The postpartum period is a critical time for women's physical and psychological health, during which significant hormonal, emotional, and social changes occur. During this period, many women experience increased stress, anxiety, and emotional vulnerability while adapting to new parental responsibilities and caring for a newborn. When these challenges are not adequately managed, they may contribute to the development of postpartum anxiety and postpartum depression, which can negatively affect maternal well-being, mother-infant bonding, breastfeeding practices, and child development. Despite the importance of postpartum mental health, non-pharmacological and easily accessible supportive interventions remain limited.
This randomized controlled experimental study aims to evaluate the effect of a structured, art-based mandala coloring activity on postpartum anxiety and postpartum depression among postpartum women. The study will be conducted at Afyonkarahisar Health Sciences University Health Practice and Research Center, Obstetrics and Gynecology Clinic, and will include women who have recently given birth at this institution. Eligible participants will be randomly assigned to either an intervention group or a control group.
Women in the intervention group will receive individual training in mandala coloring before hospital discharge and will be provided with mandala coloring materials for home use. They will be encouraged to engage in the mandala coloring activity over an eight-week period and will be followed through regular telephone contacts. In addition to monitoring participation in the activity, individualized supportive counseling will be provided based on participants' needs. Women in the control group will receive routine postpartum care without any additional intervention.
Postpartum anxiety and postpartum depression levels will be assessed at multiple time points during the study to examine changes over time. This study seeks to determine whether mandala coloring, as a low-cost and non-pharmacological art-based activity, may serve as a supportive approach to improve psychological well-being during the postpartum period. The findings may contribute to the development of accessible interventions aimed at supporting maternal mental health in the early postpartum period.
Able to speak and understand Turkish
Voluntarily agree to participate in the study and have signed the informed consent form
18 years of age or older
Literate
Have previously received psychological or psychiatric treatment or are receiving such treatment during the data collection period,
Have a serious neurological or psychiatric disorder that affects cognitive functioning,
Have serious health problems that prevent communication or participation in the study,
Have not provided informed consent,
Parallel
Mandala Coloring Activity
BehavioralStructured mandala coloring training and home practice.
Postpartum Depression
Change in postpartum depression level measured by the Edinburgh Postnatal Depression Scale (EPDS). This scale was developed to determine whether there is a risk of depression in mothers during the postpartum period . The scale consists of 10 items in a four-point Likert format scored between 0 and 3. The minimum score that can be obtained from the scale is 0 and the maximum score is 30. The cut-off score of the scale is 13. Scores above this value indicate a high risk of depression.
Postpartum Anxiety
Change in postpartum anxiety level measured by the Postpartum Anxiety Scale.The original version of the scale was developed and validated with mothers who have infants aged 0-6 months. The scale has the following subdimensions: maternal skills and attachment, newborn well-being and safety, infant care practices, and psychosocial adjustment to motherhood. The maximum possible score that can be obtained from the Likert-type scale is 176, and the cut-off score is 113.5. Higher scores on the scale indicate higher levels of anxiety symptoms.
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