الفهرس 
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Abstract
Living with hemodialysis is associated with anxiety. Thus, improving adaptive responses that increase resilience and protect against psychological distress is a priority. Mandala coloring is a form of art therapy that fosters self-expression by allowing individuals to explore their anxiety, is a good and applicable choice. Aim of the study: Explore the effect of mandala coloring nurse-led intervention program on anxiety and resilience among hemodialysis patients. Research design: Experimental design was used. Setting: The study was conducted at Hemodialysis Unit affiliated to Suez Canal University Hospital and the international 30 July center, Ismailia governorate. Subject: A sample of 64 Hemodialysis patients with chronic hemodialysis, shunt in non-dominant hands, and without antianxiety or antidepressant medications. Tools of data collection: Three tools were used: Tool(I): Demographic characteristics and clinical characteristics. Tool (II): Spielberger State-Trait Anxiety Inventory for Adults, Form Y, and Tool (III): The Connor-Davidson Resilience scale (CD-RISC). Results: It was found that hemodialysis patients had a moderate level of state anxiety and a mild level of resilience before the intervention.Regarding post and follow-up phases, the levels of anxiety decreased while resilience levels increased among the intervention group compared with the control group. An inverse correlation was also found between resilience scores and anxiety. Conclusion: The mandala coloring nurse-led intervention program significantly reduced anxiety and improved psychological resilience among hemodialysis patients in the post-follow-up study phases compared with the pre-program phase. Recommendation: Mandala coloring nurse-led intervention programs can be combined with care programs of hospitals as a complementary interventions.