The effect of a nursing program involving drawing/painting activities using a movable picture board on reducing anxiety in children undergoing chemotherapy

ABSTRACT Objective: This study aimed to evaluate the effectiveness of a nursing intervention program entitled ''Nursing Program Incorporating Drawing/Painting Activities with the Use of a Movable Picture Board (HAÇİBO-HP)'' in reducing anxiety levels among children aged 4 to 6 years undergoing chemotherapy. Methods: A quasi-experimental, single-group pretest-posttest design was employed. The study was conducted between July 2, 2024, and July 3, 2025, in the Pediatric Hematology and Oncology Clinic of Akdeniz University Hospital. The sample consisted of 30 children aged 4–6 who were receiving chemotherapy and met the inclusion criteria. The HAÇİBO-HP program was implemented over four days. On Day 1, children and their families were introduced to the study, provided with finger puppets, and completed the pretest. On Days 2 and 3, a theme was selected through guided interaction, and children created drawings on a movable picture board with the researcher. On Day 4, the posttest was administered following a final puppet-based interaction. Data were collected using the Child and Parent Information Form, the Children's Anxiety Scale–State Version (CAS-SV), and the Venham Picture Test (VPT). Data were analyzed using descriptive statistics and nonparametric tests including the Mann-Whitney U test, Kruskal-Wallis test, and Friedman test. Results: A statistically significant reduction in anxiety levels was observed in the posttest scores on both the CAS-SV and VPT following the intervention (p < .05). Conclusion: The HAÇİBO-HP program effectively reduced anxiety in young children undergoing chemotherapy. Creative, interactive nursing interventions such as this can serve as valuable tools in pediatric oncology settings. Keywords: anxiety, drawing/painting, pediatric nursing, chemotherapy, pediatric oncology, psychological support