Practice Innovations

Creative Art Expression: Using Hand-Lettering Techniques to Reduce Stress and Anxiety in Patients With Cancer

Cindy Cao

Shanna D. Sullivan

Meghan L. Underhill-Blazey

patient anxiety, nurse–patient relationship, expressive art techniques, stress
CJON 2021, 25(1), 97-99. DOI: 10.1188/21.CJON.97-99

A creative art expression intervention using hand lettering was implemented on an outpatient oncology unit and evaluated for feasibility and its relationship with stress and anxiety in patients with cancer. Results suggest that a hand lettering intervention is feasible in this type of setting and may benefit patients experiencing stress and anxiety during outpatient treatment.


  • Hand lettering is a safe, low-cost, noninvasive, and nonpharmaceutical intervention to administer to outpatients with cancer.
  • Institutions may implement hand lettering to occupy patients with cancer while awaiting treatment.
  • Hand lettering as a creative art expression intervention has produced observed benefits for outpatients with cancer experiencing stress and anxiety.
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