The Role of Mandala Painting Before Surgery

NCT07109492 | Recruiting

• 1 other identifier: NÇ.AT
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Surgical interventions often cause significant anxiety and stress in patients during the preoperative period. In this study, it is aimed to determine the effect of mandala coloring, a non-pharmacological and art-based intervention, on reducing anxiety and stress levels in individuals scheduled for elective surgery. The universe of the study will consist of patients who will undergo elective surgery between June 2025 and June 2026 in the General Surgery Clinic of Istanbul Sultangazi Training and Research Hospital. Data will be collected using the Introductory Information Form, State Anxiety Inventory (STAI-S), Perceived Stress Scale (PSS), and Physiological Parameters Form (including blood pressure, pulse, respiration rate, and oxygen saturation). One day before surgery, patients who meet the inclusion criteria will be informed about the study and randomized into intervention and control groups using a random number table created with MS Excel software. Patients in the intervention group will perform a 20-minute mandala coloring activity in the preoperative waiting period. Before and after the application, participants' anxiety and stress levels will be evaluated with the STAI-S and PSS, and their physiological parameters will be recorded. Patients in the control group will receive standard preoperative care and will be evaluated at the same time points with the same tools, without any intervention. The study aims to provide evidence for the use of mandala coloring as a simple, low-cost, and effective nursing intervention to reduce preoperative anxiety and stress.

Conditions

Mandala Painting; Surgery; Nurse's Role

Outcome Measures

Primary Outcomes (2)

• The Effect of Mandala Painting on Anxiety

  State Anxiety Inventory: In this study, the "State Anxiety Inventory (STAI-I)" will be used before and after the mandala coloring to assess patients' situational anxiety. The inventory evaluates how individuals feel at a particular moment. It includes 20 items, each scored from 1 (Not at all) to 4 (Completely), reflecting the intensity of the emotion experienced. Items 1, 2, 5, 8, 10, 11, 15, 16, 19, and 20 are reverse scored. Total scores range from 20 to 80; higher scores indicate greater anxiety. Additionally, the "Trait Anxiety Inventory (STAI-II)" measures general anxiety independent of specific situations, using a similar 20-item structure with frequency-based responses. The full inventory contains 40 items. High scores on either scale indicate higher anxiety levels. This validated tool enables objective pre- and post-intervention comparison of anxiety states in clinical settings.

  12 month

• The Effect of Mandala Painting on Stress

  Perceived Stress Scale (PSS) This scale measures the extent to which a person subjectively perceives certain situations as stressful.The scale is a 5-point Likert format (0 = never; 4 = always) and consists of 4 questions for the positive dimension and 6 questions for the negative dimension. Scores obtained from the scale range from 0 to 40, with scores between 27 and 40 indicating perceived high levels of stress, scores between 14 and 26 indicating perceived moderate levels of stress, and scores between 0 and 13 indicating perceived low levels of stress. Translated with DeepL.com (free version) The patient will answer PSS questions before and after the mandala coloring.

  12 month

Study Arms (2)

Mandala painting

EXPERIMENTAL

Pre-surgery (Before Mandala Painting) Pre-surgery (After Mandala Painting - 20 minutes later)

Other: Mandala

Standard care

NO INTERVENTION

Since standard care will be applied to the patients in this group, in order to be parallel with the mandala group, the relevant scale questions will be answered by interviewing the patient 20 minutes before and after going to the operating room.

Interventions

Mandala OTHER

Mandala Painting

Mandala painting

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Individuals who are undergoing elective surgery,
• Cholecystectomy Surgery is planned
• Age 18 and over,
• Able to communicate,
• No wounds or injuries on their hands that would prevent them from painting,
• Volunteer to participate in the study.

You may not qualify if:

• Individuals with a previous psychiatric diagnosis,
• Those with color blindness or visual perception disorders, Patients over 70 years of age
• Those taking tranquilizers (anxiolytics, antidepressants, etc.),
• Those with any health problems that may prevent them from painting (fractures, amputations, etc.),
• Those who are illiterate,
• Those with communication disabilities will be excluded from the study.

Sponsors & Collaborators

• Niran Çoban: lead

Study Sites (1)

Niran Çoban

Yalova, 77000, Turkey (Türkiye)

RECRUITING

Related Publications (6)

• Mavridou P, Dimitriou V, Manataki A, Arnaoutoglou E, Papadopoulos G. Patient's anxiety and fear of anesthesia: effect of gender, age, education, and previous experience of anesthesia. A survey of 400 patients. J Anesth. 2013 Feb;27(1):104-8. doi: 10.1007/s00540-012-1460-0. Epub 2012 Aug 3.

  PMID: 22864564 BACKGROUND

• Mitchell M. General anaesthesia and day-case patient anxiety. J Adv Nurs. 2010 May;66(5):1059-71. doi: 10.1111/j.1365-2648.2010.05266.x. Epub 2010 Mar 9.

  PMID: 20337788 BACKGROUND

• Curry, N. A., & Kasser, T. (2005). Can coloring mandalas reduce anxiety? Art Therapy, 22(2), 81-85. https://doi.org/10.1080/07421656.2005.10129441

  BACKGROUND

• Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Adamatti LC, Bandeira D, Ferreira MB. Risk factors for postoperative anxiety in adults. Anaesthesia. 2001 Aug;56(8):720-8. doi: 10.1046/j.1365-2044.2001.01842.x.

  PMID: 11493233 BACKGROUND

• Baran, T., & Demirtaş, A. (2022). Mandala boyama etkinliğinin stresle baş etme ve dikkat düzeyine etkisi. Psikoloji Çalışmaları Dergisi, 42(2), 77-91

  BACKGROUND

• Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.

  BACKGROUND

Study Officials

• NİRAN ÇOBAN

  University of Yalova

  STUDY DIRECTOR

Central Study Contacts

NİRAN ÇOBAN

CONTACT

05301586912; nirancoban@gmail.com

Aleyna TOPAL

CONTACT

05386616733; aleynaatopal15@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Asst.Prof.

Study Record Dates

• First Submitted: July 31, 2025
• First Posted: August 7, 2025
• Study Start: July 1, 2025
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: November 28, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)