| Author: | Cheng, Kai Nam |
| Title: | The effectiveness of Zentangle drawing using telehealth mode on university students : a randomized controlled trial |
| Advisors: | Lai, Cynthia (RS) Siu, Andrew (RS) |
| Degree: | DHSc |
| Year: | 2023 |
| Subject: | Art therapy Drawing -- Psychological aspects Telecommunication in medicine Stress management Occupational therapy Hong Kong Polytechnic University -- Dissertations |
| Department: | Faculty of Health and Social Sciences |
| Pages: | xii, 126 pages : color illustrations |
| Language: | English |
| Abstract: | Background: Stress management is an everyday skill for people in modern societies. The outbreak of COVID-19 altered most of our lifestyles, as well as our health and wellbeing. Telehealth service delivery mode is becoming increasingly common in mental health Occupational Therapy (OT). “Zen” in Zentangle means meditation, and “tangle” means pattern. OT assists clients in handling stress by using this easy-to-learn mindfulness-based art activity. Previous evidence supports its effectiveness in improving self-esteem and self-confidence, reducing anxiety and stress, uplifting mood, and increasing a sense of social support in face-to-face individual or group mode. Nevertheless, there is limited formal research on its therapeutic values on healthy subjects via telehealth mode. This study aimed at studying its effectiveness on stress reduction, wellbeing promotion, and mindfulness awareness promotion among university students via telehealth mode. Methods: This study used a mixed-method design, including a randomized controlled trial study and qualitative interviews, to evaluate the therapeutic values of Zentangle. Fifty-two participants who met the inclusion criteria were recruited through advertisements from The Hong Kong Polytechnic University and social media. They were randomized to join an intervention (n = 26) or a control group (n = 26). In the intervention group, a series of four one-hour Zentangle sessions were delivered by an occupational therapist who also qualified in mindfulness and Zentangle training. The participants in the control group received four one-hour free-drawing sessions in four consecutive weeks. The heart rate variability (HRV) was collected in every session via a mobile phone app called Welltory. Five psychological self-reported questionnaires, including Chinese Perceived Stress Scale (CPSS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Chinese Short Warwick-Edinburgh Mental Well-being Scale (C-SEWMWBS) and Chinese Mindfulness Attention Awareness Scale (CMAAS) were collected at baseline and after all sessions. All participants in the treatment group were invited to join a 20-minute interview to collect their experiences and feelings after all sessions. The qualitative data were analysed by thematic content analysis. Results: Results indicated that participants in the Zentangle group had improvement in stress reduction, wellness, and mindfulness awareness. Although the quantitative study showed no statistically significant difference between the two groups in HRV and psychological measurements in Two-way Repeated Measures ANOVA analyses, the qualitative study supported the therapeutic effects of Zentangle. Nearly all participants found Zentangle could help to reduce stress as it distracted people from daily hassles. It brought happiness when people gained a sense of mastery and autonomy, learnt to accept themselves, practised gratitude and enhanced their relationships with others. A few of the participants also reported an improvement in their awareness of self and surroundings. Conclusions: This study is one of the first mixed-method studies to investigate the therapeutic values of Zentangle on healthy subjects via telehealth mode. The result suggests that Zentangle may be an effective telehealth intervention for reducing stress and improving wellness. A bio-psychological theoretical framework on how Zentangle reduces stress is proposed. The intensity of practice, incorporation of inquiry sessions, handling technical issues and the choices of tangles should be considered to optimize Zentangle’s therapeutic effects when applied to at-risk and clinical populations via a telehealth approach in the future. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 7285.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 3.59 MB | Adobe PDF | View/Open |
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