The Effects of Mandala Coloring on Fatigue, Psychological Well-Being, and Coping with Stress in Patients Receiving Hemodialysis Treatment

Abstract

Background: Hemodialysis is an important health problem that negativelyaffects psychosocial status and support systems. Through practices such asmandala coloring, individuals transfer the unknowns they experience to theoutside and make them visible. This study was conducted to examine theeffects of mandala coloring on fatigue, psychological well-being, and factorsassociate with coping with stress in patients receiving hemodialysis treatment.Methods: The design was a prospective, parallel-group controlled trial. Thestudy was conducted in the dialysis unit of a university hospital in easternTurkey between April 4 and October 31, 2022, with a total of 60 patients, 30 inthe intervention group, and 30 in the control group. The patients in the inter-vention group colored mandala once a week for 2 h, for a total of 8 weeks. Thedata were collected face-to-face using a patient information form, a FatigueSeverity Scale, a Psychological Well-Being Scale, and a Ways of CopingQuestionnaire.Results: There were improvements in fatigue severity and psychological well-being over the 8-week study period in both the intervention and controlgroups. Scores were similar at baseline in the control and intervention groups,but better in the intervention groups compared to controls at 4 and 8 weeksfor both metrics (p < 0001). Five factors from the Ways of Coping Question-naire (self-confident approach, optimistic approach, seeking social support,helpless approach, and submissive approach) each improved during the8-week period in the intervention group (p < 0.001). Three of these five factorsimproved in the control group as well. Scores for each of the five coping factorswere better in the intervention group compared to controls at 4 and 8 weeks(p < 0.001).Conclusion: Mandala coloring improved fatigue and psychological well-beingand was associated with improved patient coping strategies.