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Mandala Coloring and Resilience in Midwives

NCT07788508 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 91

Last updated 2026-08-28

No results posted yet for this study

Summary

Midwives working in delivery rooms are exposed to occupational and psychological stressors associated with high workloads, shift work, time pressure, obstetric emergencies, and traumatic perinatal events. These working conditions may adversely affect their psychological resilience and well-being. Mandala coloring is a simple, low-cost, art-based activity that may promote relaxation and psychological well-being; however, evidence regarding its effect on psychological resilience among midwives is limited.

The aim of this study was to evaluate the effect of mandala coloring on psychological resilience among midwives working in delivery rooms. Secondary outcomes included depression, anxiety, stress, and psychological well-being.

The study was conducted as a two-arm, pretest-posttest, matched cluster randomized controlled trial involving midwives working in the delivery rooms of eight hospitals. Hospitals were treated as clusters and matched into four pairs according to the number of midwives working in the delivery room and the annual number of births. Within each matched pair, one hospital was randomly assigned to the intervention group and the other to the control group. A total of 91 midwives participated in the study, with 45 midwives from four hospitals allocated to the intervention group and 46 midwives from four hospitals allocated to the control group.

Midwives in the intervention group participated in a six-week mandala coloring program. They were asked to complete two mandala coloring sessions per week, for a total of 12 sessions, with each session lasting approximately 20-30 minutes. Participants in the control group continued their usual routines during the six-week study period.

Psychological resilience was assessed as the primary outcome using the Resilience Scale for Adults. Depression, anxiety, and stress were assessed using the Depression Anxiety Stress Scale-21, and psychological well-being was assessed using the Psychological Well-Being Scale. Outcomes were assessed at baseline and at the end of the six-week intervention period.

Conditions

  • Psychological Resilience Among Midwives Working in Delivery Rooms

Interventions

BEHAVIORAL

Mandala Coloring

Participants completed mandala coloring twice per week for six consecutive weeks, for a total of 12 sessions. Each session lasted approximately 20-30 minutes and was conducted during working hours at a time suitable for the participant. Participants selected one of the provided mandala designs and colored it according to their own preferences using a 12-color felt-tip pen set. Adherence was monitored through messages sent before each session and photographs of the completed mandalas sent to the researcher after each session. Reminder messages were sent twice weekly.

Sponsors & Collaborators

  • Istanbul University - Cerrahpasa

    lead OTHER

Principal Investigators

  • Neriman Güdücü, Ph.D. · Istanbul University - Cerrahpasa

Study Design

Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Model
PARALLEL

Eligibility

Sex
FEMALE
Healthy Volunteers
Yes

Timeline & Regulatory

Start
2025-01-01
Primary Completion
2025-08-30
Completion
2025-08-30

Countries

  • Turkey (Türkiye)

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07788508 on ClinicalTrials.gov