The effect of art-based mandala on mental health among patients transplanting bone marrow: a randomized controlled study

Abstract

Objective: This study aimed to investigate the effect of nurse-led art-based mandala practice on psychosocial problems in patients undergoing bone marrow transplantation. Method: This parallel-group randomized controlled study with repeated measurements was conducted in a university hospital’s bone marrow transplant unit. A total of 46 patients hospitalized for bone marrow transplant treatment were randomly assigned to the intervention and control groups. The intervention group was made to apply an art-based mandala under the leadership of a nurse for 7 sessions. The control group received only routine treatment. Patients in both groups completed the Beck hopelessness scale, distress thermometer, psychological well-being scale and state-trait anxiety questionnaires before, during, and after transplantation. The data were analyzed using the SPSS IBM 27.0 package data program. Results: During and after bone marrow transplantation, the intervention group experienced a noteworthy reduction in stress, anxiety, and hopelessness, as well as a considerable improvement in psychological well-being compared with the control group. The difference in mean scores between the groups over time was statistically significant. Conclusion: Nurse-led art-based mandala practice is an effective, safe, and well-received method for addressing the psychosocial challenges of patients undergoing bone marrow transplantation. This nursing intervention is reliable and impactful for managing psychosocial problems during the bone marrow transplantation process. © 2025 Elsevier B.V., All rights reserved.