The Effect of Mandala Art Therapy on Anxiety and Pain in Patients Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial.

PURPOSE: Total hip arthroplasty is a commonly performed surgical procedure to treat advanced joint damage; however, the perioperative process can increase anxiety and pain in patients, potentially delaying recovery and prolonging hospital stays. Therefore, complementary therapies have gained importance in the postoperative period. This study aimed to examine the effect of mandala art therapy on anxiety and pain levels in patients undergoing total hip arthroplasty.

METHODS

This single-center, randomized, controlled, two-arm, parallel-group, single-blind study was conducted between May 22 and December 30, 2024. A total of 84 patients who underwent total hip arthroplasty were included (intervention group, n = 42; control group n = 42). The intervention group received a 30-minute mandala art therapy session on the second postoperative day. Anxiety was assessed via "The State Anxiety Inventory (STAI-I),'' and pain was measured "via The Visual Analog Scale (VAS).'' The data were analyzed with SPSS 27.0.

RESULTS

There were no significant differences between the groups at baseline (p > .05). After the intervention, the intervention group presented significant reductions in both the STAI-I (41.43 ± 3.72) and VAS (4.62 ± 1.08) scores (p < .001). Generalized estimating equation (GEE) analysis indicated that mandala art therapy significantly reduced anxiety (B = -1.641; p = .031) and pain (B = -0.857; p < .001).

CONCLUSION

Mandala art therapy is an effective complementary care intervention for reducing anxiety and pain in patients after total hip arthroplasty.

NURSING PRACTICE IMPLICATIONS: Mandala art therapy is an effective complementary nursing intervention for reducing anxiety and pain after total hip arthroplasty. Nurses can integrate this method into postoperative care plans to support patients' psychological relaxation and recovery process. Its simplicity, safety, and low cost make it easy to implement in nursing practice.

CLINICAL TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov (NCT06628557).