The effectiveness of mandala drawing in reducing psychological symptoms, anxiety and depression in hospitalised adolescents with cancer: A randomised controlled trial

The Effect of Mandala Art Therapy on Anxiety, Mood, and Plasma Glucose Levels in Pregnant Women with Abnormal OGTT Values: A Randomized Controlled Study

BACKGROUND AND PURPOSE

Mandala is recognized as an art therapy that provides psychological support and healing. This study aimed to determine the effects of mandala art therapy on blood glucose levels, mood, and anxiety in pregnant women with abnormal oral glucose tolerance test (OGTT) values.

MATERIALS AND METHODS

This experimental study, designed as a pre-test post-test control group trial, was conducted in a public hospital in eastern Türkiye. The study involved 68 pregnant women (intervention group=34, control group=34). In the intervention group, the pregnant women received mandala art therapy twice: once at 0 hour after fasting plasma glucose (FPG) and once at 1 hour after plasma glucose (PG). Data collection tools included a Personal Information Form, the State-Trait Anxiety Inventory (STAI), and the Brief Mood Introspection Scale (BMIS), while glucose levels were obtained from patient records. Statistical analysis included frequency, percentage, mean, standard deviation,chi-square test, independent samples t-test, paired t-test, and ANCOVA.

RESULTS

Following the intervention, pregnant women in the intervention group had significantly lower post-test STAI total and BMIS-negative mood subscale mean scores compared to those in the control group (p<0.05). Additionally, those in the intervention group scored higher on the positive mood and overall mood subscales of BMIS compared to those in the control group (p<0.05). There was no statistically significant difference between the groups' FPG(0-hour), PG(1-hour), and PG(2-hour) measurements (p>0.05).

CONCLUSION

Mandala art therapy was found to reduce anxiety and negative mood while positively affecting positive mood and overall emotional well-being in pregnant women with abnormal OGTT values.

The effect of the art therapy interventions to alleviate depression symptoms among children and adolescents: a systematic review and meta-analysis

BACKGROUND

Existing systematic reviews provide evidence that art therapy is an effective intervention for reducing symptoms of depression in children and adolescents. This study aims to systematically review and quantify the impact of art-based interventions on depressive symptoms in this demographic through meta-analysis.

METHOD

A systematic search of databases and journals identified eligible studies for inclusion in a meta-analysis examining the efficacy of art therapy interventions on depressive symptom reduction. A random-effects meta-analysis was conducted using the Standardized Mean Difference (SMD).

RESULTS

The meta-analysis of twelve (randomized) controlled trials revealed a significant effect (SMD = -0.72; 95 % CI [-1.28, -0.16], p = 0.01), indicating that children and adolescents (n = 333) who received art therapy experienced a more significant reduction in depressive symptoms compared to those (n = 344) in the control groups.

LIMITATIONS

The existing evidence is limited to studies with low statistical power and methodological quality. Furthermore, the included studies were highly heterogeneous in terms of the intervention type, measurement tools, participant samples, and study designs.

CONCLUSIONS

The findings suggest that art-based interventions can be effective in reducing depressive symptoms in children and adolescents. However, future research requires more methodologically rigorous and well-controlled studies to strengthen the evidence base.

Efficacy of Traditional, Complementary, and Integrative Medicine in Pain and Psychological Distress Management for Pediatric Palliative Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

CONTEXT

Traditional, complementary, and integrative medicine (TCIM) is being increasingly used to manage symptoms in patients with palliative needs. However, there is a lack of evidence to guide its use in the pediatric palliative care (PPC) setting.

OBJECTIVES

This study aimed to synthesize and evaluate the current evidence on the effectiveness of TCIM in reducing pain and psychological distress in PPC.

METHODS

Four English electronic databases were searched for randomized controlled trials (RCTs) published between January 2000 and August 2023. The standardized mean difference (SMD) was used to report the pooled magnitude of the treatment effect. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the evidence for each treatment outcome.

RESULTS

Thirty RCTs were included. The interventions were massage (n = 9), music therapy (n = 6), hypnosis (n = 3), acupuncture, aromatherapy, and other TCIM modalities. Compared with the control interventions, music therapy significantly decreased pain (SMD: -1.07; 95% CI: -1.64 to -0.50; P< 0.05; I2 = 72%) and relieved anxiety (SMD: -0.75; 95% CI: -1.35 to -0.15; P< 0.05; I2 = 74%); massage significantly decreased pain (SMD: -0.74; 95% CI: -1.46 to -0.02; P< 0.05; I2 = 83%) and relieved anxiety (SMD: -0.61; 95% CI: -1.21 to -0.01; P< 0.05; I2 = 71%). Hypnosis had significant effects on procedure-related anxiety, pain, and behavioral distress management (P< 0.05). The quality of evidence was rated as "moderate" for the efficacy of music therapy in alleviating pain and anxiety and "low" for the efficacy of all of the other interventions.

CONCLUSIONS

Existing evidence supports the therapeutic benefits of music therapy, massage, and hypnosis on relieving pain and anxiety symptoms in the PPC setting, though the evidence is of low-to-moderate quality.

Effects of art therapy on psychological outcomes among children and adolescents with cancer: a systematic review and meta-analysis

BACKGROUND

The increasingly rising incidence of cancer among children and adolescents has led to notable psychological challenges for this population. Art therapy, classified within the realm of complementary and alternative medicine interventions and psychotherapy, demonstrates promising potential psychological benefits for children and adolescents. Therefore, a systematic review was conducted to determine the effects of art therapy on improving psychological outcomes among patients with pediatric cancer and identify the details of art therapy.

METHOD

A systematic review and meta-analysis was conducted. Ten English language databases, two Chinese databases, and grey literature were searched. Two researchers independently conducted study selection, quality assessment and data extraction. The Generic inverse variance method with random-effects models was applied to do meta-analysis.

RESULTS

Three randomized controlled trials (RCTs) and five quasi-experimental studies with acceptable quality involving 452 participants from five countries were included. Our meta-analysis revealed statistically significant improvement in anxiety, depression among pediatric cancer patients. Narrative findings suggested art therapy could improve the overall psychological symptoms, stress, and anger.

CONCLUSION

Art therapy can positively improve psychological outcomes, particularly anxiety and depression. However, the evidence is weakened by limited studies and methodological heterogeneity. Additional high-quality RCTs with large samples are warranted to confirm and supplement the existing evidence.

TRIAL REGISTRATION

This review was registered in PROSPERO with ID CRD42023477700 on 11 November 2023.

Comparing the effectiveness of mandala art and value clarification on the anxiety and emotional state of parents of children with cancer: A randomized controlled trial

PURPOSE

The study aims to compare the effectiveness of mandala art and value clarification practices based on Watson's Theory of Human Caring on the anxiety and emotional state of parents of children with cancer.

METHODS

The study was conducted as a randomized controlled trial and included parents of children being treated for cancer at the Pediatric Hematology and Oncology Clinic of a university hospital. The sample of the study is three groups; it consisted of a total of 75 people as mandala group (n:25), value clarification group (n:25) and control group (n:25). The mandala group participated in 2 sessions of individual mandala art accompanied by music. Value clarification group participated in the value clarification activity in 2 sessions of individual writing accompanied by music. For the pre-test data, the Personal Information Form, State Anxiety Inventory (SAI), and Positive-Negative Affect Scale (PANAS) were administered to both groups before the first session. After the second session, the same two scales were used again for the post-test data. The analyses of data were carried out with the Statistical Package for the Social Sciences software (version 23.0, SPSS Inc.). Chi-squared tests, t-tests, and one-way ANOVA were used to analyze the differences in the mean scores between the groups.

RESULTS

The parents' average age was 36.2 years (SD = 7.40), with 92.0% being female. The SAI score and PANAS negative emotion score of the mandala and value clarification groups decreased significantly compared to the control group, and the PANAS positive emotion score increased significantly (p < 0.05). However, when comparing the mandala group with the value clarification group, no statistically significant differences were found in the mean SAI and PANAS scores (p > 0.05).

CONCLUSION

The individual mandala art and writing value clarification interventions based on Watson's Theory of Human Caring are effective in increasing positive emotions and reducing negative emotions and anxiety levels among parents of children with cancer.

Intervention and application of drawing therapy in cancer patients: a scoping review

BACKGROUND

Cancer itself and its treatment process cause a range of physical and psychological discomforts to patients. Drawing therapy, as a form of complementary alternative medicine, has been proven to be effective in alleviating the physical and psychological discomforts of cancer patients, such as chemotherapy-associated nausea and vomiting, and negative emotions such as anxiety and depression.

OBJECTIVE

This scoping review aims to organize and describe the literature on drawing therapy in cancer patients, including implementers, intervention methods, and effects. It strives to provide a reference for future research on this topic.

METHODS

The methodological framework proposed by Joanna Briggs Institute (JBI) was used to guide the scoping review. PubMed, Web of Science, Embase, Medline, Cochrane, CNKI, Wanfang, VIP, and CBM databases were searched from inception until October 31, 2023. Literature screening, information extraction, and cross-checking were conducted independently by two researchers with experience in evidence-based nursing. The inclusion criteria were all peer-reviewed published studies on drawing therapy in cancer patients. The exclusion criteria were studies in which participants were primary caregivers of cancer patients, studies without full text, and articles published in languages other than Chinese or English. Information extraction mainly included basic information about the literature, sample information, intervention methods, and outcome indicators.

RESULTS

3318 literature were initially obtained after searching, of which 30 were finally included. Among them, 19 were in English and 11 were in Chinese. The study identified variations in the implementers and intervention methods of drawing therapy across different countries. Drawing therapy significantly alleviated symptoms caused by the disease and treatment, such as pain, fatigue, and chemotherapy-induced nausea and vomiting, while also assisting patients in coping with anxiety and fear. Additionally, drawing therapy bolstered social adaptability and skills. Consequently, drawing therapy improved cancer patients' overall quality of life.

CONCLUSIONS AND SUGGESTIONS

Drawing therapy demonstrates positive effects in cancer patients. Future studies should consider extending the intervention period to obtain more lasting effects and improving the evaluation system to ensure the accuracy and comprehensiveness of the assessment. From a clinical application perspective, interdisciplinary collaboration between nurses and art therapists to implement drawing therapy can promote professionalism and comprehensiveness in the implementation process.

The effect of drama on psychosocial problems and emotional states of hospitalized children with cancer

BACKGROUND AND PURPOSE

Hospitalization is a traumatic experience for children. Especially in the case of childhood cancers that require long-term hospitalization, children need psychosocial support. The study aimed to examine the effectiveness of drama in reducing psychosocial problems in hospitalized paediatric children diagnosed with cancer.

METHODS

The study used a mixed method approach, combining both qualitative and quantitative methods with a single group. Drama sessions prepared according to the Tasks and Skills Model were used to support their psychosocial conditions. The Facial Expression Form, The Assessment Scale for Psychosocial Symptoms in Hospitalized Children, and the Drawing and Writing Technique were used before and after the drama sessions.

RESULTS

This study differs from others in its use of drama intervention to reduce psychosocial problems in children undergoing cancer treatment. As a result of the study, it was found that there was a decrease in anxiety, hopelessness, anger-aggression and communication difficulties among psychosocial problems and a change in mood towards feeling happy. The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients.

CONCLUSION

The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients.

PRACTICE IMPLICATIONS

Applying drama to children undergoing long-term hospital treatment can help alleviate psychosocial problems by reducing stress, emotional suppression, and compensating for trauma.

Spiritual Interventions Among Pediatric Patients With Cancer: A Systematic Review And Meta-Analysis

CONTEXT

Although spiritual intervention is crucial in the care of childhood cancer patients (CCPs), its effectiveness has not yet been systematically evaluated.

OBJECTIVES

To determine the effectiveness of existing spiritual interventions on psychological, spiritual outcomes, and quality of life (QoL) in CCPs.

METHODS

We searched eight databases to identify relevant randomized controlled trials and quasi-experimental studies. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials. Results were either synthesized in a systematic narrative synthesis or a meta-analysis using a random effects model, where appropriate. The pooled treatment effect was estimated using the standardized mean difference (SMD) and 95% confidence interval (CI).

RESULTS

Twelve studies with 576 CCPs were included. Eight studies showed a high risk of bias. The overall effect of existing spiritual interventions on QoL (Z = 1.05, SMD = 0.64, 95%CI = -0.15 to 1.83, P = 0.29), anxiety (Z = 1.11, SMD = -0.83, 95%CI = -2.30 to 0.64, P = 0.28) and depressive symptoms (Z = 1.06, SMD = -0.49, 95%CI = -1.40 to 0.42, P = 0.12) were statistically nonsignificant. The nonsignificant findings could be attributed to the high heterogeneity among the included studies (QoL: I2 = 85%; anxiety: I2 = 90%; depressive symptoms: I2 = 58%).

CONCLUSION

Evidence to support the positive effects of existing spiritual interventions on psychological and spiritual outcomes and QoL in CCPs is insufficient. Future studies should adopt a more rigorous design and unify the outcome measures to reduce the risk of bias and heterogeneity, respectively.

Unravelling the role of mind-body therapies in paediatric palliative care: A narrative review

AIM

Given the multifaceted nature of paediatric palliative care (PPC), integrative medicine and mind-body therapies, in particular, are increasingly used in this setting. However, to our knowledge, their use in PPC has never been specifically reviewed. Therefore, this work aims to provide a comprehensive overview of the application and possible beneficial effects of mind-body therapies in the PPC setting.

METHODS

Papers about the use of meditation and mindfulness, biofeedback, hypnosis, yoga, tai chi and qi gong, imagery, creative outlets, and art therapy in PPC were identified by browsing PubMed and CINHAL.

RESULTS

We found that the harmless nature of mind-body therapies has been extensively described, and available studies consistently show some benefits on the anxiety, stress, and quality of life of parents/caregivers and healthcare providers. However, well-grounded and robust evidence does not fully support the efficacy of mind-body therapies, especially in patients.

CONCLUSION

Considering the peculiarity of the PPC setting, we suggest that mind-body therapies should be further considered and properly investigated through larger controlled studies and according to the different populations of PPC children, as well as for parents, caregivers, and healthcare professionals.

Effectiveness of Occupation-Based Nursing Program on Chemotherapy-Related Symptoms and Satisfaction Among Pediatric Oncology Patients: A Randomized Controlled Trial

OBJECTIVES

This study aimed to determine the effect of an occupation-based nursing program (OBaNuP) on chemotherapy-induced symptoms and satisfaction in pediatric oncology patients.

DATA SOURCES

This study was a randomized controlled trial. The study sample consisted of 60 hospitalized children with cancer who were aged 7 to 12. Participants were randomly assigned to an OBaNuP (intervention group, n = 30) or clinical routine care only (control group, n = 30). The intervention group participated in an OBaNuP for an average of 30 minutes per day for 5 days. The Memorial Symptom Assessment Scale 7-12 and Psychosocial Symptoms in Hospitalized Children and Child Satisfaction Questionnaire were completed by participants at baseline, the first meeting immediately after intervention, and 7 days and 14 days after the intervention.

CONCLUSION

The average scores of chemotherapy-related symptoms differed over time between the intervention and control groups (P < .05). The psychosocial symptom score averages of the children in the intervention group significantly decreased at all time points compared to the control group (P < .05). The satisfaction mean scores of the children in the intervention group increased significantly at all time points compared to the control group (P < .05).

IMPLICATIONS FOR NURSING PRACTICE

The OBaNuP initiative supported the decrease of chemotherapy-related and psychosocial symptoms, while also promoting an increase in satisfaction among children undergoing cancer treatment at the hospital consistently over all observed time periods.

Nothing less than a creative triumph: a study of children admitted to hospital for serious somatic illness or injury and their experience of art therapy

Background

Hospitalization can be an extremely distressing experience for seriously ill and injured children. Art therapy has a well-established clinical history, and recent research has begun to demonstrate its effectiveness in somatic pediatric wards. Descriptive and statistical research indicates that art therapy can alleviate anxiety and fear, improve mood, and enhance communication among children, parents, and healthcare professionals. This study aims to enhance our understanding of the specific elements of art therapy that facilitate a connection with the healthier aspects of the self.

Method

A total of 12 hospitalized children, aged 4-12, participated in an art therapy session led by a certified art therapist. Verbalizations during the sessions were recorded, and subsequent observations were synchronized with verbatim transcriptions of audio recordings. A reflexive thematic analysis was conducted to identify relevant patterns of meaning.

Findings

The study identified four significant dimensions of the children's experiences during art therapy: (1) The child feels safe, (2) The child becomes a competent artist, bursting with creativity, (3) The healthy child emerges, and (4) The child achieves something beyond its limits - a triumph.

Discussion

The active ingredients contributing to effective art therapy include the stimulation of creativity, guided art-making with scaffolding support, task variation, granting children control over the artistic process, encouragement of free expression, and the display of positive regard. This study also delves into the therapeutic alliance, emphasizing its role in facilitating children's learning, self-expression, concentration, and the creation of work they take pride in. Additionally, certain psychotherapy-like interactions, such as control-mastery dynamics, were observed. Nevertheless, more extensive research with larger sample sizes is required to draw broader conclusions.

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.

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.

A practical development protocol for evidence-based digital integrative arts therapy content in public mental health services: digital transformation of mandala art therapy

Introduction

The fundamentals of digital transformation include the conversion of the traditional method into a digital format to develop a standardized system that collects, analyzes, and processes quantitative data. This study aims to provide a comprehensive understanding of the development process and key elements of evidence-based digital integrative arts therapy.

Methods

The "Digital Mandala" service in the "Mental Health App" produced as part of a national public mental health project for personalized depression management is adopted to explain how to convert the existing mandala art therapy into digital format. A living lab approach has been applied, which can be used to address the nation's mental health challenges by promoting collaboration, innovation, and evidence-based solutions.

Results

Evidence-based digital content requires evidence that covers the structural process, the effects of existing methods, and the components and meanings of each detailed scene. In this section, we provide five stages of the development process, including preliminary research, design, development, commercialization, and advancement. Consequently, clinical elements, integrative arts therapy features, and data factors are defined as the key principles of evidence-based digital integrative arts therapy.

Discussion

Based on the data factors found in this study, it will be possible to create an evaluation dataset of digital integrative arts therapy content for managing depression. Additionally, the large-scale public data can be analyzed through artificial intelligence technology, which is expected to be used as a basis for deriving significant results in a new form, going further than the existing evaluation method. This research is significant because it establishes the foundation for digital transformation in the field of art therapy for public mental health services and investigates its potential.

Psychoneuroimmunological Markers of Psychological Intervention in Pediatric Cancer: A Systematic Review and New Integrative Model

PURPOSE

Pediatric cancer is a serious problem and still becomes a global challenge today. Various complex stressors due to diagnosis, disease symptoms, and various side-effects from the treatment that children with cancer undergo will cause problems in the child's psychoneuroimmunological aspects. Psychological interventions designed to modulate the stress response include psychoneuroimmunological markers. Unfortunately, there is little evidence to support the effect of psychological interventions on psychoneuroimmunological markers. This systematic review aims to assess the effectiveness of psychological interventions on psychoneuroimmunological markers in children with cancer and to provide a new integrative model for further research.

METHODS

This systematic review uses four main databases (Scopus, PubMed, ScienceDirect, and ProQuest). The guideline used Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Selecting articles used the Rayyan application. The quality study was conducted using Joanna Briggs Institute (JBI)'s critical appraisal tools. The data were analyzed using the population, intervention, comparison, outcome, and study design (PICO) Synthesis based on similarities and differences in study characteristics to interpret the results.

RESULTS

The search results in this systematic review found 1653 articles, 21 of which matched the predetermined inclusion and exclusion criteria. Most of the designs used were randomized controlled trials (57.1%). Massage therapy was the most common type of psychological intervention (14.2%). Almost half of the studies measured psychological responses (38.0%), and psycho-physiological responses (42.9%), and only a small proportion assessed the effectiveness of psychological interventions on neuroimmunological markers in pediatric cancer.

CONCLUSIONS

We recommend the use of psychological interventions as an additional intervention in managing psychoneuroimmunological markers of pediatric cancer. This study offers a new integrative model demonstrating the interaction between stress and psychological intervention involving neuroendocrine and immune mechanisms. However, future researchers need to test all domains of these new integrative models. This will reveal the complex interactions among these components and understand their relevance to health outcomes.

Reducing anxiety and improving self-acceptance in children and adolescents with osteosarcoma through group drawing art therapy

Purpose

This study explored the effect of group drawing art therapy (GDAT) on anxiety and self-acceptance in children and adolescents with osteosarcoma.

Methods

Using a randomized experimental study design, 40 children and adolescents with osteosarcoma who were treated in our hospital from December 2021 to December 2022 were selected as the research objects, including 20 in the intervention group and 20 in the control group. The control group received routine care for osteosarcoma, while the intervention group participated in eight sessions of GDAT, twice a week, 90-100 min each, in addition to routine care for osteosarcoma. A screening for children's anxiety disorders (SCARED) and a self-acceptance questionnaire (SAQ) were used to evaluate the patients before and after the intervention.

Results

After 8 weeks of GDAT, the SCARED total score in the intervention group was 11.30 ± 8.603, and that in the control group was 22.10 ± 11.534. The difference between the two groups was statistically significant (t = -3.357, P < 0.05). In the intervention group, the SAQ total score was 48.25 ± 4.204, with self-acceptance and self-evaluation factor scores of 24.40 ± 2.521 and 23.85 ± 2.434, respectively. In the control group, the SAQ total score was 42.20 ± 4.047; the self-acceptance factor score was 21.20 ± 3.350 and that of the self-evaluation factor was 21.00 ± 2.224. The differences between the two groups were statistically significant (t = 4.637, P < 0.001; t = 3.413, P < 0.05; t = 3.866, P < 0.001, respectively).

Conclusion

Group drawing art therapy can reduce anxiety and improve the levels of self-acceptance and self-evaluation in children and adolescents with osteosarcoma.

The effect of mindfulness-based mandala activity on anxiety and spiritual well-being levels of senior nursing students: A randomized controlled study

PURPOSE

This study aimed to determine the effectiveness of mindfulness-based mandala activity on the anxiety levels and spiritual well-being of nursing students who started clinical practice after distance education during COVID-19 period.

DESIGN AND METHODS

This study is a randomized controlled study employing a pre-/posttest design with a single-blind, parallel group. The study was completed with a total of 170 participants (n = 84, intervention group; n = 86, control group). Data were collected using the Descriptive Characteristics Form, State-trait Anxiety Inventory, Spirituality Well-Being Scale, and Scale of Positive and Negative Experience. The intervention group participated in three mindfulness-based mandala sessions. This study was registered with ClinicalTrials.gov as NCT05053178.

FINDINGS

In three sessions, there was a significant decrease in the intervention group compared with the control group regarding the mean values of pretest and posttest anxiety levels. Evaluation of the mean scores Spiritual Well-Being Scale before and after the intervention showed a significant decrease in the scores between groups (p < 0.05).

PRACTICE IMPLICATIONS

With mindfulness-based mandala activity, the well-being of nursing students can be increased.

The effect of a peer-assisted video-based training programme and counselling to reduce anxiety in children newly diagnosed with cancer: Non-randomised controlled trial

OBJECTIVE

The aim of this study is to evaluate the effect of 'peer-assisted video-based education programme' (VTPA) and counselling to reduce anxiety in children newly diagnosed with cancer.

METHODS

A non-randomised controlled trial design with repeated measures was conducted. The sample of the study consisted of 50 children between the ages of 9 and 18 who were newly diagnosed with cancer in the hospital. Intervention and control groups were created. Children in the intervention group received both VTPA training and counselling practice 3 days a week for 2 months. Data were collected with the State-Trait Anxiety Inventory for Children. The basal assessment in the research was the first meeting with the child, with interval assessments 1 month after, 2 months after and 3 months after the education.

RESULTS

In the study, it was determined that the state anxiety mean scores of the children in the PAVEP and control groups differed over time (p < 0.05). However, it was determined that there was no difference between the trait anxiety mean scores of the children (p > 0.05).

CONCLUSION

VTPA with peer assistance and counselling application supported the reduction of state anxiety in children newly diagnosed with cancer over time.