effectiveness of mandala coloring and playing with lego on children’s preoperative anxiety: a randomized clinical trial

Background: mandala coloring and playing are distraction strategies to reduce the anxiety level in children. however, their effects are inconsistent and have received little attention for the management and prevention of anxiety in hospitalized children. the main objective of this study was to compare the effect of distraction strategies of mandala coloring and playing with lego on reducing preoperative anxiety in pediatric patients undergoing surgeries.methods: the study was designed as a randomized, single-blind, tree-arm, parallel-group controlled trial. there were 96 children aged 6 to 18 years who were admitted to the pediatric surgery ward in mofid children’s hospital in tehran-iran. simple randomization was used for choosing the participants for dividing them into two intervention groups and one control group. the interventions (mandala coloring and playing with lego) lasted 15-20 minutes in mandala and lego groups. in the control group, they received care according to the ward’s routine procedure. anxiety as the main outcome variable was measured using the state-trait anxiety inventory in two stages (before the intervention and immediately after the intervention) for children. analysis of variance was used to compare the means in the three groups, and tukey’s post-hoc test was used to assess the significance of differences between pairs of group means.results: less state anxiety was observed after the intervention in the lego group compared to the mandala group (-4.69 ± 7.58, p =0.094). the data also revealed significant differences before and after the intervention in the lego group in terms of preoperative trait anxiety (35.84 ±10.25 and 34.38 ± 8.89, respectively, p = 0.038).conclusion: the results demonstrated that playing with lego and mandala coloring, compared to the control group that received care, according to the ward routine procedure, had an effective role in reducing preoperative anxiety in children; however, playing with lego had the most effect on decreasing anxiety state in children.