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

Abstract

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 chemotherapy 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 premedication 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 premedication, 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 significant decrease in state anxiety score after premedication, while patients in the control group showed no decrease.