The Effect of Mandala Coloring on Perinatal Grief and Psychological Resilience Levels in Women Experiencing Perinatal Loss

The goal of this clinical trial is to evaluate if mandala colouring helps to decrease grief symptoms and increase resilience in women who experienced perinatal loss.

The main questions are:

Does mandala coloring decrease perinatal grief symptoms? Does mandala coloring increase resilience?

Researchers will compare mandala coloring intervention with standard perinatal loss nursing care to evaluate if mandala coloring works to decrease grief symptoms.

Participants will:

Answer some questionnaires and scales, and do mandala coloring at least for 20 minutes for 10 days after perinatal loss experience.

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Key information

Conditions

Perinatal Loss

Age range

18 year and older

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Experienced perinatal loss (neonatal death, fetal death, abortion) within the last six weeks

Exclusion criteria

Serious psychological problem that requires intervention with the recommendation of a psychiatrist, such as having a previous mental disorder or use of antidepressants.
Practicing alternative methods such as yoga, meditation, acupuncture

Treatment and study plan

Mandala coloring

Other

Mandala coloring at least 20 minutes each day. Totally 10 days intervention

Primary outcomes

Perinatal Grief

Time frame: 1st day to 10th day

Perinatal Grief will be assessed via Perinatal Grief Scale. The scale is a 5-point Likert-type scale and responses range from "strongly agree to strongly disagree". The scale includes three sub-dimensions: "active grief", "difficulty coping" and "hopelessness". The total number of items in the scale is 32. Items 11 and 32 of the scale have a positive sentence structure. These items are answered in reverse. While the total grief score that can be obtained from the scale varies between 32-160, the scores that can be obtained for each sub-dimension seperately.

As the total perinatal grief score and the total score obtained from the sub-dimensions increase, it is determined that the individual's grief level is higher.
Perinatal Grief Intensity

Time frame: 1st day to 10th day

Will be assessed via Perinatal Grief Intensity Scale. The scale consists of 14 items, rated on a 4-point Likert-type scale from strongly agree to strongly disagree, and three sub-dimensions: "reality", "confrontation with others", and "adaptation". The scale contains both positive and negative expressions. Therefore, items 1, 2, 3, and 6 are evaluated as reverse items in the scoring of the scale. When calculating the scores of the sub-dimensions, the score obtained from each item is added up and divided by the number of items in the sub-dimension. Thus, a total score between 1 and 4 is obtained from each sub-dimension. The following formula is used for the total score:

3.08 + (0.41 x reality sub-dimension mean score) - (0.2 x confrontation sub-dimension mean score) - (0.15 x harmony sub-dimension mean score) The score that can be obtained from the scale varies between 2.09 - 4.37. It is predicted that the intensity of grief that will be experienced increases as the score increases

Secondary outcomes

Resilience

Time frame: 1st day and 10th day

Will be assessed via Resilience Scale for Adults. The scale has a schematic evaluation with five boxes. The scale consists of six factors titled 'Self-perception, 'Future perception,' 'Structural style,' 'Social competence,' 'Family harmony,' and 'Social resources,' and contains a total of 33 items. Cronbach's alpha coefficient of the sub-dimensions of the scale varies between 0.75-0.86

Study contacts

Contact information is provided by the study sponsor or research team.

Elif Balkan, PhD Student

CONTACT

[email protected]

+905423513125

Sponsors and collaborators

Lead sponsor

University of Yalova

Other

Registry information

Official study title

The Effect of Mandala Coloring on Perinatal Grief and Psychological Resilience Levels in Women Experiencing Perinatal Loss: A Randomized Controlled Trial

Important dates

Study start: 2025
Primary completion: 2025
Study completion: 2026
First posted: Jul 11, 2025
Registry last updated: Aug 15, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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