Effects of Mandala Coloring on Premenstrual Syndrome

Study Overview
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Brief Summary
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This research was planned as a randomized controlled experimental study in order to reduce premenstrual syndrome symptoms of women with premenstrual syndrome.

Detailed Description
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In the menstrual period, which starts with menarche and continues until menopause, which covers a significant part of a woman's life; It is seen that most women experience some physical, psychological and behavioral symptoms before menstruation. Premenstrual syndrome is a health problem that occurs in the luteal phase, decreases or regresses significantly with the onset of menstruation, and has more than 150 physical, psychological and behavioral symptoms such as breast tenderness, headache, anger outbursts, nervousness, anxiety, mood swings, eating disorders. In the first meta-analysis to determine the global prevalence of PMS, the worldwide prevalence of PMS was 47.8%. In studies conducted with university students in various countries, the prevalence of PMS varies between 39.8% and 98.2%. Symptoms experienced in the premenstrual period cause mood/affective disorder, deterioration in daily living activities and social relations, an increase in negative health behaviors in women, and also lead to results such as low academic performance, decreased participation in classes, getting low grades in exams, and absenteeism in exams. Since the etiology of premenstrual syndrome is unclear, no specific treatment method can be found and non-pharmacological therapies such as stress control, lifestyle changes, exercise and complementary therapies such as evening primrose oil, chasteberry and acupuncture are applied in its management. Psychiatrist Carl Gustav Jung discovered the psychic healing transformations created by painting mandala, one of the art therapy methods, through his own and his patients' experiences. Jung defined the mandala as the psychological expression of the unity of the self and believed that the mandala form represents psychic unity and integrity, and as a result, he made mandala coloring a part of his patients' therapeutic process.The repetitive pattern and symmetry of the mandala, which means circle in Sanskrit, is thought to have a healing and transformative effect along with meditative focus. Various studies have found that coloring mandala improves physical and psychological symptoms; It has been found to reduce anxiety and depression in cancer patients and children, pregnant women, and students. However, when the literature is examined, although studies such as yoga, swimming, aerobic exercise, acupressure, and music therapy have been conducted to improve PMS symptoms, no study has been found showing the effect of mandala coloring on PMS.

Official Title
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Effects of Mandala Coloring on Premenstrual Syndrome: Randomized Controlled Experimental Study

Conditions
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Premenstrual Syndrome

Intervention / Treatment
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* Other: Mandala coloring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Volunteering to participate in the research Fully answering survey and scale forms. Ability to read and understand Turkish Being between the ages of 18 and 30 years Having regular menstruation (between 21 and 35 days) Having 45 or more from PMSS Exclusion Criteria: Unwilling to continue working Having any problem that prevents communication (such as hearing, speaking, and understanding abilities), Having a gynecological disease (abnormal uterine bleeding, uterine fibroids, ovarian cysts, hormonal treatment, etc.) Having a chronic or physical illness Having a mental illness Being under psychiatric treatment (Pharmacotherapy or psychotherapy) Taking medication for menopausal symptoms Using one of the pharmacological or non-pharmacological methods to reduce premenstrual symptoms (COCs, acupressure, homeopathy, etc.)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 30 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mandala coloring group<br>Mandala painting will be applied to women suffering from premenstrual syndrome. | Other: Mandala coloring<br>* Each participant will be given 12 colored felt-tip pen paint sets and 12 mandala coloring pages by the researchers. Participants will be asked to dye for 3 menstrual cycles, 14 days before the start of menstruation, 1 day a week, at any time of the day and for an average of 20-30 minutes each time.<br>|
| No Intervention: Control group<br>Participants in this group will consist of people who do not routinely do any practice on their own to reduce premenstrual syndrome symptoms. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Introductory Information Form | The form consists of questions about socio-demographic and menstrual periods. | between one to six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Premenstrual Syndrome Scale (PMSS) | The Premenstrual Syndrome Scale (PMSS) was developed by Gencdogan in 2006 to measure premenstrual symptoms and determine their severity. It is a 44-item five-point Likert-type scale (Never, Rarely, Sometimes, Often, and Continuous). In scoring the scale, the Never option is evaluated as 1 point, the Very little option as 2 points, the Sometimes option as 3 points, the Often option as 4 points, and the Constantly option as 5 points. PMSS; It consists of nine sub-dimensions: depressive affect, anxiety, fatigue, irritability, depressive thoughts, pain, appetite changes, sleep changes, and bloating. PMSS Total Score is obtained from the sum of all scores from the nine sub-dimensions of the scale. For the implementation of PMSS, the person is asked to make an evaluation by taking into account the being within the period one week before menstruation. An increase in the score obtained from the scale indicates that the intensity of PMS symptoms increases. | between one to six months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Premenstrual syndrome, Mandala coloring