The Effect of Mandala Coloring on Symptom Burden and Self-Care in Female Dialysis Patients

 

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The Effect of Mandala Coloring on Symptom Burden and Self-Care in Female Dialysis Patients

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Zehra
Aydin
Zehra Aydin zehraydin@gmail.com Istanbul Atlas University Health Science Faculty Istanbul Turkey *
Emine Bakir berf2721@hotmail.com Iskenderun State Hospital Internal Hatay Turkey -
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Female patients undergoing hemodialysis often experience a high symptom burden, including fatigue, pain, pruritus, and sleep disturbances, which adversely affect self-care and quality of life. Non-pharmacological interventions such as art therapy have shown promise in alleviating these symptoms. Mandala coloring, a mindfulness-based creative activity, may promote emotional regulation and enhance self-care behaviors. This study aimed to evaluate the effect of mandala coloring on symptom burden and self-care in female hemodialysis patients.

A randomized controlled trial was conducted with 82 female patients from two dialysis centers in Istanbul between September 2024 and January 2025. Participants were randomly assigned to an intervention group (n=41) or a control group (n=41). The intervention group engaged in weekly mandala coloring sessions for 20–30 minutes during dialysis, over 8 consecutive weeks. Data were collected using the Dialysis Symptom Index (DSI) and the Self-Care Agency Scale for Chronic Dialysis Patients. Pre- and post-intervention measures were compared using t-tests and correlation analyses (p<.05).

At baseline, the intervention group reported higher DSI scores than controls (77.39±14.09 vs. 49.34±24.94, p<.05). Both groups showed significant reductions in symptom scores after 8 weeks, but the intervention group demonstrated a more pronounced decrease (p=0.000). Post-test self-care scores improved significantly in the intervention group compared to controls (28.34±3.40 vs. 26.44±3.30, p=0.012), with notable gains in diet, self-monitoring, hygienic care, and mental state subdomains. A low positive correlation was found between dialysis duration and both DSI and dietary self-care scores (r≈0.23, p<.05).

Mandala coloring reduced symptom burden and enhanced self-care abilities in female hemodialysis patients. Given its simplicity, affordability, and psychological benefits, mandala coloring may be integrated as a complementary therapy into routine dialysis sessions to promote holistic, patient-centered care.

Kewords