Drawing the Sacred: Visualizing Where Hope Lives in Hispanic Adolescent and Young Adult Cancer Survivorship

PURPOSE: Spirituality can shape coping and meaning-making for adolescents and young adults (AYAs) with cancer, but its expression is culturally situated and may not be fully captured through interviews alone. This study examined how Hispanic AYA cancer survivors represented spirituality and hope through participant-generated drawings. METHODS: This descriptive, arts-based qualitative inquiry was nested within a phenomenology-informed parent study. Ten Hispanic AYA cancer survivors completed semistructured interviews with a prospectively embedded electronic drawing activity. A board-certified art therapist conducted inductive visual thematic analysis of drawings alongside participants' explanations; candidate themes were reviewed through team discussion and compared with previously published narrative themes. RESULTS: Participants were 22-36 years old; seven were female and three were male, eight participants preferred to use the Spanish language, and two preferred to use the English language. Visual themes were Reliable Companionship, Religious Beliefs, and Safe Place and Containment. Participant-generated titles, explicit words and symbols, and verbal explanations anchored their interpretation. The visual dataset emphasized supportive spirituality and hope, although negative or ambiguous illness imagery also appeared. CONCLUSION: Participant-generated drawings offered an additional, participant-led way to examine spirituality, relationships, and place in this Hispanic AYA survivor sample. Visual methods may complement interviews when interpretation remains grounded in participants' own meanings and culturally sensitive questioning.