<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE trials [
<!ELEMENT trials (trial+)>

<!ELEMENT trial (main,contacts,countries,criteria,health_condition_code,health_condition_keyword,intervention_code,
          intervention_keyword,primary_outcome,secondary_outcome,secondary_sponsor,secondary_ids,source_support,ethics_reviews)>

<!ELEMENT main (trial_id,utrn?,reg_name,date_registration,primary_sponsor,public_title,acronym?,scientific_title,scientific_acronym?,
          date_enrolment,type_enrolment,target_size,recruitment_status,url?,study_type,study_design,phase,hc_freetext?,i_freetext?,results_actual_enrolment,results_date_completed,results_url_link,results_summary,           results_date_posted,results_date_first_publication,results_baseline_char,results_participant_flow,results_adverse_events,results_outcome_measures,results_url_protocol,results_IPD_plan, results_IPD_description)>
<!ELEMENT trial_id (#PCDATA)>
<!ELEMENT utrn (#PCDATA)>
<!ELEMENT reg_name (#PCDATA)>
<!ELEMENT date_registration (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT primary_sponsor (#PCDATA)>
<!ELEMENT public_title (#PCDATA)>
<!ELEMENT acronym (#PCDATA)>
<!ELEMENT scientific_title (#PCDATA)>
<!ELEMENT scientific_acronym (#PCDATA)>
<!ELEMENT date_enrolment (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT type_enrolment (#PCDATA)>
<!ELEMENT target_size (#PCDATA)>
<!ELEMENT recruitment_status (#PCDATA)><!-- Pending,Recruiting,Suspended,Complete,Other -->
<!ELEMENT url (#PCDATA)>
<!ELEMENT study_type (#PCDATA)><!-- interventional,observational -->
<!ELEMENT study_design (#PCDATA)>
<!ELEMENT phase (#PCDATA)>
<!ELEMENT hc_freetext (#PCDATA)>
<!ELEMENT i_freetext (#PCDATA)>
<!ELEMENT results_actual_enrolment (#PCDATA)>
<!ELEMENT results_date_completed (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_url_link (#PCDATA)>
<!ELEMENT results_summary (#PCDATA)>
<!ELEMENT results_date_posted (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_date_first_publication (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_baseline_char (#PCDATA)>
<!ELEMENT results_participant_flow (#PCDATA)>
<!ELEMENT results_adverse_events (#PCDATA)>
<!ELEMENT results_outcome_measures (#PCDATA)>
<!ELEMENT results_url_protocol (#PCDATA)>
<!ELEMENT results_IPD_plan (#PCDATA)>
<!ELEMENT results_IPD_description (#PCDATA)>


<!ELEMENT contacts (contact+)>
<!ELEMENT contact (type,firstname,middlename,lastname,address,city,country1,zip,telephone,email,affiliation)>
<!ELEMENT type (#PCDATA)><!-- Public,Scientific -->
<!ELEMENT firstname (#PCDATA)>
<!ELEMENT middlename (#PCDATA)>
<!ELEMENT lastname (#PCDATA)>
<!ELEMENT address (#PCDATA)>
<!ELEMENT city (#PCDATA)>
<!ELEMENT country1 (#PCDATA)>
<!ELEMENT zip (#PCDATA)>
<!ELEMENT telephone (#PCDATA)>
<!ELEMENT email (#PCDATA)>
<!ELEMENT affiliation (#PCDATA)>

<!ELEMENT countries (country2+)>
<!ELEMENT country2 (#PCDATA)>

<!ELEMENT criteria (inclusion_criteria,agemin,agemax,gender,exclusion_criteria)>
<!ELEMENT inclusion_criteria (#PCDATA)>
<!ELEMENT agemin (#PCDATA)>
<!ELEMENT agemax (#PCDATA)>
<!ELEMENT gender (#PCDATA)>
<!ELEMENT exclusion_criteria (#PCDATA)>

<!ELEMENT health_condition_code (hc_code+)>
<!ELEMENT hc_code (#PCDATA)>

<!ELEMENT health_condition_keyword (hc_keyword+)>
<!ELEMENT hc_keyword (#PCDATA)>

<!ELEMENT intervention_code (i_code+)>
<!ELEMENT i_code (#PCDATA)>

<!ELEMENT intervention_keyword (i_keyword+)>
<!ELEMENT i_keyword (#PCDATA)>

<!ELEMENT primary_outcome (prim_outcome+)>
<!ELEMENT prim_outcome (#PCDATA)>

<!ELEMENT secondary_outcome (sec_outcome+)>
<!ELEMENT sec_outcome (#PCDATA)>

<!ELEMENT secondary_sponsor (sponsor_name+)>
<!ELEMENT sponsor_name (#PCDATA)>

<!ELEMENT secondary_ids (secondary_id+)>
<!ELEMENT secondary_id (sec_id,issuing_authority)>
<!ELEMENT sec_id (#PCDATA)>
<!ELEMENT issuing_authority (#PCDATA)>

<!ELEMENT source_support (source_name+)>
<!ELEMENT source_name (#PCDATA)>

<!ELEMENT ethics_reviews (ethics_review+)>
<!ELEMENT ethics_review (status,approval_date,contact_name,contact_address,contact_phone,contact_email)>
<!ELEMENT status (#PCDATA)><!-- Not approved,Approved,NA -->
<!ELEMENT approval_date (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT contact_name (#PCDATA)>
<!ELEMENT contact_address (#PCDATA)>
<!ELEMENT contact_phone (#PCDATA)>
<!ELEMENT contact_email (#PCDATA)>
]>
<trials>
  <trial>
    <main>
      <trial_id>IRCT20221102056383N2</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2025-09-01</date_registration>
      <primary_sponsor>Islamic Azad University</primary_sponsor>
      <public_title>Determining the effect of mandala coloring on the anxiety</public_title>
      <acronym></acronym>
      <scientific_title>Investigatig the effect of mandala coloring on the anxiety of children candidates for tonsillectomy</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2024-08-21</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>60</target_size>
      <recruitment_status>Complete</recruitment_status>
      <url>https://irct.ir/trial/78253</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: Sampling was carried out using convenience sampling and purposive sampling based on the study’s inclusion criteria. Subsequently, the participants were assigned into intervention and control groups through a simple randomization method.

For the simple randomization procedure, 60 rows of numbers were entered into SPSS software (version 27). Then, using the commands Data, Select Cases, Random sample of cases, the software was instructed to randomly select 50% of the cases. The selected 50% were assigned to the intervention group, while the remaining 50% (unselected cases) were considered as the control group.

During patient enrollment, and in accordance with the randomization process performed by the software, the sequence of allocation was as follows: the first three admitted patients were assigned to the intervention group, the next four patients to the control group, the following two patients to the intervention group, the next four patients to the control group, one patient to the intervention group, the next patient to the control group, the subsequent patient to the intervention group, the next patient to the control group, the following six patients to the intervention group, two patients to the control group, and so forth until the 60th patient (the last patient recruited according to the calculated sample size) was allocated.</study_design>
      <phase>N/A</phase>
      <hc_freetext>Anxiety caused by tonsillectomy.</hc_freetext>
      <i_freetext>Intervention 1: Intervention group: The samples are asked to color a raw mandala sample measuring 25×17 for 30-45 minutes using 10 colored pencils. It should be noted that in this study, 5 designs are used, and the participants will choose one of them according to their taste. After the intervention, the Spence Child Anxiety Scale will be completed by the participants in the intervention group. Intervention 2: Control group: No intervention was performed in this group and they will simply complete the questionnaire.</i_freetext>
      <results_actual_enrolment></results_actual_enrolment>
      <results_date_completed></results_date_completed>
      <results_url_link></results_url_link>
      <results_summary></results_summary>
      <results_date_posted></results_date_posted>
      <results_date_first_publication></results_date_first_publication>
      <results_baseline_char></results_baseline_char>
      <results_participant_flow></results_participant_flow>
      <results_adverse_events></results_adverse_events>
      <results_outcome_measures></results_outcome_measures>
      <results_url_protocol></results_url_protocol>
      <results_IPD_plan>Yes - There is a plan to make this available</results_IPD_plan>
      <results_IPD_description>What will be shared:
Only de-identified data relevant to the primary outcomes of the study will be shared upon request.

When:
Data will be available starting 6 months after the publication of the study results.

To whom:
Qualified researchers and postgraduate students in the related field

Conditions:
For academic and clinical research purposes aimed at improving healthcare outcomes and reducing anxiety in the studied population, under appropriate ethical approval.

Where to obtain:
To the principal investigator at Islamic Azad University, Khomein Branch

How to obtain:
If someone requests the data or documentation of the study, they must send a written request via email to the principal investigator. Upon review and approval by the research team, and if necessary, after obtaining approval from the Ethics Committee, the de-identified data will be shared with the requester. This process may take between 2 to 4 weeks.

Comments:
</results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Zeynab Beheshti</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Islamic Azad University, Khomein Branch, University Town, Daneshgah Boulevard, Shohada-ye Daneshjoo Boulevard</address>
        <city>Khomein</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>۳۸۸۱۵۱۷۱</zip>
        <telephone>+98 86 4634 3493</telephone>
        <email>zeynabbeheshti7941@yahoo.com</email>
        <affiliation>Islamic Azad University, Khomein Branch</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Zeynab Beheshti</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Islamic Azad University, Khomein Branch, University Town, Daneshgah Boulevard, Shohada-ye Daneshjoo Boulevard</address>
        <city>Khomein</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>۳۸۸۱۵۱۷۱</zip>
        <telephone>+98 86 4634 3493</telephone>
        <email>zeynabbeheshti7941@yahoo.com</email>
        <affiliation>Islamic Azad University, Khomein Branch</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Iran (Islamic Republic of)</country2>
    </countries>
    <criteria>
      <inclusion_criteria>Age between 8 and 15 years
Consent of the patient and the patient’s parents
Score higher than 84% on the Spence Anxiety Test</inclusion_criteria>
      <agemin>8 years</agemin>
      <agemax>15 years</agemax>
      <gender>Both</gender>
      <exclusion_criteria>Suffering from severe psychiatric disorders
Severe visual or motor impairments that interfere with the ability to perform coloring activities
Inability to establish basic verbal communication with the therapist or researcher
Use of anxiolytic or other stable psychiatric medications within the past three months</exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code></hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword></hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>Other</i_code>
      <i_code>Other</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Intervention group: The samples are asked to color a raw mandala sample measuring 25×17 for 30-45 minutes using 10 colored pencils. It should be noted that in this study, 5 designs are used, and the participants will choose one of them according to their taste. After the intervention, the Spence Child Anxiety Scale will be completed by the participants in the intervention group.</i_keyword>
      <i_keyword>Control group: No intervention was performed in this group and they will simply complete the questionnaire.</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>Average anxiety score. Timepoint: Before and after the intervention, mandala coloring. Method of measurement: At the beginning of the study, a demographic questionnaire and Spence questionnaire were completed, and after the mandala coloring was completed, the Spence questionnaire was completed again, and based on this, the patients' anxiety level was determined.</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome></sec_outcome>
    </secondary_outcome>
    <secondary_sponsor>
      <sponsor_name></sponsor_name>
    </secondary_sponsor>
    <secondary_ids>
      <secondary_id>
        <sec_id></sec_id>
        <issuing_authority></issuing_authority>
      </secondary_id>
    </secondary_ids>
    <source_support>
      <source_name>Islamic Azad University</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2024-07-10</approval_date>
        <contact_name>Research Ethics Committees of Islamic Azad University- Aligudarz branch</contact_name>
        <contact_address>Islamic Azad University, Aligoudarz Branch, Daneshgah Square Aligudarz Lorestan Iran (Islamic Republic of)</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
