Abstract
To investigate the effect of mandala coloring, plaid pattern coloring, and free-form drawing activities on anxiety and mood in older Taiwanese adults. A total of 120 older adults aged 55 years to 75 years were recruited from 18 community-based learning centers for older adults in southern Taiwan. They were randomly assigned to engage in one of the following four activities for 20 minutes: (1) mandala coloring group, (2) plaid pattern coloring group, (3) free-form drawing group, and (4) reading group (control). Information on sociodemographic, lifestyle, and perceived health status was collected at the baseline. In addition, anxiety levels, measured using the 20-item State-Trait Anxiety Inventory–State Anxiety Scale (STAI-S), were ascertained at the baseline (T1), after a brief anxiety induction (T2), and at the end of the assigned activity (T3). The mean anxiety levels among the four groups at T3 were analyzed using analysis of covariance, followed by Šidák multiple comparison test, as appropriate. The mean age of the 120 study participants was 65.1 years and 73.3% were females. A significantly lower anxiety level was observed only in the mandala coloring group (least square mean = 28.2; 95% confidence interval = 24.7–31.7) compared with the control group (least square mean = 36.0; 95% confidence interval = 32.9–39.2) (P=0.004, partial eta-squared = 0.113). Furthermore, when the STAI-S was analyzed at the item level, the mandala coloring group was significantly different from the control group in the following six feelings: calmed down, safe, at ease, rested, satisfied, and I feel good. In conclusion, short-term mandala coloring activity could significantly alleviate self-induced anxiety in community-dwelling older adults. Further studies on the long-term effects of mandala coloring activity in improving the emotional well-being of older adults are warranted.
Highlights
With a global trend in population aging, the issue of anxiety has become a widespread health concern [1]
Epidemiological studies have estimated that the global prevalence of anxiety disorders in older adults ranges from 0.9% to 28.3%, and they are highly associated with social, physical, psychological, and economic impacts [2]
E discomfort caused by late-life anxiety can adversely impact on the physical and psychological health status, which may lead to depression and increased health care costs [1]
Summary
With a global trend in population aging, the issue of anxiety has become a widespread health concern [1]. Epidemiological studies have estimated that the global prevalence of anxiety disorders in older adults ranges from 0.9% to 28.3%, and they are highly associated with social, physical, psychological, and economic impacts [2]. Various psychosocial interventions with participatory arts have been explored to alleviate anxiety, depression, and negative mood in older adults [3,4,5,6]. A number of studies have suggested that coloring a mandala could serve as an effective intervention for alleviating anxiety and improving mood [7,8,9,10,11]. A mandala is a spiritual geometric configuration of symbols used in various religions In modern use, it usually means a geometric pattern, typically with a radial balance that is associated with a sense of wholeness and healing [12]. To the best of our knowledge, no studies have been conducted on communitydwelling older adults in Taiwan. erefore, the aim of this randomized controlled trial was to compare the short-term effect of mandala coloring, plaid pattern coloring, and freeform color drawing in alleviating self-induced anxiety in older adults recruited from community-based learning centers for older adults in southern Taiwan
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