Coloring complex shapes decreases patient anxiety in three care environments: a pilot study with color analysis.

Introduction: This study was conducted to determine the effectiveness of coloring activity of circular symmetrical shape with complex patterns, so-called mandala, on anxiety associated with chronic illness in three different ambulatory medical situations (general consultation, psychiatric day hospital, and hemodialysis session). Methods: Thirty patients were included in three groups and came from three different ambulatory medical situations: a hemodialysis group (n = 10), a psychiatric day hospital group (n = 10), and a nephrology consultation group (n = 10). We asked the patients to fill STAI-S and STAI-T questionnaires before to color complex circular shape with complex patterns, then to fill the STAI-S questionnaire again and a questionnaire on the experience of the activity. Results: The results show that the STAI-S score was significantly lower after coloring for the hemodialysis (p = 0.02) and psychiatric groups (p = 0.005) but not for the general consultation group (p = 0.26). STAI-T scores did not differ between groups. The distribution of colors in the mandala was different in the three groups of patients. A positive subjective experience of the activity was found in all groups. Discussion: These results show the effectiveness of a coloring activity of a circular shape with complex patterns on anxiety associated with chronic illness in care environment. The different distribution of the colors of the mandala in the three groups raises the question of the influence of the context on the mood of the patients and the deeper meaning of the choice of colors and their placement in the mandala. Our study reinforces the multiple applications of art activities in different medical disciplines and encourages their development within healthcare settings.

S100ß protein for non-traumatic subarachnoid hemorrhage diagnosis.

INTRODUCTION: The S100ß protein (PS100ß) is a biomarker, which has demonstrated its importance in diagnoses ruling out intracranial hemorrhages in people with light head traumas This study aims to evaluate if the PS100ß presents an interest in the diagnostic strategy for subarachnoid hemorrhages (SAH). METHODS: Prospective non-randomized multicentric study in three hospitals from October 2018 to January 2020. Every patient who came into the emergency department for an intense non-traumatic headache lasting less than 3 h received an PS100ß assay and a non-injected head computed tomography (CT) scan. The primary endpoint was the number of patients with a diagnosis of SAH on the head CT scan with a PS100ß level of under 0.10 µg/L. RESULTS: 60 patients were included and five patients had a SAH. Four patients had an SAH with a PS100ß level lower than 0.10 µg/L and one patient had an SAH with a PS100ß level higher than 0.10 µg/L. The negative predictive value for the PS100ß with a discriminating threshold less than or equal to 0,10 µg/L in the diagnosis ruling out SAH was 93% [IC 95%: 0,86-1]. CONCLUSION: S100ß protein assay with a discriminating threshold of 0,10 µg/L does not demonstrate any interest in the diagnostic strategy for non-traumatic SAH.