The effect of mandala activity on psychological symptoms and anxiety/depression level of adolescents receiving cancer treatment

Objective: It was aimed to determine the effect of individual mandala activity on adolescents receiving cancer treatment on psychological symptoms, anxiety and depression. Method: The research was conducted as a randomized controlled trial with adolescents aged 12-17 years who received cancer treatment at Akdeniz University Hospital Child Hematology and Oncology Clinic. ClinicalTrials.gov registered number: NCT04297982. Study data were collected between March 2019 and March 2020. In the sample selection, closed envelope system was used with simple randomization technique. The sample of the study consisted of 60 adolescents receiving cancer treatment, intervention group (n: 30) and control group (n: 30). The intervention group had 2 sessions mandala drawing activity with a minimum of 48 and a maximum of 72 hours with music. In the study, individual mandala activity was preferred. In each session, hospitalized adolescents was supported create a mandala. The Memorial Symptom Assessment Scale (MSAS-P) and Hospital Anxiety and Depression Scale (HADS) were administered to the intervention group first day and fifth day. Routine nursing care of the clinic was applied to the control group and the same scales were applied with the intervention group at five days intervals. Results: HADS and MSAS scores decreased across the pre-test and post-test in the intervention group (all p < 0.05). HADS and MSAS scores were significantly lesser for the intervention group than for the control group after mandala intervention (t=-3.103, p=0.003, η2=0.80; t=5.426, p=0.000, η2=1.40). No significant reduction in HADS and MSAS were obtained over time in the control group. Conclusion: Mandala activity was an effective method on reduction psychological symptoms, anxiety and depression levels in adolescents receiving cancer treatment.