Art and music therapy as a support post-chemotherapy pain management in children: a quasi-experimental study in Indonesia

Abstract

Background: Children with cancer undergoing chemotherapy often experience significant posttreatment pain, leading to both physical discomfort and psychological distress. Pharmacological treatment alone is often insufficient to manage this pain effectively. Non-pharmacological approaches such as art therapy and music therapy are increasingly considered as complementary strategies to enhance pain management and improve emotional well-being. However, studies directly comparing the effectiveness of these two methods remain limited. Methods: This quantitative, quasi-experimental study used a two-group pretest-posttest design at Dr. Moewardi General Hospital in Surakarta, Indonesia. A total of 44 children aged 6 to 12 years undergoing chemotherapy participated. Participants were recruited using convenience sampling and chose one of two interventions: the art therapy group engaged in 30 minutes of coloring, while the music therapy group listened to instrumental music for 10 minutes. Pain intensity was measured daily for seven consecutive days before and after the interventions using the Wong-Baker Faces Pain Scale-Revised. Data were analyzed using the Wilcoxon and Mann–Whitney tests. Results: Both therapies significantly reduced pain levels (p < 0.001; 95% CI: Art Therapy = 3.45– 4.55; Music Therapy = 2.67–3.41) from baseline to the final assessment on Day 7. The art therapy group showed an average decrease of 4.00 points, while the music therapy group had a decrease of 3.04 points. Although there was a numerical difference, statistical analysis showed no significant difference between the two groups (p = 0.342). Conclusion: Both art therapy and music therapy are effective in reducing post-chemotherapy pain in pediatric patients. These therapies provide safe, simple, and useful non-pharmacological options to support pain relief and enhance the emotional comfort of children undergoing cancer treatment.