Effect of Expressive Arts Therapy on Death Anxiety in Intensive Care Unit Nurses (Expressive Art)

March 24, 2026 updated by: serap güleç keskin, Ondokuz Mayıs University
This randomized controlled trial aimed to evaluate the effect of expressive arts therapy on death anxiety among intensive care unit nurses. A total of 66 nurses were randomly assigned to either an intervention group or a control group. The intervention group participated in a structured expressive arts therapy programme consisting of weekly sessions for six weeks, while the control group received no intervention during the study period. Death anxiety levels were assessed using the Death Anxiety Scale before and after the intervention. The study aimed to determine whether expressive arts therapy is effective in reducing death anxiety and improving psychological well-being among intensive care unit nurses.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This randomized controlled study aimed to evaluate the effectiveness of a structured expressive arts therapy program in reducing death anxiety among intensive care unit nurses. Participants were randomly assigned to either an expressive arts therapy intervention group or a control group. The intervention consisted of six weekly sessions incorporating creative techniques such as drawing, clay work, and collage to facilitate emotional expression and reflection on experiences related to death and patient care. Death anxiety levels were assessed at baseline and immediately after the intervention using the Death Anxiety Scale. The study aimed to determine whether expressive arts therapy could reduce death anxiety and improve psychological well-being among intensive care nurses exposed to frequent patient mortality.

Study Type

Interventional

Enrollment (Actual)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Samsun
      • Atakent, Samsun, Turkey (Türkiye), 55200
        • Samsun Training and Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

Registered nurses working in intensive care units At least 1 year of experience in an intensive care setting Having previously encountered patient death in clinical practice Willingness to participate in the study

Providing written informed Exclusion Criteria:

Currently receiving psychological or psychiatric treatment for severe mental health problems Participation in similar psychological or psychosocial intervention programs during the study period

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control Group
No Intervention
Experimental: Expressive Arts Therapy Group
This group participated in a structured expressive arts therapy programme consisting of weekly sessions for six weeks. Each session included creative activities such as drawing, clay work, and collage to facilitate emotional expression and processing of death-related experiences.
Behavioral: Expressive Arts Therapy
Expressive arts therapy was delivered as a structured group intervention consisting of six weekly sessions including drawing, clay work, and collage.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Death Anxiety Scale Total Score
Time Frame: Baseline and Week 6 (post-intervention)

Death anxiety was assessed using the Death Anxiety Scale (DAS; Sarıkaya & Baloğlu, 2016), a validated self-report instrument consisting of 20 items rated on a 5-point Likert scale (1-5).

Total scores range from 20 to 100, with higher scores indicating greater levels of death anxiety.
Baseline and Week 6 (post-intervention)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in "Uncertainty About Death" Subscale Score
Time Frame: Baseline and Week 6 (post-intervention)

The Uncertainty About Death subscale of the Death Anxiety Scale evaluates ambiguity and fear related to the unknown aspects of death.

Subscale scores are derived from relevant items within the DAS, with higher scores indicating greater uncertainty and anxiety regarding death.
Baseline and Week 6 (post-intervention)
Change in "Thoughts About Death and Witnessing Death" Subscale Score
Time Frame: Baseline and Week 6 (post-intervention)

This subscale measures cognitive and emotional responses related to thinking about death and exposure to dying individuals.

Higher scores indicate more frequent and distressing death-related thoughts and experiences.
Baseline and Week 6 (post-intervention)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ondokuz Mayıs University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2024

Primary Completion (Actual)

July 1, 2024

Study Completion (Actual)

January 13, 2026

Study Registration Dates

First Submitted

February 28, 2026

First Submitted That Met QC Criteria

March 6, 2026

First Posted (Actual)

March 10, 2026

Study Record Updates

Last Update Posted (Actual)

March 30, 2026

Last Update Submitted That Met QC Criteria

March 24, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • OMU-BAP04-A-2024-5002-RCT
  • BAP04-A-2024-5002 (Registry Identifier: Effect of Expressive Arts Therapy on Death Anxiety in Intensive Care Unit Nurses: A Randomized Controlled Trial)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to ethical and confidentiality considerations. The dataset contains sensitive information collected from healthcare professionals, and sharing individual-level data was not included in the original informed consent or ethics approval. Only aggregated data are available within the published results.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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