Visual Art Therapy on Caregiver Burden (Visual art)

The Effect of Visual Art Therapy Applied to Family Caregivers of Patients Hospitalized in a Palliative Care Unit on Caregiver Burden, Caregiving Stress, and Burnout: A Randomized Controlled Trial

This study aims to determine the effect of Zentangle practice on perceived caregiver burden, stress levels, and burnout among family caregivers of patients receiving palliative care. Zentangle is a visual art therapy method used for meditative purposes by promoting creativity and focused attention in individuals under stress, which can facilitate mental relaxation, stress relief, and mindfulness. The study is designed as a randomized controlled experimental trial with a pretest-posttest design. The sample consists of 60 family caregivers of patients hospitalized in a palliative care unit, randomized into an intervention group (n=30) and a control group (n=30). Participants in the intervention group receive a two-week meditative art therapy intervention based on the Zentangle method, while data are collected through face-to-face interviews using validated psychological scales before and after the intervention period.

Study Overview

• Status: Completed
• Conditions: Palliative Care; Psychological Stress; Family Caregivers
• Intervention / Treatment: Behavioral: Visual arts design training program

Detailed Description

Background: Zentangle is a visual art therapy method that can be used for meditative purposes by promoting creativity and focused attention in individuals under stress, thereby indirectly facilitating mental relaxation, stress relief, and mindfulness.

Aim: This study aimed to determine the effect of Zentangle practice on perceived caregiver burden, stress levels, and burnout among family caregivers of patients receiving palliative care.

Design: This study was designed as a randomized controlled experimental trial with a pretest-posttest design and was conducted between March and June 2025.

Setting/Participants: The study sample consisted of 60 family caregivers of patients hospitalized in a palliative care unit, including 30 participants in the intervention group and 30 in the control group.

Intervention: Participants in the intervention group received a two-week meditative art therapy intervention based on the Zentangle method. The control group followed the standard routine care process without the art therapy intervention.

Data Collection: Data were collected through face-to-face interviews. The data collection tools included an Individual Descriptive Information Form, the Caregiver Burden Scale, the Caregiver Stress Index, and the Maslach Burnout Inventory-General Survey. These tools were administered to both groups as pretest measures before the intervention and as posttest measures immediately following the completion of the two-week study period.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Elâzığ
    • Elâzığ, Elâzığ, Turkey (Türkiye), 23100
      • Fırat University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Being a family caregiver of a patient hospitalized in the palliative care unit

Volunteering to participate in the study

Being aged 18 years or older

Being able to communicate in the local language

Providing care for the patient for at least one month

Exclusion Criteria:

Having a previously diagnosed major psychiatric illness or cognitive impairment that prevents participation in art therapy

Having visual or physical impairments that interfere with performing fine motor tasks required for the Zentangle method

Participating in any other concurrent psychological or art therapy intervention during the study period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention group; Caregivers in this group will receive Zentangle training in addition to standard hospital routines. The program aims to provide informative instruction on the method and support caregivers.	Behavioral: Visual arts design training program; The fact that this type of sampling has never been applied before.
No Intervention: Control group; Caregivers in this group will follow the standard hospital routine and receive regular follow-ups without any additional intervention, education, or specific training program during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregiver Burden Scale	Outcome Measure Title: Change from baseline in Caregiver Burden Scale scores at 2 weeks. Description: Caregiver burden is assessed using the Caregiver Burden Scale. The scale evaluates the physical, emotional, and social burden experienced by caregivers. Total scores range from 0 to 88, with higher scores indicating a higher perceived caregiver burden.	2 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Caregiver Stress Index	Outcome Measure Title: Change from baseline in Caregiver Stress Index scores at 2 weeks. Description: Caregiver stress levels are assessed using the Caregiver Stress Index. This tool evaluates the stress related to caregiving activities. Total scores range from 0 to 13, with higher scores indicating a higher level of caregiver stress.	2 months

Collaborators and Investigators

• Sponsor: Firat University

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 2025
• Primary Completion (Actual): May 25, 2025
• Study Completion (Actual): January 20, 2026

Study Registration Dates

• First Submitted: July 1, 2026
• First Submitted That Met QC Criteria: July 9, 2026
• First Posted (Actual): July 14, 2026

Study Record Updates

• Last Update Posted (Actual): July 14, 2026
• Last Update Submitted That Met QC Criteria: July 9, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: palliative care; caregiver burden; Zentangle; burnout; visual art therapy
• Additional Relevant MeSH Terms: Behavioral Symptoms; Behavior; Burnout, Psychological; Caregiver Burden; Stress, Psychological
• Other Study ID Numbers: 3171272024-184

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No