The effect of mandala coloring on symptom burden and self-care in female hemodialysis patients: A randomized controlled trial.

OBJECTIVE

This randomized controlled study aimed to evaluate the effect of mandala coloring on symptom burden and self-care among female patients receiving hemodialysis.

METHODS

The study was conducted with 82 female hemodialysis patients at a dialysis center in Istanbul, Türkiye, who were randomly assigned to an intervention group (n=41) or a control group (n=41). Participants in the intervention group performed mandala coloring for approximately 20-30 minutes once weekly for 8 weeks during routine hemodialysis sessions. Data was collected between September 2024 and January 2025 using a Personal Information Form, the Dialysis Symptom Index, and the Self-Care Agency Scale for Chronic Dialysis Patients.

RESULTS

Although baseline symptom burden was higher in the intervention group, both groups showed significant reductions in DSI scores after the intervention (p<.05), with greater improvement observed in the intervention group (p<.001). Post-intervention self-care scores were significantly higher in the intervention group, particularly in diet, self-monitoring, hygienic care, and mental status domains (p=.012). A weak positive correlation was observed between dialysis duration and DSI scores and dietary self-care (r≈0.23, p<.05), while no significant associations were found for other self-care domains.

CONCLUSION

Mandala coloring appears to be an effective non-pharmacological intervention for reducing symptom burden and improving self-care behaviors among female patients receiving hemodialysis. The findings support the potential integration of structured art-based interventions into routine dialysis care to promote patient well-being.