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Mandala coloring reduces pain, perceived stress, and improves sleep quality in children hospitalized in a burn unit

In a randomized controlled trial of 40 children aged 7-12 in a burn unit, daily 30-minute mandala coloring sessions for seven days significantly reduced pain and perceived stress and improved sleep quality compared to routine care. Significant Group x Time interactions were found for pain (F(1,38)=38.329, p<.001, ηp2=0.508), perceived stress (F(1,38)=65.595, p<.001, ηp2=0.639), and sleep quality (F(1,38)=9.100, p=.005, ηp2=0.197), with large to very large effect sizes.

Last updated: Aug 3, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. The effect of mandala coloring on pain, stress, and sleep quality in children hospitalized in a burn unit: A randomized controlled trial.

observational

G&#xfc;rgan Y, Akdogan R · Journal of pediatric nursing (2026)

Participants: N/A
Duration: 7 days
Intervention: 30-minute mandala coloring sessions daily for seven days
Outcome: Pain (Wong-Baker Faces Pain Rating Scale), perceived stress (Perceived Stress Scale for Children), sleep quality (Children's Sleep Habits Questionnaire)
Effect Size: ηp2=0.508 (pain), ηp2=0.639 (stress), ηp2=0.197 (sleep quality)
Population: Children aged 7-12 years hospitalized in a pediatric burn unit

Result:

PubMed: 42531754DOI: 10.1016/j.pedn.2026.07.057

Mechanism Graph

Engaging in mandala coloring provides a distracting cognitive focus
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Coloring promotes relaxation and reduces physiological arousal
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Reduced stress and pain perception may facilitate better sleep
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Result: Lower pain and stress scores and improved sleep quality

Limitations

  • ⚠Single-center study with a relatively small sample size (n=40)
  • ⚠No blinding of participants or personnel due to the nature of the intervention
  • ⚠Short-term follow-up (7 days) limits assessment of long-term effects

Frequently Asked Questions

How long does the mandala coloring intervention last?▼

Each session lasts 30 minutes, and the intervention is delivered daily for seven days.

What age group was studied?▼

Children aged 7 to 12 years who were hospitalized in a pediatric burn unit.

What outcomes were measured?▼

Pain, perceived stress, and sleep quality were measured using validated scales.

Is mandala coloring effective for reducing pain in burn patients?▼

Yes, the study found a significant reduction in pain with a large effect size (ηp2=0.508) compared to routine care.

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References

  1. 1.G&#xfc;rgan Y, Akdogan R. "The effect of mandala coloring on pain, stress, and sleep quality in children hospitalized in a burn unit: A randomized controlled trial.." Journal of pediatric nursing, 2026. PMID: 42531754 DOI: 10.1016/j.pedn.2026.07.057
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.