Abstract / Summary
This study aimed to determine the levels of alexithymia and social anxiety in children with cancer, to examine the relationship between these constructs, and to identify psychosocial factors and selected clinical characteristics associated with social anxiety in pediatric oncology. This cross-sectional study was conducted in a pediatric hematology/oncology clinic (January–December 2025). Participants were 142 children aged 10–18 years diagnosed with cancer for ≥ 6 months. Data were collected using a sociodemographic form, the Children’s Alexithymia Scale, and the Social Anxiety Scale for Children. Correlation analyses (Pearson or Spearman, as appropriate to the distribution) and hierarchical multiple linear regression were performed. Age, gender, family type, and illness duration were entered in the first block, and total alexithymia was entered in the second block to examine its incremental contribution to social anxiety. Participants demonstrated moderate levels of alexithymia, while social anxiety scores were consistent with a moderate level of social anxiety. Social anxiety was positively associated with total alexithymia (rs = 0.233, p = .005), with the strongest association observed for difficulty identifying emotions (rs = 0.263, p = .002). After adjustment for age, gender, family type, and illness duration, total alexithymia remained independently associated with social anxiety (B = 0.678, p < .001). Illness duration and family type also contributed significantly to the model, which explained 20.8% of the variance in social anxiety (adjusted R² = 0.208). Social anxiety in children with cancer appears to be closely linked to emotional awareness and processing difficulties, particularly problems in identifying emotions. Total alexithymia, family type, and illness duration remained independently associated with social anxiety, highlighting the multidimensional psychosocial vulnerability experienced during the cancer trajectory. Routine assessment of alexithymia in pediatric oncology settings may help identify children at risk for social anxiety. Nursing-led interventions that support emotion recognition, emotional expression, and communication—while considering illness duration and family context—may contribute to improved psychosocial adjustment during prolonged cancer treatment.