Educational ProblemsMandalaNCT06695650
The Effect of Mandala Coloring Activity on Test Anxiety
A study testing Mandala Coloring in people with Educational Problems and Anxiety, run by Nursemin ÜNAL at 1 site in Turkey (Türkiye).
Trial summary
This study aims to investigate the effect of mandala coloring activity on test anxiety of nursing students. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Educational Problems, Anxiety, Test Anxiety
- What is being tested?
- Mandala Coloring
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 62 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 2 Dec 2024to 1 Mar 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Being a student enrolled in the Mental Health and Psychiatric Nursing course at the selected private university.
- Proficiency in the Turkish language.
- Having no physical disability that would hinder coloring activities.
- Willingness to participate voluntarily.
Who cannot join
- Students with psychological diagnoses such as anxiety or depression.
- Students who do not fully complete the questionnaire/survey forms.
- Students who neglect mandala coloring for two consecutive sessions.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Ankara Medipol University
Ankara
Nursemin ÜNAL, 05077433629
About this study
Official title: Investigating the Effect of Mandala Coloring Activity on Test Anxiety: A Randomized Controlled Trial
This study aims to investigate the effect of mandala coloring activity on test anxiety of nursing students.
Read the detailed description
University life poses various challenges for students, such as being away from family, financial difficulties, and exam anxiety, which can increase stress levels. Test anxiety, a form of situation-specific anxiety, negatively impacts students' academic performance and well-being by reducing concentration and learning efficiency. The combination of theoretical and clinical demands in nursing education further amplifies stress, making it a particularly challenging field for students.
This study is a randomized controlled experimental research conducted between December 2, 2024, and January 13, 2025. The study population consists of nursing students enrolled in the Mental Health and Psychiatric Nursing course at a private university during the 2024-2025 academic year. Based on sample size calculations conducted using the G*Power program, considering similar studies and measurement methods, it was determined that 26 students per group are required. Accounting for potential data loss, it is planned to conduct the study with a total of 62 students, 32 in each group.
Students will be informed about the research, and those who voluntarily agree to participate will complete a "Demographic Characteristics Form" and a pre-test using the "Test Anxiety Inventory." Subsequently, students will be randomly assigned to the intervention and control groups in a 1:1 ratio using a random numbers table, with 31 students in each group. Students in the intervention group will be provided with mandala templates and coloring materials. They will be asked to color for 15 minutes twice a week over a two-month period. Email reminders will be sent to the students about the coloring sessions, and they will submit their completed mandalas to the researchers every Friday. Students who fail to complete two consecutive coloring sessions will be excluded from the study. Thirty minutes before the exam, the "Test Anxiety Inventory" will be applied as a post-test, and the study will be concluded. The data obtained will be subjected to statistical analysis, and the process of writing the manuscript will follow.
- Conditions
- Educational Problems, Anxiety, Test Anxiety, Mental Health
- Being tested
- Mandala Coloring
- Keywords
- Test anxiety, Nursing education, Mandala coloring, Randomized Controlled Trial
- Medical subject headings
- Anxiety Disorders, Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mandala ColoringOther
Students in the intervention group will be provided with mandala templates and coloring materials. They will be asked to color for 15 minutes twice a week over a two-month period
| Study group | Role | What they receive |
|---|---|---|
| Mandala Group | Experimental | Students in the intervention group will be provided with mandala templates and coloring materials. They will be asked to color for 15 minutes twice a week over a two-month period. Email reminders will be sent to the students about the coloring sessions, and they will submit their completed mandalas to the researchers every Friday.
"Demographic Characteristics Form" and a pre-test using the "Test Anxiety Inventory." Thirty minutes before the exam, the "Test Anxiety Inventory" will be applied as a post-test. Receives: Other: Mandala Coloring |
| Control Group | No intervention | Non intervention. "Demographic Characteristics Form" and a pre-test using the "Test Anxiety Inventory." Thirty minutes before the exam, the "Test Anxiety Inventory" will be applied as a post-test. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from test anxiety values at two hours
The items of the scale was created by including 50 anxiety statements developed by Baltaş (1999) with permission. The reliability analysis of the scale was conducted with the participation of 206 undergraduate students studying in Nursing, Physical Education Teaching, and Science Education departments. Data obtained from the application were subjected to factor analysis. As a result of the analysis, 12 items were removed from the scale due to factor load values being below 0.40, and 4 items were excluded for being non-discriminative (overlapping). The remaining 34 items were distributed across five sub-dimensions, with factor loadings ranging from 0.41 to 0.74. The scale is in a 5-point Likert format, and the internal reliability coefficient of the scale was calculated as Cronbach's Alpha (α) = 0.87.
Measured: At the beginning of the study irst admission. Two months later.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Nov 2024
- Study start2 Dec 2024
- Primary completion13 Feb 2025
- Study completion1 Mar 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Educational ProblemsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 62 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Nursemin ÜNAL
- Sponsor type
- University, hospital or other
- Collaborators
- Ankara Medipol University
- Responsible party
- Sponsor-investigator, Nursemin ÜNAL, Ankara University
- Investigators
- Gamze ACAVUT, Principal investigator, Ankara Medipol University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06695650
- Sponsor's protocol ID
- 2024/11
- Acronym
- Mandala
- Status last verified
- Feb 2025
- First submitted
- 17 Nov 2024
- Last updated
- 28 Feb 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Sari Ozturk C, Kilicarslan Toruner E. The effect of mindfulness-based mandala activity on anxiety and spiritual well-being levels of senior nursing students: A randomized controlled study. Perspect Psychiatr Care. 2022 Oct;58(4):2897-2909. doi: 10.1111/ppc.13138. Epub 2022 Jul 3.
PubMed 35780483Khademi F, Rassouli M, Rafiei F, Moayedi S, Torres M, Marzban N, Haji E, Golitaleb M. The effect of mandala colouring on anxiety in hospitalized COVID-19 patients: A randomized controlled clinical trial. Int J Ment Health Nurs. 2021 Oct;30 Suppl 1(Suppl 1):1437-1444. doi: 10.1111/inm.12901. Epub 2021 Jun 18.
PubMed 34143568Zhang MQ, Liu X, Huang Y. Does Mandala Art Improve Psychological Well-Being in Patients? A Systematic Review. J Integr Complement Med. 2024 Jan;30(1):25-36. doi: 10.1089/jicm.2022.0780. Epub 2023 Sep 1.
PubMed 37668598
Study at a glance
From the registry record, last updated by the sponsor on 28 Feb 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Investigating the Effect of Mandala Coloring Activity on Test Anxiety: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06695650
- Acronym / sponsor ID
- Mandala / 2024/11
- Conditions
- Educational Problems, Anxiety, Test Anxiety, Mental Health
- Keywords
- Test anxiety, Nursing education, Mandala coloring, Randomized Controlled Trial
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 62 participants (estimated)
- Lead sponsor
- Nursemin ÜNALUniversity, hospital or other
- Collaborators
- Ankara Medipol University
- Study start
- 2 Dec 2024 (actual)
- Primary completion
- 13 Feb 2025 (actual)
- Study completion
- 1 Mar 2025 (estimated)
- First posted
- 19 Nov 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to investigate the effect of mandala coloring activity on test anxiety of nursing students.
Detailed description
University life poses various challenges for students, such as being away from family, financial difficulties, and exam anxiety, which can increase stress levels. Test anxiety, a form of situation-specific anxiety, negatively impacts students' academic performance and well-being by reducing concentration and learning efficiency. The combination of theoretical and clinical demands in nursing education further amplifies stress, making it a particularly challenging field for students.
This study is a randomized controlled experimental research conducted between December 2, 2024, and January 13, 2025. The study population consists of nursing students enrolled in the Mental Health and Psychiatric Nursing course at a private university during the 2024-2025 academic year. Based on sample size calculations conducted using the G*Power program, considering similar studies and measurement methods, it was determined that 26 students per group are required. Accounting for potential data loss, it is planned to conduct the study with a total of 62 students, 32 in each group.
Students will be informed about the research, and those who voluntarily agree to participate will complete a "Demographic Characteristics Form" and a pre-test using the "Test Anxiety Inventory." Subsequently, students will be randomly assigned to the intervention and control groups in a 1:1 ratio using a random numbers table, with 31 students in each group. Students in the intervention group will be provided with mandala templates and coloring materials. They will be asked to color for 15 minutes twice a week over a two-month period. Email reminders will be sent to the students about the coloring sessions, and they will submit their completed mandalas to the researchers every Friday. Students who fail to complete two consecutive coloring sessions will be excluded from the study. Thirty minutes before the exam, the "Test Anxiety Inventory" will be applied as a post-test, and the study will be concluded. The data obtained will be subjected to statistical analysis, and the process of writing the manuscript will follow.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Mandala Group | Experimental | Other: Mandala ColoringStudents in the intervention group will be provided with mandala templates and coloring materials. They will be asked to color for 15 minutes twice a week over a two-month period. Email reminders will be sent to the students about the coloring sessions, and they will submit their completed mandalas to the researchers every Friday. "Demographic Characteristics Form" and a pre-test using the "Test Anxiety Inventory." Thirty minutes before the exam, the "Test Anxiety Inventory" will be applied as a post-test. |
| Control Group | No intervention | –Non intervention. "Demographic Characteristics Form" and a pre-test using the "Test Anxiety Inventory." Thirty minutes before the exam, the "Test Anxiety Inventory" will be applied as a post-test. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (4 listed)
- Being a student enrolled in the Mental Health and Psychiatric Nursing course at the selected private university.
- Proficiency in the Turkish language.
- Having no physical disability that would hinder coloring activities.
- Willingness to participate voluntarily.
Key exclusion criteria (3 listed)
- Students with psychological diagnoses such as anxiety or depression.
- Students who do not fully complete the questionnaire/survey forms.
- Students who neglect mandala coloring for two consecutive sessions.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Mandala ColoringStudents in the intervention group will be provided with mandala templates and coloring materials. They will be asked to color for 15 minutes twice a week over a two-month period | Other | Mandala Group |
Primary outcome
Change from test anxiety values at two hours
Time frame: At the beginning of the study irst admission. Two months later.
The items of the scale was created by including 50 anxiety statements developed by Baltaş (1999) with permission. The reliability analysis of the scale was conducted with the participation of 206 undergraduate students studying in Nursing, Physical Education Teaching, and Science Education departments. Data obtained from the application were subjected to factor analysis. As a result of the analysis, 12 items were removed from the scale due to factor load values being below 0.40, and 4 items were excluded for being non-discriminative (overlapping). The remaining 34 items were distributed across five sub-dimensions, with factor loadings ranging from 0.41 to 0.74. The scale is in a 5-point Likert format, and the internal reliability coefficient of the scale was calculated as Cronbach's Alpha (α) = 0.87.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Feb 2025.
- Background: PubMed 35780483Sari Ozturk C, Kilicarslan Toruner E. The effect of mindfulness-based mandala activity on anxiety and spiritual well-being levels of senior nursing students: A randomized controlled study. Perspect Psychiatr Care. 2022 Oct;58(4):2897-2909. doi: 10.1111/ppc.13138. Epub 2022 Jul 3.
- Background: PubMed 34143568Khademi F, Rassouli M, Rafiei F, Moayedi S, Torres M, Marzban N, Haji E, Golitaleb M. The effect of mandala colouring on anxiety in hospitalized COVID-19 patients: A randomized controlled clinical trial. Int J Ment Health Nurs. 2021 Oct;30 Suppl 1(Suppl 1):1437-1444. doi: 10.1111/inm.12901. Epub 2021 Jun 18.
- Background: PubMed 37668598Zhang MQ, Liu X, Huang Y. Does Mandala Art Improve Psychological Well-Being in Patients? A Systematic Review. J Integr Complement Med. 2024 Jan;30(1):25-36. doi: 10.1089/jicm.2022.0780. Epub 2023 Sep 1.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Gamze ACAVUT principal investigator
Ankara Medipol University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mandala Coloring in people with Educational Problems and Anxiety, run by Nursemin ÜNAL at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 28 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Nursemin Unal (+905077433629, nurse_unal@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change from test anxiety values at two hours (time frame: At the beginning of the study irst admission. Two months later.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06695650, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Feb 2025.