NCT07470632

Effect of Twin Hearts Meditation and Mandala Coloring on Exam Anxiety in Nursing Students

Comparison of Mandala Coloring and Twin Hearts Meditation on Practical Exam Anxiety: A Randomized Clinical Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 100 (actual)
• Sponsor: Near East University, Turkey · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Accepted

Summary

This randomized clinical trial aimed to compare the effectiveness of Mandala coloring and Twin Hearts Meditation in reducing exam anxiety among undergraduate nursing students. Participants were randomly assigned to either the Mandala coloring group or the Twin Hearts Meditation group. Both interventions were administered before a practical examination. Anxiety levels were measured before and after the intervention using the State-Trait Anxiety Inventory (STAI). The study evaluated which complementary and non-pharmacological intervention was more effective in reducing exam-related anxiety among nursing students.

Detailed description

Study Purpose The purpose of this study was to compare the effectiveness of Mandala coloring and Twin Hearts Meditation as complementary and non-pharmacological interventions for reducing exam anxiety among undergraduate nursing students. Study Design This study was designed as a randomized clinical trial conducted among undergraduate nursing students. Participants were randomly assigned to two intervention groups: Mandala coloring and Twin Hearts Meditation. Sample Size Out of 110 eligible nursing students, 100 who met the inclusion criteria were recruited. Based on previous research and a mean comparison formula with a significance level of 0.05 and a statistical power of 80%, the required sample size was calculated as 48 participants per group. Considering possible dropout, 50 participants were included in each group. Data Collection Tools Data were collected using: * A demographic questionnaire (age, gender, marital status, academic information) * The State-Trait Anxiety Inventory (STAI), a validated 40-item self-report instrument measuring state and trait anxiety. Intervention Participants were randomly assigned to one of two groups: Twin Hearts Meditation Group: Participants received a guided Twin Hearts Meditation session lasting 30 minutes under the supervision of the researcher. Mandala Coloring Group: Participants engaged in mandala coloring for 30 minutes using printed mandala designs and colored pencils under the supervision of the researcher. Both interventions were conducted before a practical examination. Outcome Assessment Anxiety levels were measured before and after the intervention using the State-Trait Anxiety Inventory (STAI). Ethical Considerations The research received approval from the Cyprus International University Ethics Review Board (Approval No: EKK23-24/012/07). The study followed the ethical standards of the Council of Ethics and adhered to the principles of the Declaration of Helsinki (1964). Statistical Analysis Data were analyzed using SPSS software. Descriptive statistics, paired t-tests, independent t-tests, and chi-square tests were used. A P value \< 0.05 was considered statistically significant.

Conditions

• Exam Anxiety

Interventions

Type	Name	Description
BEHAVIORAL	Twin Heart Meditation	Participants in this group receive Twin Hearts Meditation, a guided meditation technique based on the principles of loving-kindness and spiritual energy. The intervention aims to reduce exam-related anxiety by promoting emotional balance and relaxation. Intervention: Behavioral: Twin Hearts Meditation Participants practice guided meditation sessions lasting 30 minutes under the supervision of the researcher. The meditation protocol includes: Physical warm-up exercises Activation of the heart chakra Activation of the crown chakra Blessing the Earth with loving-kindness Silent meditation using the phrase "Amen" Expression of gratitude Closing exercises Sessions are conducted in a quiet room using audio guidance.
BEHAVIORAL	Mandala Coloring	Participants were provided with a printed mandala outline on A4 paper and six colored pencils (red, orange, yellow, green, blue, purple). They engaged in free, unstructured mandala coloring for 30 minutes

Timeline

• Start date: 2025-01-05
• Primary completion: 2025-01-20
• Completion: 2025-01-20
• First posted: 2026-03-13
• Last updated: 2026-03-13

Locations

1 site across 1 country: Cyprus