Effectiveness of mandala coloring in reducing anxiety in women with early-stage breast cancer receiving chemotherapy for the first time

Akbulak F., CAN G.

EXPLORE-THE JOURNAL OF SCIENCE AND HEALING, vol.19, no.1, pp.42-47, 2023 (SCI-Expanded) identifier identifier identifier


Context: Many people with cancer experience fear or anxiety when starting chemotherapy for the first time. Mandala coloring is an art therapy approach commonly used for anti-stress therapy.Objective: To assess whether mandala coloring reduces the anxiety experienced by women with early-stage breast cancer during their first chemotherapy session.Design: A quasi-experimental controlled study with pretest/posttest design.Setting: The study was conducted in the outpatient chemotherapy unit of the Istanbul University Institute of Oncology between March 2017 and May 2018.Participants: Eight-four women with early-stage breast cancer who presented for their first session of chemo-therapy were included, 41 in the intervention group and 43 in the control group. Intervention: Patients in the intervention group were asked to color a mandala for 30 min while receiving pre-medication prior to chemotherapy. No intervention was applied to the control group.Main outcome measures: Levels of distress and anxiety were assessed before and after premedication using the distress thermometer and State-Trait Anxiety Inventory.Results: The sample group consisted primarily of women who had primary school education, were married, and were homemakers. Average distress levels were low in both the intervention and control group before pre-medication, and state anxiety scores did not differ statistically between the groups before or after premedication. However, patients in the intervention group who had high distress levels before premedication showed a sig-nificant decrease in state anxiety score after premedication, while patients in the control group showed no decrease.