The Effect of Mandala Coloring, Sleep Quality, Anxiety With Premenstrual Syndrome

Premenstrual syndrome (PMS) is a common condition among women of reproductive age and is characterized by a range of physical, psychological, and behavioral symptoms that may negatively affect daily functioning, social relationships, academic and occupational life, and psychological well-being. Anxiety and sleep disturbances are among the commonly reported problems associated with PMS. Mandala coloring, as an accessible and easy-to-use art-based activity that does not require specific skills, may promote psychological relaxation, reduce anxiety, and improve sleep quality. However, the effects of mandala coloring on sleep quality and anxiety among women experiencing PMS have not been directly investigated. Therefore, this clinical trial aims to evaluate the effect of a mandala coloring intervention on sleep quality and anxiety levels in women with PMS. The findings may provide evidence for the use of mandala coloring as a simple, accessible, and non-pharmacological approach to support the management of PMS-related symptoms.

Inclusion Criteria: * Female students aged 18 and older * Scoring 45 or higher on the Premenstrual Syndrome Scale * Scoring 36 or higher on the State-Trait Anxiety Inventory (STAI) * Scoring 5 or higher on the Pittsburgh Sleep Quality Index (PSQI) * Having a regular menstrual cycle (21-35 days) * Volunteering to participate in the study * Fully completing the survey and scale forms Exclusion Criteria: * Not wishing to continue participating in the study * Having any condition that hinders communication (such as impairments in hearing, speech, or comprehension) * Having a gynecological condition (e.g., abnormal uterine bleeding, uterine fibroids, ovarian cysts, undergoing hormonal therapy) * Having a chronic or physical illness * Having a psychological disorder * Undergoing psychiatric treatment (pharmacotherapy or psychotherapy) * Using pharmacological or non-pharmacological methods to alleviate premenstrual symptoms (e.g., oral contraceptives, acupressure, homeopathy, yoga) * Having a sleep-related issue and receiving treatment for it * Individuals who exercise regularly