17th Dec 2023

Introduction: During childhood cancer treatment, there are many pressures on the family unit detrimentally impacting the time spent together. Free (leisure)-time physical activities are fun, non-competitive, increase physical ability self-efficacy, and, during a child’s cancer treatment, are more accessible for all. The aim of this study was to engage the whole family to hear their experiences of family free-time activities, pre and post their child’s cancer diagnosis, whilst on treatment.
Methods: Individual focus groups with three families of childhood cancer survivors were conducted using participatory methods, including a write-draw-show-tell activity and vignettes, to explore experiences of and suggestions for family-based activities pre and post-diagnosis. Focus groups were recorded, transcribed, and analysed inductively using reflexive thematic analysis.
Results: At all times, key barriers for family-based, free-time activities were weather, emotions, and illness. Enabling factors were play, involving others (friends, family, and animals), and visiting new places especially on holidays. During treatment, themes for family activities were disruptions to family life, the importance of family time, and the centrality of hospital in their now, medicalised lives. Sub-themes that flow though these themes are nature, modifying activities, maintaining ‘normality’, isolation and enforced separation.
Conclusions: The themes highlighted two contrasting experiences for families which represented: a) isolation and enforced separation, b) enhancing family connections during time together when the child is well enough, or the activity was modified. Hearing children’s voices alongside those of their parents through inclusive child-centred methodologies has facilitated the deeper exploration of family-based, leisure-time activities during treatment to inform intervention development to meet the needs of the whole family.