Identifying symptoms using the drawings of 4-7 year olds with cancer.

Purpose: Symptom burden in children with cancer who are less than 8 years old is not well understood. Our research focuses on identifying how to structure a self-report instrument for younger children. Our aim was to describe how children with cancer, aged 4-7 years, express their symptoms through drawings.

Methods: Children were asked to make drawings of a day when they were "feeling bad or not good". Content of 18 children's drawings was analyzed.

Results: Four themes were established: physical symptoms, emotions, location and miscellaneous. Most of the drawings illustrated specific symptoms important to this age group, while also facilitating our understanding of how children with cancer view their symptoms.

Conclusion: Having children draw pictures may help initiate communication regarding how they feel, and develop rapport between the interviewer and children.