Background: Hospitalization has emotional and developmental impact on the children. Art therapy is distraction strategy to reduce anxiety and stress level of hospitalized child, improves mood and communication, promoting emotional and physical wellbeing. Method: 40 children aged between 3-7 years who were admitted to G V Pai and Alvas health canter, Karnataka were selected for the study. True experimental design with simple random sampling technique was adopted to select samples and dividing them as control and art therapy group (20 in each group). The intervention Art therapy was initiated for 15-20 minutes. Anxiety as the main outcome variable measured using the Self-Structured Anxiety Inventory. Descriptive and inferential statistics was utilized for analysis. Results: The mean percentage of post intervention anxiety score in the experimental group (27.89%) was lower than the pre-test anxiety scores (37.02) % showing a reduction of (9.12) % anxiety. Pre-test and post-test mean anxiety scores were statistically significant at 0.05 level of significance Art therapy was found to be effective in significantly reducing anxiety levels in the intervention group. Paired differences of mean anxiety scores among both groups is statistically significant p < 0.05, It shows that anxiety levels among the experimental group reduced compared to the control group. Conclusion: The study demonstrated that art therapy proved to reduce anxiety levels among participants in the experimental group than control group. Therefore, art therapy emerges as a valuable, non-invasive, non-pharmacological and child-friendly intervention that can be effectively integrated into the care of hospitalized children.

Keywords: Art therapy; children; Anxiety; Hospitalization; Fear

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1. Freyleue, S., Arakelyan, M., & Leyenaar, J. (2023). Epidemiology of pediatric hospitalizations at general hospitals and freestanding children's hospitals in the United States: 2019 update.. Journal of hospital medicine. https://doi.org/10.1002/jhm.13194.
2. Berry, J., Hall, M., Hall, D., Kuo, D., Cohen, E., Agrawal, R., Mandl, K., Clifton, H., & Neff, J. (2013). Inpatient growth and resource use in 28 children's hospitals: a longitudinal, multi-institutional study. JAMA pediatrics, 167 2, 170-7 https://doi.org/10.1001/jamapediatrics.2013.432
3. Amandeep Kaur, Kanwaljit Kaur Gill. An Exploratory Study to Assess the Level of Stress and Coping Strategies Among the Parents of Children Admitted in Paediatric Ward in the Selected Hospital, Ludhiana, Punjab. Int. J. Nur. Edu. and Research. 2017; 5(3): 297-302. doi: 10.5958/2454-2660.2017.00061.8
4. Claridge AM, J Powell O. Children's experiences of stress and coping during hospitalization: A mixed-methods examination. J Child Health Care. 2023 Dec;27(4):531-546. doi: 10.1177/13674935221078060. Epub 2022 Mar 24. PMID: 35324345.
5. Christian B. J. (2018). Translational Research - The Stress and Uncertainty of Hospitalization and Strategies for Pediatric Nurses to Improve the Quality of Care for Children and Families. Journal of pediatric nursing, 41, 140–145. https://doi.org/10.1016/j.pedn.2018.05.012.
6. Akanksha, "Effectiveness of Art Therapy on Level of Anxiety among Hospitalized Children", International Journal of Science and Research (IJSR), Volume 12 Issue 5, May 2023, pp. 707-709, https://www.ijsr.net/getabstract.php?paperid=SR23509084536, DOI: https://www.doi.org/10.21275/SR23509084536
7. amazing therapeutic benefits of art for anxiety management and innovative treatment. (2024, June 12). Retrieved May 3, 2025, from Mindful Health Solutions website: https://mindfulhealthsolutions.com/9-amazing-therapeutic-benefits-of-art-for-anxiety-management/
8. Sri Ramdaniati, Susy Hermaningsih, Muryati (2016) Comparison Study of Art Therapy and Play Therapy in Reducing Anxiety on Pre-School Children Who Experience Hospitalization. Open Journal of Nursing,06,46-52. doi: 4236/ojn.2016.61005
9. Maheswari and A. Reena Evency (2021) “Effectiveness of art therapy on level of anxiety among hospitalized school age children in a selected hospital at kanyakumari district,” International journal of nursing education, 13(4), pp. 30–33. Available at: https://doi.org/10.37506/ijone.v13i4.16584.
10. Raj et al. "A study to assess the effectiveness of art therapy on anxiety level among hospitalized children in selected hospital, Chennai." (2016).
11. Sri Ramdaniati, Susy Hermaningsih, Muryati (2016) Comparison Study of Art Therapy and Play Therapy in Reducing Anxiety on Pre-School Children Who Experience Hospitalization. Open Journal of Nursing,06,46-52. doi: 4236/ojn.2016.61005
12. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children. J Pediatr. 2019 Mar;206:256-267.e3. doi: 10.1016/j.jpeds.2018.09.021. Epub 2018 Oct 12. PMID: 30322701; PMCID: PMC6673640.
13. Schlegelmilch, M., Punja, S., Jou, H., Mackie, A., Conway, J., Wilson, B., Spavor, M., Hartfield, D., & Vohra, S. (2019). Observational Study of Pediatric Inpatient Pain, Nausea/Vomiting and Anxiety. Children, 6. https://doi.org/10.3390/children6050065
14. Dalei SR, Nayak GR, Pradhan R. Effect of art therapy and play therapy on anxiety among hospitalized preschool children. J Biomed Sci [Internet]. 2020 [cited 2025 Apr 18];7(2):71–6. Available from: https://nepjol.info/index.php/JBS/article/view/34006
15. Li, W., Chung, J., Ho, K., & Kwok, B. (2016). Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatrics, 16. https://doi.org/10.1186/s12887-016-0570-5.
16. Delvecchio, E., Salcuni, S., Lis, A., Germani, A., & Di Riso, D. (2019). Hospitalized Children: Anxiety, Coping Strategies, and Pretend Play. Frontiers in Public Health, 7. https://doi.org/10.3389/fpubh.2019.00250.

Background: Hospitalization has emotional and developmental impact on the children. Art therapy is distraction strategy to reduce anxiety and stress level of hospitalized child, improves mood and communication, promoting emotional and physical wellbeing. Method: 40 children aged between 3-7 years who were admitted to G V Pai and Alvas health canter, Karnataka were selected for the study. True experimental design with simple random sampling technique was adopted to select samples and dividing them as control and art therapy group (20 in each group). The intervention Art therapy was initiated for 15-20 minutes. Anxiety as the main outcome variable measured using the Self-Structured Anxiety Inventory. Descriptive and inferential statistics was utilized for analysis. Results: The mean percentage of post intervention anxiety score in the experimental group (27.89%) was lower than the pre-test anxiety scores (37.02) % showing a reduction of (9.12) % anxiety. Pre-test and post-test mean anxiety scores were statistically significant at 0.05 level of significance Art therapy was found to be effective in significantly reducing anxiety levels in the intervention group. Paired differences of mean anxiety scores among both groups is statistically significant p < 0.05, It shows that anxiety levels among the experimental group reduced compared to the control group. Conclusion: The study demonstrated that art therapy proved to reduce anxiety levels among participants in the experimental group than control group. Therefore, art therapy emerges as a valuable, non-invasive, non-pharmacological and child-friendly intervention that can be effectively integrated into the care of hospitalized children.

Keywords: Art therapy; children; Anxiety; Hospitalization; Fear

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Freyleue, S., Arakelyan, M., & Leyenaar, J. (2023). Epidemiology of pediatric hospitalizations at general hospitals and freestanding children's hospitals in the United States: 2019 update.. Journal of hospital medicine. https://doi.org/10.1002/jhm.13194.
2. Berry, J., Hall, M., Hall, D., Kuo, D., Cohen, E., Agrawal, R., Mandl, K., Clifton, H., & Neff, J. (2013). Inpatient growth and resource use in 28 children's hospitals: a longitudinal, multi-institutional study. JAMA pediatrics, 167 2, 170-7 https://doi.org/10.1001/jamapediatrics.2013.432
3. Amandeep Kaur, Kanwaljit Kaur Gill. An Exploratory Study to Assess the Level of Stress and Coping Strategies Among the Parents of Children Admitted in Paediatric Ward in the Selected Hospital, Ludhiana, Punjab. Int. J. Nur. Edu. and Research. 2017; 5(3): 297-302. doi: 10.5958/2454-2660.2017.00061.8
4. Claridge AM, J Powell O. Children's experiences of stress and coping during hospitalization: A mixed-methods examination. J Child Health Care. 2023 Dec;27(4):531-546. doi: 10.1177/13674935221078060. Epub 2022 Mar 24. PMID: 35324345.
5. Christian B. J. (2018). Translational Research - The Stress and Uncertainty of Hospitalization and Strategies for Pediatric Nurses to Improve the Quality of Care for Children and Families. Journal of pediatric nursing, 41, 140–145. https://doi.org/10.1016/j.pedn.2018.05.012.
6. Akanksha, "Effectiveness of Art Therapy on Level of Anxiety among Hospitalized Children", International Journal of Science and Research (IJSR), Volume 12 Issue 5, May 2023, pp. 707-709, https://www.ijsr.net/getabstract.php?paperid=SR23509084536, DOI: https://www.doi.org/10.21275/SR23509084536
7. amazing therapeutic benefits of art for anxiety management and innovative treatment. (2024, June 12). Retrieved May 3, 2025, from Mindful Health Solutions website: https://mindfulhealthsolutions.com/9-amazing-therapeutic-benefits-of-art-for-anxiety-management/
8. Sri Ramdaniati, Susy Hermaningsih, Muryati (2016) Comparison Study of Art Therapy and Play Therapy in Reducing Anxiety on Pre-School Children Who Experience Hospitalization. Open Journal of Nursing,06,46-52. doi: 4236/ojn.2016.61005
9. Maheswari and A. Reena Evency (2021) “Effectiveness of art therapy on level of anxiety among hospitalized school age children in a selected hospital at kanyakumari district,” International journal of nursing education, 13(4), pp. 30–33. Available at: https://doi.org/10.37506/ijone.v13i4.16584.
10. Raj et al. "A study to assess the effectiveness of art therapy on anxiety level among hospitalized children in selected hospital, Chennai." (2016).
11. Sri Ramdaniati, Susy Hermaningsih, Muryati (2016) Comparison Study of Art Therapy and Play Therapy in Reducing Anxiety on Pre-School Children Who Experience Hospitalization. Open Journal of Nursing,06,46-52. doi: 4236/ojn.2016.61005
12. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children. J Pediatr. 2019 Mar;206:256-267.e3. doi: 10.1016/j.jpeds.2018.09.021. Epub 2018 Oct 12. PMID: 30322701; PMCID: PMC6673640.
13. Schlegelmilch, M., Punja, S., Jou, H., Mackie, A., Conway, J., Wilson, B., Spavor, M., Hartfield, D., & Vohra, S. (2019). Observational Study of Pediatric Inpatient Pain, Nausea/Vomiting and Anxiety. Children, 6. https://doi.org/10.3390/children6050065
14. Dalei SR, Nayak GR, Pradhan R. Effect of art therapy and play therapy on anxiety among hospitalized preschool children. J Biomed Sci [Internet]. 2020 [cited 2025 Apr 18];7(2):71–6. Available from: https://nepjol.info/index.php/JBS/article/view/34006
15. Li, W., Chung, J., Ho, K., & Kwok, B. (2016). Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatrics, 16. https://doi.org/10.1186/s12887-016-0570-5.
16. Delvecchio, E., Salcuni, S., Lis, A., Germani, A., & Di Riso, D. (2019). Hospitalized Children: Anxiety, Coping Strategies, and Pretend Play. Frontiers in Public Health, 7. https://doi.org/10.3389/fpubh.2019.00250.