The effects of art therapy using the Zentangle method for older adults with depressive symptoms
| ISRCTN | ISRCTN66410347 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN66410347 |
| ClinicalTrials.gov (NCT) | Nil known |
| Clinical Trials Information System (CTIS) | Nil known |
| Protocol serial number | Nil known |
| Sponsor | Hong Kong Polytechnic University |
| Funder | investigator initiated and funded |
- Submission date
- 05/04/2021
- Registration date
- 14/04/2021
- Last edited
- 27/06/2023
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Approximately 10% of older adults in Hong Kong have depression. Antidepressant medications and psychotherapy have always been recommended for treating older adults with depression. Medication may have side effects. Hence, the high level of involvement of well-trained experts or professionals is necessary to provide timely and intensive psychotherapy intervention. The original Zentangle method is an art form that promotes calmness and increases awareness by drawing structured patterns. It may also enhance one’s self-compassion. A growing interest has been observed in applying Zentangle in mental health or elderly services in Hong Kong. However, no empirical study has been conducted on the effects of this method.
Who can participate?
Community-dwelling older adults (aged 60 years or above) with depression.
What does the study involve?
A six-session protocol of intervention was developed on the basis of the original Zentangle method. Participants were randomly assigned to the intervention group and the waitlist control group. The effects were examined by comparing the participants who received a six-week Zentangle intervention with those in the waitlist control group.
What are the possible benefits and risks of participating?
None
Where is the study run from?
NAAC Shumshuipo District Elderly Community Centre (Hong Kong, China)
When is the study starting and how long is it expected to run for?
August 2019 to September 2020
Who is funding the study?
Investigator initiated and funded
Who is the main contact?
Dr Henri Chun-yiu Chan, henrichan@vtc.edu.hk
Contact information
Public
Hong Kong Institute of Vocational Education (Sha Tin)
21 Yuen Wo Road, Sha Tin, New Territories
Hong Kong
-
Hong Kong
 ORCID ID |
0000-0001-6275-2636 |
|---|---|
| Phone | +852 92880458 |
| henrichan@vtc.edu.hk |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Randomized waitlist controlled trial |
| Secondary study design | Randomised controlled trial |
| Participant information sheet | ISRCTN66410347_PIS.pdf |
| Scientific title | The effects of the original Zentangle method for older adults with depressive symptoms: a randomised waitlist controlled trial |
| Study objectives | 1. Older adults randomised to the Zentangle programme have more improvements in the symptoms of depression than those in the waitlist control group 2. Older adults randomised to the Zentangle programme have more improvements in the level of self-compassion than those in the waitlist control group |
| Ethics approval(s) | Approved 20/08/2019, Human Subjects Ethics Sub-committee, The Hong Kong Polytechnic University (Hung Hom, Hong Kong, China; +852 2766 6378; cherrie.mok@polyu.edu.hk), ref: HSEARS20190806001 |
| Health condition(s) or problem(s) studied | Community-dwelling older adults with depressive symptoms |
| Intervention | Participants were randomly assigned to the intervention group and the waitlist control group. The effects were examined by comparing the participants who received a six-week Zentangle intervention with those in the waitlist control group. Baseline (T0), post-intervention (T1, six weeks after T0) and six-week follow-up (T2, twelve weeks after T0) measures were completed in this study. Forty-six community-dwelling older adults with scores of five or above in the Patient Health Questionnaire-9 (PHQ-9) were recruited. Outcomes including depressive symptoms, self-compassion, self-soothing tendency, self-defeating tendency, positive affect, negative affect, participation in pleasant activities and perceived health were assessed. Same treatment is provided to the waitlist-control group after the data-collection period. |
| Intervention type | Behavioural |
| Primary outcome measure(s) | Measured at baseline, 6 and 12 weeks: 1. Depression is measured using PHQ-9 2. Self-compassion is measured using Self-Compassion Scale- Short Form (SCS-SF) |
| Key secondary outcome measure(s) | There are no secondary outcome measures |
| Completion date | 30/09/2020 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Senior |
| Sex | All |
| Target sample size at registration | 42 |
| Total final enrolment | 46 |
| Key inclusion criteria | 1. The older adult is living in the community 2. The older adult is aged 60 or above 3. The older adult scored over 5 or above in the Patient Health Questionnaire-9 (PHQ-9) 4. The older adult should have no formal diagnosis of other mental health illness other than depression based on their self-report in the pre-test interview 5. The older adult should be able to understand Cantonese 6. The older adult should have no visual impairment 7. The older adult should be able to hold a pen and have no severe medical conditions with physical mobility based on their self-report in the pre-test interview 8. The older adult should be able to attend 80% of the programme sessions |
| Key exclusion criteria | 1. The older adult has formal diagnosis of other mental health illness other than depression based on their self-report in the pre-test interview 2. The older adult is not able to understand Cantonese 3. The older adult has no visual impairment 4. The older adult is not able to hold a pen and has severe medical conditions with physical mobility based on their self-report in the pre-test interview 5. The older adult is not able to attend 80% of the programme sessions |
| Date of first enrolment | 01/09/2019 |
| Date of final enrolment | 30/06/2020 |
Locations
Countries of recruitment
- Hong Kong
Study participating centre
Shek Kip Mei Estate
100 Woh Chai Street
Sham Shui Po
Kowloon
Hong Kong
-
Hong Kong
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan summary | Available on request |
| IPD sharing plan | Dr. Henri Chan, henrichan@vtc.edu.hk, Individual participant data that underlie the results reported in this article, after deidentification the datasets used and/or analysed during the study are available upon reasonable request. Data requestors will need to sign a data access agreement. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | 05/05/2023 | 27/06/2023 | Yes | No | |
| Participant information sheet | 04/05/2021 | No | Yes | ||
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
| Thesis results | 01/01/2021 | 04/10/2022 | No | No |
Additional files
- ISRCTN66410347_PIS.pdf
- uploaded 04/05/2021
Editorial Notes
27/06/2023: Publication reference added.
04/10/2022: Added link to thesis.
04/05/2021: The participant information sheet was uploaded as an additional file.
14/04/2021: Internal review.
12/04/2021: Trial's existence confirmed by The Hong Kong Polytechnic University.
