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Menopause is a natural life stage associated with hormonal changes that may affect women physically and psychologically. During this period, women may experience increased stress levels, negative attitudes toward menopause, and decreased mindfulness. Mandala coloring is a structured art-based intervention that may promote relaxation and improve psychological well-being. This randomized controlled trial aims to evaluate the effect of mandala coloring on attitudes toward menopause, perceived stress, and mindfulness levels among menopausal women.
Menopause is a natural stage of life characterized by hormonal changes that may affect women's physical and psychological well-being. During this period, women may experience vasomotor symptoms, sleep disturbances, mood changes, increased stress, and negative attitudes toward menopause. Supporting women's psychological well-being during menopause has become an important aspect of women's health care.Mindfulness-based and art-based interventions have increasingly been used as non-pharmacological approaches to improve psychological health and reduce stress. Mandala coloring is a structured art-based intervention that promotes concentration, helps individuals focus on the present moment, and may contribute to emotional regulation and relaxation. Previous studies have shown that mandala coloring may reduce anxiety and stress levels while improving overall well-being.This study will be conducted as a parallel-group randomized controlled experimental trial. The study will take place at Islampasa Family Health Center No.12 located in Rize, Türkiye. A total of 140 menopausal women aged between 45 and 55 years who meet the eligibility criteria will be included in the study.Participants will be randomly assigned to either an intervention group or a control group using a web-based randomization procedure. Women assigned to the intervention group will participate in structured mandala coloring sessions for four weeks, three times per week, for a total of 12 sessions. The first session will be conducted face-to-face at the family health center under researcher supervision. The remaining sessions will be completed individually by participants at home during evening hours.Participants in the control group will receive routine care provided at the family health center without any additional intervention.Data will be collected before and after the intervention using the Personal Information Form, Menopause Attitude Scale, Perceived Stress Scale, and State Mindfulness Scale.The primary purpose of this study is to determine whether structured mandala coloring has an effect on attitudes toward menopause, perceived stress, and mindfulness levels in menopausal women.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mandala Intervention Group | Experimental | Participants in this group will receive mandala coloring sessions three times a week for four weeks in addition to routine care. |
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| Control Group | Active Comparator | Participants in this group will receive routine care provided by the family health center without mandala coloring intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mandala Coloring Program | Behavioral | Participants in the intervention group will receive a mandala coloring program for 4 weeks. The program will be performed 3 times per week, for a total of 12 sessions. The first session will be conducted face-to-face at the family health center, and the remaining sessions will be completed at home. Participants will use standardized mandala templates and coloring materials provided by the researchers. |
| Measure | Description | Time Frame |
|---|---|---|
| Perceived Stress Level | Changes in perceived stress levels of menopausal women will be assessed using the Perceived Stress Scale (PSS-10). Higher scores indicate higher perceived stress. | Baseline and 4 weeks after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Menopause Attitude | Changes in attitudes toward menopause will be assessed using the Menopause Attitude Scale. Higher scores reflect more positive attitudes toward menopause. | Baseline and 4 weeks after intervention |
| State Mindfulness |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| CEMRE ÇİLİNGİR, MSc Student | Contact | +90 536 274 36 46 | cemrecilingir3103@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| NAZLI BALTACI, Assoc. Prof. Dr. | Ondokuz Mayis University Faculty of Health Sciences | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 12 No. Islampasa Family Health Center, Rize | Rize | Rize Province | 53020 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39045964 | Background | Kirca AS, Dagli E, Derin E, Aka N. The effect of mandala coloring on anxiety and quality of life of women in the climacteric period: a randomized controlled study. Rev Assoc Med Bras (1992). 2024 Jul 19;70(6):e20240059. doi: 10.1590/1806-9282.20240059. eCollection 2024. |
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Individual participant data will not be shared due to privacy concerns and ethical restrictions related to participant confidentiality.
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| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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Participants will be randomly assigned to either the mandala coloring intervention group or the routine care control group in parallel.
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| Routine Care | Other | Participants in the control group will receive routine care provided by the family health center. This includes general health monitoring, menopausal health counseling, and standard follow-up services without any mandala coloring intervention during the study period. |
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Changes in mindfulness levels will be assessed using the State Mindfulness Scale. Higher scores indicate greater mindfulness awareness.
| Baseline and 4 weeks after intervention |