Mandala Coloring and Music for Cancer Fear and Screening Anxiety

August 27, 2026 updated by: NURTEN ÖZÇALKAP, Agri Ibrahim Cecen University

The Effect of Mandala Coloring and Music Interventions on Cancer Fear and Screening Anxiety Among Individuals Applying to Cancer Early Diagnosis, Screening and Training Centers (KETEM): A Randomized Controlled Trial

Cancer screening is important for detecting cancer at an early stage. However, women attending cancer screening may experience fear of cancer and anxiety related to the screening process. Simple, non-drug approaches that promote relaxation may help reduce these feelings and make the screening experience more comfortable.

The purpose of this randomized controlled study is to determine whether a combined mandala coloring and music intervention can reduce cancer fear and anxiety among women attending a Cancer Early Diagnosis, Screening and Training Center (KETEM) for cancer screening.

Women aged 30 to 65 years who attend the KETEM unit for their first or routine cancer screening, meet the study eligibility criteria, and agree to participate will be included in the study. Participants will be randomly assigned to one of two groups: an intervention group or a control group.

Participants in the intervention group will color a mandala for 20 minutes while listening to slow-tempo instrumental music. The intervention will take place in the KETEM waiting area. Participants in the control group will receive the standard information and routine services provided at KETEM without the mandala coloring and music intervention.

Cancer fear and anxiety will be assessed using questionnaires before and after the intervention. The researchers will compare the results between the intervention and control groups to determine whether the combined mandala coloring and music intervention helps reduce cancer fear and anxiety during the cancer screening process.

The findings of this study may provide information about whether a simple, low-cost, and non-drug intervention can be used to support women attending cancer screening and make the screening experience less stressful.

Study Overview

Status

Enrolling by invitation

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

90

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

    • Ağri
      • Ağrı, Ağri, Turkey (Türkiye), 04100
        • Ağrı İbrahim Çeçen University

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:

  • Being a woman aged 30-65 years.

    *Applying for cancer screening for the first time or for routine screening.

  • Being able to read and write in Turkish.
  • Providing voluntary informed consent to participate in the study.

Exclusion Criteria:

  • Having a diagnosed psychiatric disorder.
  • Having a hearing impairment severe enough to interfere with the music intervention.
  • Having a history of diagnosed cancer.

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 1 mandala
Participants will receive a 20-minute mandala intervention before the screening procedure.
Participants will receive a 20-minute mandala coloring intervention before the screening procedure.
No Intervention: 3 control
control
Experimental: 2 musıc
Participants will receive a 20-minute music intervention before the screening procedure.
**Participants will receive a 20-minute music intervention before the screening procedure.**

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
2. Fear of Cancer Scale (FOCS)
Time Frame: Baseline (immediately before the intervention) and immediately after the 30-minute intervention

The Fear of Cancer Scale (FOCS) was developed by Feng and colleagues and the validity and reliability study of the Turkish version was conducted by Öztürk and Kuday. The scale consists of 17 items and two subscales: Direct Fear (items 1, 2, 4, 8, 9, 10, 12, and 13) and Indirect Fear (items 3, 5, 6, 7, 11, 14, 15, 16, and 17).

Each item is rated on a 5-point Likert scale ranging from 0 to 4 (0 = Strongly Disagree, 1 = Disagree, 2 = Neither Agree nor Disagree, 3 = Agree, and 4 = Strongly Agree). The total score ranges from 0 to 68, with higher scores indicating greater fear of cancer.

The overall Cronbach's alpha coefficient of the scale was reported as 0.920. The Cronbach's alpha coefficients were 0.870 for the Direct Fear subscale and 0.861 for the Indirect Fear subscale.

Baseline (immediately before the intervention) and immediately after the 30-minute intervention
1. Personal Information Form
Time Frame: Baseline
The Personal Information Form was developed by the researchers based on the relevant literature and includes questions assessing the participants' sociodemographic characteristics.
Baseline
3. State Anxiety Inventory (STAI-I)
Time Frame: Baseline (immediately before the intervention) and immediately after the 30-minute intervention

According to Öner and Le Compte, anxiety can be conceptualized as two distinct forms: state anxiety and trait anxiety. This distinction was initially proposed through the factor-analytic studies of Cattell and Scheier and subsequently formed the basis of the two-factor theory of anxiety developed through the work of Spielberger and colleagues

The State-Trait Anxiety Inventory is a self-report instrument consisting of brief statements designed to assess anxiety. Although it was originally developed to assess anxiety among psychiatrically healthy adults, subsequent studies have demonstrated its applicability to high school students as well as individuals with psychiatric and physical health conditions.

Baseline (immediately before the intervention) and immediately after the 30-minute intervention

Collaborators and Investigators

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

Investigators

  • Principal Investigator: Nurten OZCALKAP, asisst. prof, Agri Ibrahim Cecen University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Oner N, Le Compte A. Durumluk-Sürekli kaygı envanteri elkitabı, 20. Basım İstanbul: Boğaziçi Üniversitesi Yayınları, 1985. s.3-5.

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)

May 1, 2026

Primary Completion (Estimated)

August 30, 2026

Study Completion (Estimated)

December 30, 2026

Study Registration Dates

First Submitted

August 23, 2026

First Submitted That Met QC Criteria

August 25, 2026

First Posted (Actual)

August 27, 2026

Study Record Updates

Last Update Posted (Actual)

August 31, 2026

Last Update Submitted That Met QC Criteria

August 27, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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.

Subscribe