Mandala Coloring for Pain, Fatigue, and Sleep in Patients With Fibromyalgia

Fibromyalgia is a chronic condition commonly associated with widespread pain, fatigue, and poor sleep quality. This randomized controlled study aims to determine whether mandala coloring, when added to routine treatment, improves pain, fatigue, and sleep quality in adults with fibromyalgia. A total of 60 eligible participants will be randomly assigned in a 1:1 ratio to either a mandala coloring group or a control group. Participants in the mandala coloring group will complete eight 60-minute coloring sessions over four weeks, with two sessions per week, while continuing their routine treatment. Participants in the control group will continue their routine treatment without taking part in a structured coloring activity. Pain, fatigue, and sleep quality will be assessed at the beginning of the study and at the end of the fourth week. Changes in these outcomes will be compared between the two groups.

Inclusion Criteria: * Aged 18 years or older * Diagnosed with fibromyalgia * Pain intensity score of 5 or higher on the Visual Analog Scale * Fatigue Severity Scale score of 4 or higher * Pittsburgh Sleep Quality Index global score of 5 or higher * Able to communicate and complete the study assessments * No physical limitation preventing mandala coloring * Willing to participate and provide written informed consent Exclusion Criteria: * Presence of a communication problem that prevents participation or completion of the assessments * Presence of a physical limitation that prevents mandala coloring * Refusal to participate or provide written informed consent