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- MakaleYalnız künye2026Effects of a puppet-assisted house-tree-person test on fear and anxiety in children receiving chemotherapy and associated influencing factors: A projective, quasi-experimental study
KAHRIMAN, Ilknur; AKSOY, Bahar; KANDAZ, Ufuk; BORAN, Serpil; GÖGER, Berrin; KIRBAŞ, Zila Özlem
Objectives This study investigated the effect of the puppet-assisted House-Tree-Person Test (HTP-T) on fear and anxiety levels in children undergoing chemotherapy treatment and the factors influencing these outcomes. Methods The study employed a one-group pretest–posttest quasi-experimental design combined with HTP-T analysis. The study was conducted with 29 children aged 5–12 years receiving chemotherapy at the pediatric hematology-oncology outpatient clinics of a university hospital in the Eastern Black Sea Region of Türkiye during the 2022–2024 years. Data were collected using “the Demographic Information Form for Children and Parents, the Children's State Anxiety Scale (CSA), the Children's Fear Scale (CFS), and HTP-T". Data analysis was performed using descriptive statistics, repeated measures ANOVA, and HTP-T analysis. Results Statistically significant differences were observed in children's mean CSA (F = 3.898, p = 0.026, η2 = 0.122) and CFS (F = 5.313, p = 0.008, η2 = 0.159) scores across the pre-treatment, during-treatment, and post-treatment measurements. The HTP-T analysis revealed that children had difficulty regulating anxiety and fear, expressed concerns about family and environmental events, reported feelings of loneliness, and exhibited strong emotional attachment to their families. Conclusion The study demonstrated that incorporating puppet-assisted HTP-T during chemotherapy contributed to reducing children's fear and anxiety and offered a useful approach for identifying influencing factors. Implications for nursing practice HTP-T, a therapeutic play technique incorporating puppetry and projective methods, may be effective in reducing fear and anxiety among children undergoing chemotherapy.
- Derleme MakaleAçık Erişim2023“Who am I?” A qualitative meta-synthesis of Chemotherapy‐induced alopecia and body image perception in breast cancer patients
Kocan, Sema; Aktug, Cemile; Gursoy, Ayla
Background: Since alopecia may be the first physical evidence and sign of cancer diagnosis and treatment, it may have a more serious and challenging effect on a woman than the loss of breast tissue. Objective: The purpose of this study was to summarize the current qualitative research which explores the body image perceptions of breast cancer patients with chemotherapy-induced alopecia. Material and methods: We searched three electronic databases and reviewed studies from December 2011 to December 2021 for qualitative results analysing the experiences of women with breast cancer and chemotherapy-induced alopecia. The Joanna Briggs Institute critical (JBI) appraisal tool was used to assess the quality of the targeted studies. The Meta-synthesis process developed by Sandelowski and Barroso was used to collect and analyse the data. Results: We discovered two main and five sub-themes from the meta-synthesis findings of 11 qualitative studies involving 225 women. The main themes were “I am not comfortable in this body” and “Who am I?”. The first main theme revealed patients’ intense reactions to their hair loss: “I'm in emotional chaos”, “I am looking for a place to hide” and “I knew it and now I’m experiencing it”.The second main theme of “Who am I?” contained two sub-themes: “What did my hair take from my femininity when it was gone?” and “Will I lose my partner after my hair?”. Conclusion: Meta-synthesis provided an up-to-date and integrated interpretation of scientific results about the experiences of women with breast cancer, alopecia, and their body image perceptions. This interpretation will facilitate a more comprehensive understanding of the alopecia-body image relationship. Thus, the aim of the meta-synthesis results is that these will contribute to nurses’ understanding of how alopecia, although a temporary symptom, affects women's perceptions of body image.