Effects of art-based mandala intervention on distress and anxiety in cancer patients

A comparison between effects of sudoku and mandala painting on anxiety of breast cancer patients undergoing chemotherapy

Introduction

Once diagnosed with breast cancer, many women may experience psychological complications, such as anxiety. The grueling treatments that such patients may undergo, for example, chemotherapy, not only cause specific complications for them but also increase their anxiety level. A technique to manage these psychological consequences in patients with breast cancer is to play Sudoku or do Mandala painting.

Purpose

This study aimed to compare the effects of Sudoku and Mandala painting on the anxiety level of patients with breast cancer undergoing chemotherapy.

Methodology

This randomized clinical trial was conducted on 70 patients with breast cancer in Arak, Iran. The patients who met the inclusion criteria were selected through purposive sampling, and then they were assigned to one of the Mandala painting or Sudoku groups using block randomization. The data were collected using a demographics form and the Spielberger State-Trait Anxiety Inventory (STAI). All participants in both groups completed the research questionnaires before the intervention. The obtained data were analyzed using descriptive and inferential statistics in SPSS-26.

Results

The results indicated that there was a significant difference between the pre-test and post-test anxiety scores in both Sudoku and Mandala painting groups (P = 0.0001). The difference between the pre-test and post-test mean anxiety scores was 6.09 ± 4.02 in the Sudoku group and 48.93 ± 13.8 in the Mandala painting group. The results of the inter-group comparison also showed a significant difference between the two groups in post-test mean anxiety score (P = 0.0001), proving that Mandala painting was more effective in reducing the anxiety of patients.

Conclusion

Mandala painting was more effective than Sudoku in reducing the anxiety level of patients with breast cancer. It can be hence concluded that Mandala painting can be used as a relaxing art therapy technique in these patients.

Does Mandala Art Improve Psychological Well-Being in Patients? A Systematic Review

Objectives: Psychological disorders and symptoms are common and can significantly impair functioning in some areas in patients. We aimed to investigate the effects of mandala art (MA) on psychological well-being in patients. Design: A systematic review. Methods: We did a systematic review to assess the associations between MA and psychological well-being among patients. A systematic search of PubMed, EMBASE, Web of Science, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trial databases was conducted by independent reviewers from database inception to April 2023. We include randomized controlled trials, quasi-experimental studies, and qualitative studies. Outcome measures included any measurement of subjective and objective psychological well-being outcomes, such as stress, anxiety, depression, distress, mindfulness, hope, resilience, pain, mood, fatigue, and trauma symptoms. Results: Eleven studies of 405 participants were identified in the systematic review. Overall, the included studies provided preliminary evidence to suggest that MA may improve negative symptoms and hope, relieving pain, and reducing some physiological indicators of stress in patients. However, the quality of the existing evidence limited the generalization of results. Conclusions: According to the current evidence, the therapeutic benefits of using mandalas for improving the psychological well-being of patients are uncertain. More well-designed and high-quality studies in the field of MA are needed in the future.

The effect of mandala coloring on pregnancy-related anxiety

PURPOSE

In the literature, the efficacy of mandala coloring on pregnancy-related anxiety has been investigated, and no study has been found on its effect on anxiety. This randomized controlled trial was designed to assess the efficacy of mandala coloring application on pregnancy-related anxiety.

METHODS

The study included 77 primiparous pregnant women: 39 in the control group and 38 in the experimental group, and was carried out in an education-research hospital's obstetric clinic. Data for the study were gathered using Information Form, the Pregnancy-related Anxiety Scale, and the State Anxiety Inventory. While the experimental group did mandala coloring during a month twice in a week, and the control group was not do anything. The "Pregnancy-related Anxiety Scale" and "The State Anxiety Inventor" were used to assess anxiety in all groups before and after application. In the statistical analysis of the data, the SPSS 23.0 package program was used. In all tests, p < 0.005 was considered statistically significant.

RESULTS

Immediately post-intervention, the women in the experimental group had a significantly higher reduce pregnancy-related anxiety (p < 0.05). Especially in the mandala group within according to control group were found to have significantly reduced anxiety the application (PrAS-1 82,50 ± 2,47 vs. 84,41 ± 4,12; PrAS-2 77,92 ± 2,16 vs. 83,89 ± 3,80; PrAS-3 72,05 ± 3,97 vs. 84,10 ± 4,35; PrAS-Total 77,49 ± 5,21 vs. 84,13 ± 4,07; STAI-1 52,39 ± 2,50 vs. 51,17 ± 1,16; STAI-2 49,73 ± 0,75 vs. 49,05 ± 1,27; STAI-3 48,84 ± 3,17 vs. 49,02 ± 1,22; STAI-Total 50,32 ± 2,8 vs. 49,75 ± 1,58).

CONCLUSIONS

Mandala coloring is effective in reducing pregnancy-related anxiety.

CLINICAL TRIAL NUMBER

(NCT05534867).

Does Mandala Art Therapy Improve Psychological Well-Being of Gynecological Cancer Patients During the Perioperative Period? A Quasi-Experimental Study

BACKGROUND

Women with gynecological cancer often experience psychological distress, particularly in response to surgical procedures. The impact of mandala art therapy (MAT) during the perioperative period for gynecological cancer patients remains uncertain. We aimed to examine the effects of the MAT program in women with gynecological cancer.

METHODS

Employing a quasi-experimental design, we recruited 126 gynecological cancer patients from a university hospital through convenience sampling. Participants were assigned to either receive the MAT program or standard perioperative care. The interventions comprised a three-session MAT program guided by a team of trained mandala psychologists. Generalized estimating equations (GEE) were employed to analyze the effects of MAT over time.

RESULTS

A total of 126 patients were enrolled, and 118 completed the entire study. Over 90% of participants completed the perioperative MAT interventions, reporting relatively high satisfaction with the program (7.70 out of 10). Individuals in the MAT group exhibited improved therapeutic effects on STAI-S, VASS, and vital signs over time. Notably, significant group*time interaction effects were noted in STAI-S scores at both the first evaluation, T1 (β = -4.220, P < .005) and the third evaluation, T3 (β = -3.797, P < .05), and VASS scores at T1 (β = -11.186, P < .005), T2 (β = -9.915, P < .05) and T3 (β = -9.831, P < .05). Regarding vital signs, the multivariate GEE model revealed significant interaction effects in systolic blood pressure values at both T1 (β = -7.102, P < .05) and T3 (β = -10.051, P < .005), diastolic blood pressure values at T3 (β = -6.441, P < .005), and pulse values at T1 (β = -6.085, P < .005). No significant differences were observed between groups for pain, hope, or self-acceptance.

CONCLUSION

This study posited that MAT could serve as a valuable complementary approach in perioperative care for addressing the psychological needs of women with gynecological cancer. Subsequent research employing more robust methodologies and larger, more diverse participant samples will be necessary to validate these conclusions.

The effect of mandala colouring on anxiety in hospitalized COVID-19 patients: A randomized controlled clinical trial

COVID-19 significantly affects patients' mental health, triggering a wide range of psychological disorders, including anxiety. The aim of this study was to investigate the effect of mandala colouring on the anxiety of hospitalized COVID-19 patients. In this randomized controlled clinical trial, 70 hospitalized patients with COVID-19 were randomly divided between the intervention and control groups. Standard care was provided for both groups. The intervention group spent 30 min/day for six consecutive days performing mandala colouring. Patient anxiety was measured prior and subsequent to the intervention in both groups using the Spielberger State-Trait Anxiety Inventory. Data were analysed using SPSS software version 25. The mean anxiety score was not significantly different between the two groups before the intervention (P = 0.08). Subsequent to the intervention, the mean anxiety score in the intervention and control groups was 44.05 ± 4.67 and 67.85 ± 6.25, respectively, indicating a statistically significant (P = 0.0001) decrease in the anxiety measured among the intervention group as compared with that of the control group. The results of this study show that 30 min of mandala colouring daily is an effective strategy for reducing anxiety in hospitalized COVID-19 patients. Mandala colouring can complement routine treatment and provides a non-pharmaceutical option for decreasing patient anxiety.