Understanding the perceptions of children battling cancer about self and others through drawing

BACKGROUND: Childhood cancer is a stressful experience and may cause a change in the child's perception of himself/ herself, the family and the world around him/ her. AIMS: This study sought to (a) explore the self-perception of children; and (b) examine the relation of children with others. MATERIALS AND METHODS: The total population of the study consisted of all the children, undergoing cancer treatment at Children Cancer Hospital, located in Karachi. The participants were asked to draw a drawing on self and others. Through qualitative approach (phenomenology), themes and sub-themes were derived. RESULTS: Using purposive sampling, the total sample size drawn for this study was 78 children aged 7-12, receiving treatment for cancer (1st stage) at the Children Cancer Hospital, Karachi, Pakistan. The drawings of the children were categorized into facial expressions, self images and family ties. Within each category, there were sub-categories. Under facial expressions, the common emotions reflected were sadness, seriousness, anger; and pain. The self-image pictures uniformly reflected low self-esteem, especially focusing on hair loss, missing body parts. Under the category of family ties, most of the children's drawings reflected their isolation or emotional detachment from or abandonment by their family members. CONCLUSIONS: The study concludes that the self- image of most of the participants is deteriorated and they are socially isolated. Social and moral support can bring positive emotional development and helps to correct their self-perception.