Unveiling the Lessons Learned: A Metaphorical Qualitative Study of Adolescent's Experiences After a Cancer Diagnosis Through Photo Art.

Background: A cancer diagnosis during childhood profoundly alters a child's emotional, cognitive, and social world. Beyond medical treatment, the illness experience often becomes a source of deeply personal learning and transformation.

Aim: This study aimed to explore the emotional and cognitive insights adolescents gain following a cancer diagnosis, as well as how they interpret and express these learnings symbolically through metaphor and visual representation.

Method: A qualitative, interpretive research design was employed. Fifteen adolescents aged 10-18, undergoing cancer treatment in a pediatric oncology clinic, participated in two interviews. A semi-structured interview guide with four open-ended questions was used. In the first interview, adolescents were invited to imagine a symbolic image representing their learnings. In the second interview, face-to-face, in-dept interview was conducted and AI-generated visual prompts based on their metaphors were co-created. The data were analyzed using Braun and Clarke's six-phase thematic analysis.

Results: Three major themes emerged: (1) Balancing the Positive and Negative Aspects of Change, (2) Wisdom Through Hardship: Lessons and Insights from the Illness Journey, and (3) Transformation in Perspectives on Life and the Future. Adolescents expressed a wide range of emotional and cognitive shifts, including increased empathy, self-awareness, value formation, and future-oriented thinking. Metaphor analysis revealed symbolic representations of vulnerability, resilience, hope, and inner growth.

Conclusion: The study highlights the transformative potential of illness in childhood, emphasizing how adolescents construct meaning, adapt, and evolve through adversity. Incorporating adolescents's metaphorical and visual expressions could enrich psychosocial care practices and provide deeper insight into their inner worlds.