121. Effects of martial arts therapy on psychological state in psychiatric nursing

Abstract Background Anxiety and depression are common in psychiatry. While standard treatments are effective, limitations like side effects or low motivation exist. Martial arts therapy, integrating physical movement, breath control, and mindfulness, may offer a non-verbal channel for emotional regulation. However, its effectiveness and mechanisms in Chinese psychiatric care lack systematic evidence. This study used structured martial arts therapy to explore its effects on anxiety, depression, and emotional state in inpatients, and analyze its action pathways. Methods A randomized controlled trial design was adopted. Ninety inpatients with mild to moderate anxiety and depressive symptoms (Hamilton Anxiety Rating Scale, HAMA≥14; Hamilton Depression Rating Scale, HAMD≥17) from a city mental health center were recruited and randomly assigned to an experimental group (n = 45) or a control group (n = 45). Both groups received standard psychiatric medication and nursing care. Additionally, the experimental group underwent an 8-week, 3-sessions-per-week structured martial arts therapy program based on simplified Tai Chi and Baduanjin, emphasizing slow movements, diaphragmatic breathing, and mind–body awareness. The control group participated in routine recreational activities (e.g., handicrafts, reading) with equal frequency. Assessments using the HAMA, HAMD, and General Well-Being Schedule (GWB) were conducted at baseline (T0) and post-intervention (T1) by assessors blinded to group allocation. Quantitative data were analyzed using repeated-measures ANOVA in SPSS 22.0. Post-intervention, semi-structured interviews were conducted with 15 patients from the experimental group, and qualitative data were analyzed thematically using Nvivo 11.0. Results At T0, no significant differences existed between the two groups on HAMA, HAMD, or GWB scores (p>.05). At T1, repeated-measures ANOVA revealed a significant interaction effect between time and group (p<.01). Simple effect analysis showed that the experimental group’s HAMA score (M = 10.2, SD = 2.8) and HAMD score (M = 12.5, SD = 3.1) at T1 were significantly lower than the control group’s (HAMA M = 15.1, SD = 3.2; HAMD M = 16.8, SD = 3.5), with statistically significant differences (p<.001). The GWB score of the experimental group (M = 78.5, SD = 6.4) was significantly higher than that of the control group (M = 70.2, SD = 7.1, p<.01). Interview analysis indicated that 87% of interviewees experienced enhanced sense of bodily control, regaining autonomy over their bodies through completing movements. 80% of participants reported that the exercise process provided an effective channel for emotional release, where focus and breathing helped temporarily detach from negative emotions. 73% of patients reported increased self-efficacy, gaining a significant sense of achievement and confidence from learning and completing martial arts sequences. Discussion This study confirms that introducing structured martial arts therapy alongside routine psychiatric care can effectively alleviate patients’ anxiety and depressive symptoms and enhance their subjective well-being. The mechanisms may involve regulating neurotransmitter levels through regular physical activity, enhancing the individual’s sense of control over their emotions and body through mind–body integrated practice, and rebuilding impaired self-efficacy by mastering new skills. The findings hold clear clinical significance. As a low-cost, high-adherence intervention with cultural affinity, martial arts therapy can be promoted as an effective supplementary approach in psychiatric rehabilitation nursing. It is recommended to include basic related skills in nursing training programs. Funding No. 2024GCC008; No. 2025JGB367.