Investigation of the Benefits of Drawing and Coloring Art Activities for Female Breast Cancer Patients on Anxiety and Physiological Responses

Autor: LIN, LING-HUI, 林玲慧
Rok vydání: 2019
Druh dokumentu: 學位論文 ; thesis
Popis: 107
Background and objective: Breast cancer is well known as the most common cancer in women worldwide and the prevalence is still fairly high until now. The 5-year relative survival rate and recurrence rate after treatment are much better than others due to the prognosis and treatment modalities for early breast cancer improved greatly. However, a frequent and disabling symptom in breast cancer patients and survivors is anxiety which might worsen quality of life, elevate risk for severe depression, induce medical treatment failure, and influence clinical outcomes. To reduce the adverse effects caused by anticancer treatments, the complementary and alternative medicine (CAM) therapies were widely used to overcome the anxiety in female patients with breast cancer. Art therapies have been shown to decrease anxiety and especially the mandala drawings was proposed as qualified assessment tools for women with breast cancer. Therefore, the aim of this study was to investigate the potential effects of coloring art activities on reducing anxiety and affecting physiological responses in female breast cancer patients. Participants and methods: The pre-test post-test comparison group design was conducted in this project. Female breast cancer patients receiving chemotherapy at a metropolitan hospital in southern Taiwan were invited to participate. Subjects were excluded if they had brain metastases, dementia, severe mental disorder, or refuse to continue with the trial. After completing consent procedures, the applicants were randomly divided into three experimental groups: (1) coloring mandala group, (2) plaid group, and (3) free-form group; and a normal activity control group. In addition to the socio-demographic, degree of engagement in different artistic and cultural activities, perceived health status, previous therapeutic modalities and medication of the participants; the following physiological responses were also measured before, during, and after the study intervention: State-Trait Anxiety Inventory (STAI), blood pressure (diastolic blood pressure and systolic blood pressure), and heart rate. The anxiety induction in participants was by asking them to think about the time that they felt most fearful, and then writing for 4 minutes about that experience on a piece of unlined A4-sized paper. Regardless of whether they were assigned to any experimental group, all participants were instructed to color the paper in front of them for 20 minutes using the six colored pencils (red, orange, yellow, green, blue, and purple) provided by executor. SPSS 22.0 statistical software was used to analyze the data. Independent-Sample t test, One-way and two-way analysis of variance (ANOVA) were conducted to compare the scores of STAI and the physiological responses between the groups. Results: The study period from recruitment to completion was from February 2018 to April 2019. The mean age of the participants was 54.3 years. The mean total STAI score of the sample before anxiety was 41.3 ± 11.4 (meanSD), and it was higher after anxiety induction (46.2 ± 11.6). Result indicated that anxiety scores were significantly declined in the coloring mandala group (-11.3 ± 7.3, P=0.034 versus +3.8 ± 2.4 of the control group). There were no statistically significant differences between the groups with respect to the physiological responses. Conclusion: The present study found that coloring mandala activity could effectively reduce the anxiety level in participants. This finding enable us to understand the possibility of coloring art activities for reducing anxiety in breast cancer patients during receiving chemotherapies. Our study recommends that health care units could provide more innovative and effective information during policy decision-making process against anxiety in breast cancer patients. This finding also could be provided to female breast cancer patients as a safe nondrug remedy for anxiety and encourage them to engage mandalas drawing activities for relieving their adverse side effects.
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