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This study aims to evaluate the effect of mandala coloring on nausea, vomiting, fatigue, and psychological well-being in cancer patients receiving chemotherapy. The intervention involves guided mandala coloring sessions applied during chemotherapy cycles. The outcomes will be assessed using standardized scales measuring symptom severity and psychological well-being before and after the intervention.
This study is a clinical trial designed to investigate the effects of mandala coloring on nausea, vomiting, fatigue, and psychological well-being in cancer patients receiving chemotherapy. Chemotherapy is commonly associated with both physical and psychological side effects that negatively impact patients' quality of life.
The intervention consists of structured mandala coloring sessions conducted during chemotherapy cycles. Participants will perform the coloring activity in a calm and appropriate clinical environment. No pharmacological or additional psychological interventions will be applied during the study period.
Outcome measures include the severity of nausea, vomiting, and fatigue, as well as psychological well-being levels, assessed using validated scales at baseline and after the intervention. Differences in these outcomes will be analyzed to evaluate the effectiveness of the mandala coloring intervention.
The study is expected to provide evidence regarding low-cost, non-pharmacological supportive care methods that may improve symptom management and psychological health in chemotherapy patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The effect of mandala practice on nausea, vomiting, and fatigue | Experimental | Cancer patients receiving chemotherapy in this group participated in a structured mandala painting intervention in addition to standard care. The intervention was applied during chemotherapy infusion and continued within the first 24 hours after treatment. Patients engaged in individual coloring activities using standardized mandala templates in a calm environment aimed at promoting relaxation and reducing symptom burden. |
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| Control: Standard Care | No Intervention | Patients in this group received standard chemotherapy care only without any additional non-pharmacological intervention. Outcomes such as nausea, vomiting, fatigue, and psychological well-being were assessed for comparison with the experimental group. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mandala Coloring Intervention | Other | Participants in the intervention group performed a structured mandala coloring activity designed to promote relaxation and reduce chemotherapy-related symptoms. Pre-designed mandala patterns and colored pencils were provided. The session was conducted in a quiet environment and lasted approximately 20-30 minutes. The intervention was applied once. Outcomes including nausea, vomiting, fatigue, and psychological well-being were assessed within 24 hours after the intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| The Effect of Mandala Coloring on Nausea, Vomiting, Fatigue, and Psychological Well-Being in Cancer Patients Receiving Chemotherapy | Nausea and vomiting severity were assessed using the Rhodes Index of Nausea, Vomiting, and Retching (RINVR). Fatigue levels were measured using a standardized fatigue scale, and psychological well-being was assessed using a validated psychological well-being scale. Outcome measures were compared between the mandala painting group and the control group before and within 24 hours after the intervention. | Within 24 hours after the intervention |
| The effects of mandala painting on nausea, vomiting, fatigue, and psychological well-being in cancer patients undergoing chemotherapy. | Fatigue Severity Questionnaire: The fatigue severity scale is a unidimensional questionnaire with a total score of 16 on a seven-point Likert scale, and higher total scores indicate greater fatigue. Psychological Well-being Scale: The scale consists of 8 items and is a 7-point Likert type. The scale is single-dimensional, with a minimum score of 8 and a maximum score of 56. Higher scores on the scale indicate higher overall psychological well-being. | 24 hours after intervention |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Adile NeÅŸe | University of Gaziantep | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gaziantep University Vocational School of Health Services | Gaziantep | Şehitkamil | 27000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41308533 | Background | Yuruk E, Todil T, Askan F, Kara M, Hacisalihoglu A. Effects of mandala art therapy (coloring) on nausea, vomiting, pain and anxiety in children and youth receiving outpatient chemotherapy. J Pediatr Nurs. 2026 Jan-Feb;86:366-374. doi: 10.1016/j.pedn.2025.11.029. Epub 2025 Nov 26. | |
| 40729075 | Background | Dadashi N, Khanali Mojen L, Ilkhani M, Nasirie M, Mirzaee HR, Boozaripour M. Effect of Mandala Art Therapy on Quality of Life in Breast Cancer Patients. Asian Pac J Cancer Prev. 2025 Jul 1;26(7):2533-2540. doi: 10.31557/APJCP.2025.26.7.2533. |
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| ID | Term |
|---|---|
| D014839 | Vomiting |
| D009325 | Nausea |
| D005221 | Fatigue |
| D000092862 | Psychological Well-Being |
| ID | Term |
|---|---|
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010549 | Personal Satisfaction |
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This study was conducted as an interventional study using a parallel assignment design. The mandala coloring intervention was applied to participants during the chemotherapy treatment process and within a 24-hour period. Participants in the intervention group received mandala coloring activities in addition to routine care. In the control group, no intervention was applied, and only assessment tools were administered. Outcome measures were evaluated within a 24-hour period following the intervention, and comparisons were made between the groups.
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experimental and control group
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| D001519 | Behavior |