The Effects of Mindfulness-Based Mandala Coloring, Made in Nature, on Chronic Widespread Musculoskeletal Pain: Randomized Trial

Abstract

This study aimed to investigate the effects of mindfulness-based mandala coloring made within nature on individuals with chronic widespread musculoskeletal pain (CWP). Thirty-six participants were randomly allocated. In the experimental group, identical interventions and procedures were administered for each experiment. The control group members were untreated and remained in an urban environment. Overall, the experiment showed significant improvements in tender points (f = 8.791, p = 0.006), total stress level (f = 14.570, p = 0.001), depressive symptoms (f = 15.205, p = 0.001), anger symptoms (f = 7.263, p = 0.011) and salivary cortisol (f = 10.619, p = 0.003) in the experimental group. The results reflect that MBMC within nature is effective in reducing pain, psychological stress responses, and cortisol levels in individuals with CWP. The positive results could be a product of the experimental design rather than the treatment itself. A rigorous experimental design provides better understanding of MBMC within nature.

Does Mandala Art Improve Psychological Well-Being in Patients? A Systematic Review

“…Among the eligible studies in this review, intervention durations ranged from 15 min to 8 weeks, with 1 to 12 sessions in total. In addition, each session duration differed from 15 min to 4 h. In two studies, the intervention group receives the cointervention: meditation techniques 18 and mindfulness-based intervention, 20 respectively. Only two studies included software-based intervention.…”

“… 19 The outcome measures for depression included the Center for Epidemiologic Studies-Depression Scale, 39 and the HADS. 38 The outcome measures for stress included the Stress Response Inventory-Modified Form 20 ; the specific physiological stress response reflected in changes in vital signs 19 , 40 and stress hormone cortisol. 20 …”

“… 19 , 33–35 However, there is some evidence suggesting that not all individuals respond favorably to MA. Previous studies reported that MA had no effects on depression, 36 stress, 21 fatigue, 20 resilience, and subjective well-being 27 in patients; even increased distress scores in cancer survival patients. 18 …”

The Effects of a Forest Therapy on Work-Related Stress for Employees in the Manufacturing Industry: Randomized Control Study

“…33 Moreover, this study has reported similar results that a previous study in which indicated implementing forest therapy and mindfulness-based intervention in nature have increased health-related quality of life 34 and stress level. 35 for patients with chronic widespread pain. In terms of changes in HRV, the result identified a significant increase in heart rate.…”

The effect of mindfulness‐based mandala activity on anxiety and spiritual well‐being levels of senior nursing students: A randomized controlled study

“…A review of the literature shows that mandala studies in nursing can have a positive effect on pediatric oncology patients (Gurcan & Atay Turan, 2021), coping with university students' anxiety (Carsley & Heath, 2020), and spirituality (Shiah & Hwang, 2019). Mindfulness‐based activities keep one's attention on “the moment,” causing the person to make sense of their experiences, increase their well‐being, and feel more comfortable (Choi et al, 2021). The literature shows that there are reasons to believe that people with high mindfulness can experience spirituality more, thereby increasing their well‐being and comfort (Da Silva & Pereira, 2017; Liu et al, 2020).…”