"Holding Hope in Their Hands": Mothers' Meaning-Making Experiences of Handcraft-Based Art Therapy During Their Children's Cancer Treatment: An Art-based Phenomenological Qualitative Study.

OBJECTIVES: Mothers of children undergoing cancer treatment often carry intense emotional, relational, and existential burdens, while their own psychosocial needs remain largely unarticulated. Art-based interventions may offer unique pathways for meaning-making beyond verbal expression, yet little is known about how mothers experience and interpret such processes during their child's cancer trajectory. This study aimed to explore mothers' meaning-making experiences of a handcraft-based art therapy intervention during their children's pediatric cancer treatment. METHODS: An art-based phenomenological qualitative design was employed. Twelve mothers of children receiving active treatment in a pediatric oncology unit participated in the study. Data was generated through in-depth semi-structured interviews and participant-produced photographs documenting their handcraft processes and symbolic meanings. Interviews were conducted following the art-making experience and analyzed alongside visual data using interpretative phenomenological thematic analysis. RESULTS: Children had a mean age of 9.33 years, with the majority diagnosed with leukemia. Mothers had a mean age of 37.08 years. Five main themes emerged: (1) Holding emotional weight and hope through the hands, reflecting how tactile engagement enabled mothers to embody and transform emotional distress; (2) Reclaiming agency in an uncontrollable illness trajectory, where creating with their hands fostered a sense of control and intentionality; (3) Creating space for the self beyond caregiving and illness, highlighting moments of self-recognition and emotional respite; (4) Meaning-making within motherhood and relational bonds, emphasizing how art reinforced maternal identity and connection with the child; and (5) Unmet needs and expectations at the boundary of meaning, revealing limitations of existing psychosocial support and mothers' longing for sustained, mother-centered care. CONCLUSIONS: Handcraft-based art therapy may offer a meaningful supportive approach for mothers of children with cancer by helping them reflect on meaning, regulate difficult emotions, and reconnect with perceived inner strength. Integrating art-based, mother focused psychosocial interventions into pediatric oncology care can address unmet emotional needs and support mothers' well-being during treatment. IMPLICATIONS FOR NURSING PRACTICE: Integrating structured, handcraft-based art activities into routine pediatric oncology care may provide nurses with a practical, low-cost strategy to support mothers' emotional well-being and coping during their child's treatment.