The effect of mandala art therapy on comfort level in patients receiving hemodialysis treatment

This randomized controlled and experimental study, which was conducted to determine the effect of mandala painting on the comfort level of patients receiving hemodialysis treatment, was conducted between December 2023 and March 2024 in a private dialysis center in Gaziantep province with 98 patients (49 intervention group, 49 control group) who met the inclusion criteria and whose sample size was determined by power analysis (alpha=0.05, power=0.80). The groups were determined by minimization method considering age, gender and scores obtained from the comfort scale. Before starting the study, the necessary permissions were obtained from the institution, patients and the ethics committee. The data were collected as pre-test and post-test using the Questionnaire and Hemodialysis Comfort Scale Version- II (scored between 26-130 points and the higher the score, the higher the comfort level) by face-to-face interview method. In the analysis of the data, mean and standard deviation or median and minimum-maximum values for continuous variables, frequency and percentage values for qualitative variables, significance test of the difference between two means or one-way ANOVA for group comparisons, chi-square test for group comparisons of qualitative variables were used. p<0.05 was considered significant. After the pretest was applied to both groups, mandala painting consisting of eight sessions was applied during the hemodialysis session to patients in the intervention group who did not have fistula in the dominant arm. The intervention and control groups were homogeneously distributed. Before mandala painting, the mean pretest Hemodialysis Comfort Scale Version- II total score of the intervention group was 88.22±14.86 and 89.92±13.71 in the control group and there was no difference between the two groups in terms of pretest mean score (p>0.05). It was determined that the total score and all sub-dimension mean scores of the intervention group increased in the post-test (96.53±10.71) compared to the pre-test (88.22±14.86), while the total score mean, psychospiritual relaxation and psychospiritual empowerment sub-dimension mean scores were lower in the post-test (88.761±2.81) compared to the pre-test (89.92±13.71) in the control group and these results created a significant difference (p<0.05). There was a significant difference between the comfort scale posttest scores in both groups and the comfort scale posttest score of the intervention group was higher than that of the control group (p<0.05). In conclusion, it was found that mandala coloring applied during hemodialysis treatment increased the comfort level and psychospiritual dimensions. Accordingly, mandala coloring, which is a nonpharmacologic method, is recommended to be used by patients to increase the comfort level of patients receiving hemodialysis treatment.