The Effect of an Art-Based Emotion Regulation Program on Anxiety, Emotion Regulation Skills, and Symptom Burden in Adolescents Undergoing Cancer Treatment: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 60
- 主要终点
- State Anxiety Inventory for Children (SAIC)
研究概览
简要总结
Adolescents receiving cancer treatment often experience increased anxiety, difficulties in emotion regulation, and a high symptom burden due to treatment-related physical effects and psychosocial stressors. Supportive, non-pharmacological interventions that promote emotional regulation are therefore needed.
The purpose of this randomized controlled trial is to evaluate the effect of an art-based emotion regulation program on anxiety levels, emotion regulation skills, and symptom burden in adolescents undergoing cancer treatment.
This single-blind, parallel-group randomized controlled study will include 60 adolescents aged 10-18 years receiving cancer treatment at Gazi University Health Application and Research Center and Etlik City Hospital Pediatric Hematology-Oncology units between January 30, 2026 and March 20, 2027. Participants will be randomly assigned to either the intervention group or the control group. The intervention group will receive a 4-week art-based emotion regulation program, while the control group will receive routine care. Outcomes will be assessed using validated self-report measures at baseline and at the end of the intervention period.
详细描述
Adolescents undergoing cancer treatment frequently experience a combination of physical symptoms and psychosocial stressors that negatively affect their emotional well-being, anxiety levels, and ability to regulate emotions. Difficulties in emotion regulation may intensify perceived symptom burden and interfere with treatment adherence and overall quality of life. Art-based interventions offer developmentally appropriate, expressive, and non-invasive strategies to support emotional regulation in this population.
This study is designed as a single-blind, parallel-group randomized controlled trial to examine the effectiveness of an art-based emotion regulation program in adolescents receiving cancer treatment. The study will be conducted between January 30, 2026 and March30, 2027 at the Pediatric Hematology-Oncology units of Gazi University Health Application and Research Center and Etlik City Hospital.
A total of 60 adolescents aged 10-18 years who have been receiving cancer treatment for at least six months will be enrolled and randomly assigned to either the intervention group (n=30) or the control group (n=30). Stratified block randomization based on age and gender will be performed by an independent statistician using an online randomization tool. Outcome assessors will be blinded to group allocation.
The intervention group will participate in a 4-week art-based emotion regulation program consisting of progressive muscle relaxation exercises, emotion-color mapping activities, and gratitude mandala practices. During the first week, adolescents will receive a progressive muscle relaxation video and complete the first session together with the researcher. They will then be asked to practice the exercise at least twice weekly throughout the program. Emotion-color mapping activities will be conducted during weeks 1-3 to help adolescents visually express and monitor changes in emotional states and symptom intensity. In the second week, a gratitude mandala activity will be added to enhance awareness of positive emotions. Weekly follow-up discussions will be conducted to support engagement and reflection. In the fourth week, relaxation exercises will continue, emotion-color maps will be reviewed for change, and post-test assessments will be completed.
The control group will receive routine hospital care without any additional intervention. Both groups will complete the same assessment tools at baseline and at the end of the fourth week.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
盲法说明
Due to the nature of the art-based intervention, blinding of participants and intervention providers is not feasible. However, outcome assessors will be blinded to group allocation. Data collection and outcome assessments will be conducted by assessors who are not involved in the intervention delivery and are unaware of participants' group assignments to minimize assessment bias.
入排标准
- 年龄范围
- 10 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Inclusion Criteria for the Study:
- •Receiving cancer treatment for at least 6 months,
- •Aged between 10 and 18 years,
- •The participant and their parent/guardian consent to participate in the study and provide written informed consent.
排除标准
- •Those who have experienced a significant life event (death, relocation, etc.) unrelated to their illness in the last six months,
- •Those who have not received chemotherapy treatment,
- •Those in the terminal stage,
- •Those with a severe psychological diagnosis and taking medication
研究组 & 干预措施
Control Group
Received Standart Care
rt-Based Emotion Regulation Program
Received Art-Based Emotion Regulation Program
干预措施: Art-Based Emotion Regulation Program (Other)
结局指标
主要结局
State Anxiety Inventory for Children (SAIC)
时间窗: Baseline (pre-intervention) and immediately post-intervention (at the end of the 4-week intervention period).
The State Anxiety Inventory for Children (SAIC) was developed by Spielberger (1973) to assess situational anxiety levels in children and adolescents. The Turkish validity and reliability study was conducted by Özusta (1995). The scale consists of 40 items, including 20 items measuring state anxiety and 20 items measuring trait anxiety. In this study, only the State Anxiety subscale is used to evaluate the child's current feelings of anxiety. Total scores range from 20 to 60, with higher scores indicating higher anxiety levels. The original scale demonstrated Cronbach's alpha values between 0.78 and 0.81, while the Turkish version reported a Cronbach's alpha of 0.82 for the state anxiety subscale. The scale has been widely used among children and adolescents aged 9-18 years in Turkey.
Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA)
时间窗: Baseline (pre-intervention) and immediately post-intervention (at the end of the 4-week intervention period).
The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) was originally developed by Gullone and Taffe (2012) and adapted into Turkish by Tetik and Önder (2021). The scale is a self-report measure designed to assess differences in emotion regulation strategies among children aged 10-18 years. It consists of 10 items and includes two subscales: Cognitive Reappraisal (6 items) and Expressive Suppression (4 items). Items are rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate more frequent use of the corresponding emotion regulation strategy. The Turkish version demonstrated good internal consistency, with Cronbach's alpha values of 0.83 for the reappraisal subscale and 0.75 for the suppression subscale.
Symptom Screening in Pediatrics Tool (SSPedi)
时间窗: Baseline (pre-intervention) and immediately post-intervention (at the end of the 4-week intervention period).
The Symptom Screening in Pediatrics Tool (SSPedi) is a validated instrument developed to assess symptom burden in children aged 8-18 years undergoing cancer treatment. The original validity and reliability study for the electronic version was conducted by O'Sullivan et al. (2018), reporting a Cronbach's alpha coefficient of 0.88. The tool evaluates 15 common symptoms experienced by children over the past two days, with each symptom rated using a 5-point Likert scale. Total scores range from 0 to 60, with higher scores indicating greater symptom burden and distress. The Turkish validity and reliability study was conducted by Çelik et al. (2021).
次要结局
未报告次要终点
研究者
Hazal Ozdemir Koyu
Dr. Research Assistant
Gazi University