric play spaces for children and their families. Advancing knowledge on play space design can help to optimize the quality of these important spaces and to ensure their designs meaningfully enhance children's play experiences and quality of care.

Effectiveness of Group Spiritual Care on Leukemia Patients' Hope and Anxiety in Iran: A Randomized Controlled Trial

This study examined the effectiveness of a group spiritual care program on leukemia patients' hope and anxiety. This randomized controlled trial involved 94 leukemia patients hospitalized in the two oncology departments of Shahid Beheshti Hospital, Hamadan, Iran. This study was carried out from November 2022 to April 2023. The participants were selected based on the study inclusion criteria using the convenience sampling method then they were randomized to either the experimental (N = 46) or the control group (N = 48). The participants completed the written informed consent form, the demographic information form, and Beck's anxiety and Snyder's hope questionnaires. The spiritual care program was provided in six sessions (one 45-60 min per week), including a spiritual needs assessment, religious care, spiritual care, psychological-spiritual care, supportive-spiritual care, and evaluation. The participants then completed Beck's anxiety and Snyder's hope questionnaires immediately, one and two months after the intervention. At baseline, there was no significant between-group difference in leukemia patients' mean scores of hope (P = 0.313) and anxiety (P = 0.141); however, immediately, one and two months after the intervention, a significant between-group difference in the mean scores of hope and anxiety was observed (P < 0.001). Also, from baseline to two months after the intervention, a significant decrease and increase in anxiety and hope mean scores, respectively, were observed in the experimental group (within-group difference) (P < 0.001). However, in the control group, from baseline to two months after the intervention, a significant increase and decrease in mean scores of anxiety and hope, respectively, were observed (within-group difference) (P < 0.001). As a result, it is recommended that nurses should consider providing spiritual care to leukemia patients as a part of holistic care.

A Scoping Review of Pediatric Healthcare Built Environment Experiences and Preferences Among Children With Disabilities and Their Families

BACKGROUND

Some children with disabilities (CWD) frequently visit pediatric healthcare settings for appointments. Their age, disability, and regular visits mean that they have unique experiences in healthcare settings. While previous research has explored the clinical experiences of CWD, little is known about their experiences of pediatric healthcare built environments, even though these environments may play an important role in shaping their perceptions of care. Given the significant time that some CWD and chronic illnesses (e.g., cancer) spend in healthcare environments and the impact that these settings can have on their experiences, the knowledge gap concerning how they view, and experience healthcare built environments demands attention.

OBJECTIVE

To explore how CWD and their families experience pediatric healthcare built environments.

METHODS

A scoping review was conducted by searching five health science and interdisciplinary literature databases using terms related to children, disability, healthcare, and built environment. The search identified 5,397 records that were screened independently by three reviewers.

RESULTS

Nineteen studies met inclusion criteria and were considered in the final review. Findings indicate that CWD and their families value healthcare built environment features that support social engagement, patient privacy, and parental presence. Further, the age of a child was highlighted as an important factor that influences the built environment preferences of CWD.

CONCLUSIONS

CWD and their families prefer certain healthcare built environment features to optimize their experiences in these settings. Healthcare designers can leverage these findings to advance more inclusive pediatric healthcare spaces to improve care and the quality of life for CWD and their families.

Realities and ideals: Experiences and needs of pediatric oncology nurses in communication processes with children and their families at the end-of-life period: A photovoice qualitative study

Effective communication in end-of-life care for pediatric cancer patients is crucial. Yet, limited research focuses on the communication experiences of pediatric oncology nurses during this period. This study aims to investigate the communication experiences and needs of these nurses with children and their families during the end-of-life period. A qualitative study design with photo voice methodology was followed. The research was conducted with 16 pediatric oncology nurses working in the pediatric oncology wards of a university hospital between January and May 2023. Data were collected the "Characteristic Information Form", "Semi-Structured Interview Form", and photovoice methodology. Data were analyzed through reflexive thematic analysis. Most of the nurses are at the undergraduate level, and their working experience in pediatric oncology wards ranges from 4 months to 17 years. Seven main themes emerged: Optimistic Communication-Interaction, Mindfulness, Active Coping, Behavioral Actions, Death Uncertainty Dilemma, Interpersonal and Environmental Factors, and Discrepancy between Ideals and Reality. The study sheds light on the importance of pediatric oncology nurses' ideals versus realities upstream approach in communicating with end-of-life children and their families, empowering pediatric oncology nurses on the journey to ideal end-of-life care.

Hospital classroom experiences of hospitalized school-age pediatric oncology patients: A qualitative study

PURPOSE

In this study, it was aimed to examine the hospital classroom experiences of school-age children who received treatment and care at a pediatric oncology-hematology clinic in Turkey.

METHODS

The study was conducted using the in-depth interview method with the participation of 17 children who were hospitalized in the pediatric oncology-hematology clinic of a research and training hospital in the Ankara province of Turkey. The data were collected using a "Semi-Structured Interview Form". The interviews started with the question "How do you perform the assignments given by your teacher while you are hospitalized?", and the interviews were recorded as audio with the consent of the children and their parents.

RESULTS

As a result of the interviews, three main themes, (1) Learning, (2) Maintaining normalcy, and (3) Expectations, and 9 subthemes (teacher, continuation of learning, learning through play, feeling good, continuation of routines, peer interaction, communication with the school-teacher, basic sport activity, and tablet/internet access) were generated from the data.

CONCLUSIONS

Hospital classrooms had a significant role in increasing the children's adaptation to hospital conditions and ensuring the continuation of school/learning.

PRACTICE IMPLICATIONS

Pediatric nurses can refer children with long and repeated hospitalizations (e.g., pediatric oncology patients and children with chronic diseases) to hospital classrooms. Thus, children can adapt more easily to the procedures performed in the hospital.

Exploring the Use of Arts-Based Interventions and Research Methods in Families of Seriously Ill Children: A Scoping Review

Family care is essential to pediatric nursing practice, as the entire family is affected by childhood illness. However, little is known about art making for therapeutic purposes and how art is used to better understand families' experiences. Our purpose was to examine the nature of arts-based interventions and research methods used with, and the experiences of families of children facing life-limiting and life-threatening illnesses, and those families who are bereaved. Academic peer-reviewed sources published between January 1999 and May 2022 were retrieved via four databases using key search terms. Twenty-five articles were analyzed, resulting in three multifaceted categories including Social, Emotional, and Family Health. Critical strengths and limitations were also identified. Art making has been incorporated into interventions and research studies due to its benefits for family well-being. Understanding the potential of art making can inspire nurses to implement such activities to enhance family nursing practice and research.

Art Unfolds Words: Expressing Hope Through Creative Art Among Adolescents and Young Adults Who Have Advanced Cancer

Hope's role in the care of adolescents and young adults (AYAs) who have advanced cancer (AC) is not well understood. This study aimed to conceptualize the essence of hope among AYAs who have AC based on their lived experiences and illustrate hope through verbal and artistic depictions of the AYA's lived experiences. Fifteen AYAs, aged 12 to 21 years, diagnosed with AC completed two semistructured interviews to share their lived experiences of hope perspectives in the form of a descriptive narrative and a creative-art outcome. Participants who chose to draw pictures narrated the conceptual meanings based on elements of each picture. A board-certified art therapist performed a post hoc analysis of the drawings and participants' verbatim descriptions of their meanings. Five of the 15 AYA participants created drawings depicting their lived experiences of hope. The artistic process of mapping their cancer journey revealed distinct views of hope through nature landscapes and metaphors. Participants provided titles for their drawings such as "Over the Rainbow," "Growth in the Valley," and "The Light at the End of the Tunnel." The pictures embodied the AYAs' thoughts, perceptions, and lived experiences related to hope and its role during their cancer journey. Drawing is one simple art form that can facilitate an AYA's expression of well-being (including hope) beyond what may be verbally articulated. Creative art should be further researched as a screening tool to assess how AYAs with AC cope with an uncertain future and psychological and/or existential distress symptoms.

Qualitative Research and Cancer Nursing: A Guide for Novice Researchers

OBJECTIVE

To introduce the cancer nurse to qualitative research.

DATA SOURCES

A search of published literature including articles and books was conducted to inform the article using University libraries (University of Galway and University of Glasgow) and CINAHL, Medline, and Google Scholar databases using broad terms, including qualitative research, qualitative methods, paradigm, qualitative, and cancer nursing.

CONCLUSION

It is important for cancer nurses wishing to read, critically appraise, or undertake qualitative research to understand the origins and different methods employed in qualitative research.

IMPLICATIONS FOR NURSING PRACTICE

The article is of relevance for cancer nurses globally who wish to read, critique, or undertake qualitative research.

Emotional and spiritual hope: Back to the future

A cognitive approach to hope has dominated psychology for five decades. Representing the farthest reaches of human intentionality, hope, thus rendered, can be viewed as both a product and promoter of the cognitive revolution and larger Western ideals. A different understanding of hope appears in medicine, the arts and humanities, as well as early psychological accounts. In this article, I review evidence for understanding hope as an emotion with extra-rational elements. I focus on recent research but also incorporate classic insights, highlighting grounded studies (e.g., lay beliefs and clinical data) as well as empirical data that distinguishes an emotional and spiritual hope from the cognitive construct. A motivational account of hope is offered, highlighting the needs for attachment, survival, mastery, and spirituality.

Using Communication Tools to Explore Young Siblings’ Experiences of Having a Brother or Sister with Pediatric Palliative Care Needs

Siblings of children with palliative care needs often suffer feelings of being neglected, and their needs for information and involvement are frequently unmet. This study aims to explore the experiences and feelings of siblings of children with palliative care needs, and to determine what is important to them. Nine siblings, aged 6–14 years, were interviewed using four different communication tools: See-Hear-Do pictures, including the empty body as a separate element, Bear cards, and words originating from previous sibling research. Data were analyzed using conventional content analysis. Five categories emerged concerning aspects that the siblings described about their situation and things that they found important: being part of a special family; school—a place for leisure, friends, and learning; relentless feelings of guilt and self-blame; losses and separations; and awareness of death—not if, but when. Siblings of children with rare diseases expressed an awareness that their brother or sister would die, although still felt they were part of a special, happy family. Siblings of children with palliative care needs due to an accident described relentless feelings of self-blame and guilt. The needs of siblings may vary depending on the condition that resulted in the ill sibling’s palliative care needs.

Through the Lens: Youth Experiences with Cancer in Rural Appalachian Kentucky Using Photovoice

Rural Appalachian Kentucky experiences disproportionately high cancer incidence and mortality rates. This cancer burden is due to social determinants of health and cultural factors prominent in the region. The firsthand experiences of community members-especially young people-can highlight these factors and identify areas for improvement. The purpose of this study was to encourage Appalachian Kentucky youth to consider determinants of cancer and visualize the effects that cancer has on their families or communities by asking them to take photographs of cancer-related objects around them. Content analysis was performed on 238 photographs submitted by 25 students, and photographs were organized into themes, subthemes, and subtopics. The six themes that emerged were risk factors and exposures, marketing, awareness and support, health care, experiences, and metaphorical representations. Many of the submitted photographs aligned with cultural, environmental and/or situational factors prevalent in Appalachian Kentucky. Of the submitted photographs, 54 were displayed as an installment in two Kentucky art galleries. Viewer comments at the exhibitions demonstrated that young community members can educate and motivate change in those around them. Ultimately, this project demonstrates that young community members can recognize cancer-related issues around them and connect personal experiences back to the larger Appalachian Kentucky cancer disparity while also having an impact on other community members.