Integrative educational intervention to promote school continuity for hospitalized children with cancer in Indonesia: A quasi-experimental evaluation of hospital-based schooling supported by child-centered communication and therapeutic play

Objective: This study aimed to evaluate the effectiveness of an integrative educational intervention – combining hospital-based schooling programs, child-centered communication, and therapeutic play – on clinical, psychosocial, and educational outcomes among school-aged children with cancer. Materials and Methods: A quasi-experimental pre- and post-test control group design was conducted at the pediatric oncology unit of Rumah Sakit Islam Jemursari, Surabaya, Indonesia. Fifty-two hospitalized children aged 6–18 years were randomly assigned to an intervention group ( n = 26) or a control group ( n = 26). The intervention lasted 1 month and integrated hospital-based lessons aligned with the national curriculum, therapeutic play, and developmentally appropriate communication by trained staff. Outcomes included pain intensity (Wong–Baker FACES Scale), treatment adherence, quality of life (Pediatric Cancer Quality of Life-32 [PCQL-32]), anxiety (Revised Children’s Manifest Anxiety Scale), and literacy–numeracy performance. Data were analyzed using paired t -tests, ANCOVA, and Cohen’s d , with significance set at P < 0.05. Results: Compared with controls, the intervention group showed significant improvements in pain reduction ( P < 0.001), treatment adherence ( P < 0.001), and quality of life across all PCQL-32 domains ( P < 0.001). Anxiety levels decreased significantly ( P < 0.001), and academic performance in literacy and numeracy improved markedly ( P < 0.001). Conclusion: The integrative educational intervention effectively enhanced clinical recovery, psychosocial well-being, and academic continuity among hospitalized children with cancer, emphasizing the need to integrate hospital-based education and play-based communication into pediatric oncology care.