Mandala Therapy in Nurses: Effects on Psychological Well-Being and Organizational Cynicism

February 16, 2026 updated by: TUĞBA ÖZNUR YILMAZ, Karadeniz Technical University

Evaluation of the Effect of Mandala Therapy on Nurses' Psychological Well-Being and Organizational Cynicism Level

This study aimed to examine the effect of mandala therapy on psychological well-being and organizational cynicism levels among nurses. The study was conducted with nurses working in a public training and research hospital using an experimental intervention design. Participants were allocated to an intervention group receiving mandala therapy and a control group receiving routine working conditions. Psychological well-being and organizational cynicism were assessed before and after the intervention using validated measurement tools.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Nursing is a profession characterized by high emotional labor, intensive workload, and continuous occupational stress, which may negatively affect psychological well-being and contribute to negative organizational attitudes such as organizational cynicism. Supporting nurses' psychological well-being is therefore essential for sustaining professional functioning and quality of care.

Mandala therapy is an art-based behavioral intervention that provides individuals with a space for free expression through unstructured drawing and coloring activities. Unstructured mandala practices allow participants to express their inner experiences without predetermined guidance, supporting emotional awareness and self-regulation.

This experimental study was conducted to evaluate the effect of unstructured mandala therapy on nurses' psychological well-being and organizational cynicism levels. The study was carried out with nurses working in a public training and research hospital. Participants were allocated to an intervention group receiving unstructured mandala therapy and a control group receiving routine working conditions.

Mandala therapy sessions were conducted in small groups over a defined period, based on a free-expression approach. Psychological well-being and organizational cynicism levels were assessed at baseline and after the intervention using standardized and validated measurement tools. Ethical approval was obtained prior to data collection, and written informed consent was obtained from all participants. The study was retrospectively registered.

Study Type

Interventional

Enrollment (Actual)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Having at least 6 months of professional nursing experience at the hospital where the study is conducted
  • Willingness to participate voluntarily in the study

Exclusion Criteria:

  • Being on leave or on medical report during the data collection period
  • Participation in individual psychotherapy or group-based intervention programs
  • Receiving psychiatric medication treatment
  • Having visual impairments or visual disorders
  • Having prior experience with meditation practices

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mandala
Participants receiving unstructured mandala therapy sessions.
Behavioral: Unstructured Mandala Therapy
Unstructured mandala drawing and coloring activities were conducted as a behavioral intervention, allowing participants to freely express their emotions without predefined guidelines or themes.
No Intervention: Control
Participants continuing routine working conditions without any intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Psychological Well-Being
Time Frame: Baseline, 4 weeks after intervention initiation, and 8 weeks post-intervention
Psychological well-being will be assessed using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), a validated 14-item scale ranging from 14 to 70, with higher scores indicating better psychological well-being.
Baseline, 4 weeks after intervention initiation, and 8 weeks post-intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Organizational Cynicism
Time Frame: Baseline, 4 weeks after intervention initiation, and 8 weeks after intervention initiation
Organizational cynicism was assessed using the Organizational Cynicism Scale, a 13-item instrument rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 13 to 65, with higher scores indicating higher levels of organizational cynicism.
Baseline, 4 weeks after intervention initiation, and 8 weeks after intervention initiation

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Stress Level
Time Frame: Baseline, 4 weeks after intervention initiation, and 8 weeks after intervention initiation
Stress level was assessed using a self-reported numerical rating scale (NRS) ranging from 1 (no stress) to 10 (maximum stress). Higher scores indicate higher perceived stress levels.
Baseline, 4 weeks after intervention initiation, and 8 weeks after intervention initiation

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Karadeniz Technical University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Sarı Öztürk E, Kılıçarslan Törüner E. Effects of mandala-based interventions on psychological outcomes in nurses. Journal of Nursing Management. 2023.Wang TQ. Mandala therapy: What it is and what it offers. The Asian Educational Therapist. 2024;2(2):13-22.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 25, 2024

Primary Completion (Actual)

December 30, 2024

Study Completion (Actual)

December 30, 2024

Study Registration Dates

First Submitted

December 29, 2025

First Submitted That Met QC Criteria

February 16, 2026

First Posted (Actual)

February 17, 2026

Study Record Updates

Last Update Posted (Actual)

February 17, 2026

Last Update Submitted That Met QC Criteria

February 16, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2023/135

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to ethical approval limitations and confidentiality considerations.

Study Data/Documents

  1. No individual participant data or supporting information are available for sharing.
    Information identifier: 2023/135
    Information comments: No additional comments.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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