Effect of Recreational Play Activities on Anxiety in Children Receiving Chemotherapy and Their Parents

January 16, 2026 updated by: Sule ŞENOL, Akdeniz University

The Effect of Recreational Play Activities on Anxiety Levels of Children Undergoing Chemotherapy and Their Parents: A Quasi-Experimental Study

Children receiving chemotherapy often experience high levels of anxiety, which may also affect their parents. Anxiety during treatment can negatively influence emotional well-being, treatment adherence, and overall quality of life. Non-pharmacological and supportive interventions, such as recreational play activities, may help reduce anxiety in pediatric patients and their caregivers.

The aim of this study is to evaluate the effect of recreational play activities on anxiety levels of children undergoing chemotherapy and their parents. The study was conducted using a quasi-experimental design in a pediatric oncology setting. Children receiving chemotherapy and their parents participated in structured recreational play activities in addition to routine care. Anxiety levels of both children and parents were assessed before and after the intervention using validated anxiety assessment tools.

The findings of this study are expected to contribute to evidence-based nursing practices by highlighting the potential benefits of recreational play activities as a supportive intervention to reduce anxiety in pediatric oncology patients and their parents.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study aimed to examine the effect of recreational play activities on anxiety levels of children undergoing chemotherapy and their parents. A quasi-experimental study design was used. The study was conducted in a pediatric oncology unit and included children receiving chemotherapy and their parents who met the inclusion criteria.

Participants were assigned to an intervention group that received structured recreational play activities in addition to routine care. Recreational play activities were planned according to the age and developmental level of the children and were implemented during chemotherapy sessions. The activities included age-appropriate games and play-based interactions designed to promote relaxation, emotional expression, and coping.

Anxiety levels of children and parents were assessed before and after the intervention using validated anxiety measurement scales. Demographic and clinical data were also collected. The primary outcome of the study was the change in anxiety levels of children and parents following participation in recreational play activities.

Ethical approval was obtained from the relevant Clinical Research Ethics Committee prior to the initiation of the study. Written informed consent was obtained from parents, and assent was obtained from children when appropriate. All study procedures were conducted in accordance with ethical principles and institutional guidelines.

The results of this study provide evidence on the effectiveness of recreational play activities as a non-pharmacological nursing intervention to reduce anxiety in pediatric oncology settings and support the integration of play-based approaches into routine clinical care.

Study Type

Interventional

Enrollment (Actual)

62

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Antalya, Turkey (Türkiye), 7090
        • Akdeniz University Hospital, Pediatric Oncology and Hematology Clinic

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Children aged 4-10 years receiving inpatient chemotherapy treatment in a pediatric oncology and hematology clinic;
  • Children and parents who agreed to participate in the study and provided written informed consent;
  • Children able to communicate verbally; parents who are able to read and write in Turkish.

Exclusion Criteria:

  • Children who experienced a significant life event unrelated to the disease within the last six months (such as parental divorce, death of a parent, or relocation);
  • Children receiving more than one chemotherapy cycle simultaneously;
  • Children in the terminal stage of the disease;
  • Children or parents who declined participation or withdrew before completion of the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Play-Based Intervention Group
Children and their parents received structured play-based supportive care activities in addition to routine chemotherapy care.
Behavioral: Play-Based Supportive Care Activities
Structured play-based supportive care activities were provided to children during chemotherapy sessions to reduce anxiety and pain and to support emotional coping. Parents accompanied the children during the activities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anxiety level of children undergoing chemotherapy
Time Frame: Baseline (before the intervention) and immediately after the intervention during the chemotherapy session
Children's anxiety was assessed using the Child Anxiety Scale-State (CAS-State), an age-appropriate visual analog scale designed for children aged 4-10 years. The scale ranges from 0 to 10, where higher scores indicate higher levels of state anxiety. Anxiety scores were recorded at baseline (before the play-based recreational activity intervention) and immediately after the intervention during the chemotherapy session.
Baseline (before the intervention) and immediately after the intervention during the chemotherapy session

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Parental anxiety level
Time Frame: Baseline (before the intervention) and immediately after the intervention during the chemotherapy session
Parental anxiety was assessed using the State Anxiety Inventory (STAI-I), a validated self-report questionnaire consisting of 20 items with total scores ranging from 20 to 80, where higher scores indicate higher levels of anxiety.
Baseline (before the intervention) and immediately after the intervention during the chemotherapy session

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Akdeniz University

Investigators

  • Principal Investigator: Şule Şenol, PhD, Akdeniz Üniversitesi Hemşirelik Fakültesi

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 15, 2024

Primary Completion (Actual)

May 7, 2025

Study Completion (Actual)

May 7, 2025

Study Registration Dates

First Submitted

January 9, 2026

First Submitted That Met QC Criteria

January 9, 2026

First Posted (Estimated)

January 16, 2026

Study Record Updates

Last Update Posted (Actual)

January 20, 2026

Last Update Submitted That Met QC Criteria

January 16, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 241 (University Clinical Research Ethics Committee (Turkey))

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to the inclusion of pediatric participants and the absence of specific consent for data sharing.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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