Bedside Visual Art Interventions for Cancer Patients
Simple art making experiences may mediate pain, mood and anxiety.
Posted April 24, 2018
Can a relatively brief, art-based intervention presented bedside make a significant difference in the life of cancer patients? A recent study (Saw et al, 2018) at the Mayo Clinic with hematological cancer patients points to a qualified “yes” in terms of mood, anxiety and perception of pain.
In this non-randomized trial, twenty-one adult patients (19 women and two men; median age 53.5 years with an age range of 19 to 75) with hematological cancers (leukemia, lymphoma, multiple myeloma) who were admitted to the Mayo Clinic for inpatient services participated in the study. Adults with hematology-related cancers are often more seriously ill at the time of hospitalization and generally have more symptoms that are both debilitating as well as life-threatening. In particular, pain for these individuals is particularly distressing and often rated as moderate to severe while in hospital. Additionally, emotional distress is substantial and includes worry, fear, depression and irritability due to the unpredictable course of illness and various invasive treatments. In contrast, relatively few psychosocial supports, including art-based ones, have been studied to determine how to best serve this adult patient population.
The researchers in the Mayo Clinic study specifically sought to evaluation what they refer to as a “bedside visual art intervention” or BVAI with the participants. This intervention allowed individuals to engage in creating art without a specifically targeted psychotherapeutic goal; in other words, the BVAI’s goal was simply to provide a relatively brief art making experience for each participant. However, the study did seek to measure results in three important areas: pain, anxiety and mood.
Artist educators were recruited from a community art center with oversight from the Humanities in Medicine program at the Mayo Clinic. The artist educators were trained to carry out the actual art-based intervention and emphasized healthcare-relevant issues such as confidentiality and professionalism in interactions with patients. In brief, an artist educator was instructed to teach art (identified as the BVAI) at the patient’s bedside for approximately 30 minutes and included experiences with non-toxic watercolors, oil pastels, pencils and or clay; materials were left with patients so that they could continue art making after the session. Families were also invited to participate or observe the sessions.
Researchers used standard instruments and inventories to evaluate patients’ perceptions of pain, anxiety and mood, pre- and post-BVAI. The overall results were encouraging across measurements. Patients had a significant decrease in anxiety, indicating a 21.6% reduction overall. Additionally, the scale measuring positive and negative mood showed an increase of 14.6% in positive mood while negative mood decreased 18.0%. Among the 14 patients who reported having pain symptoms prior to the BVAI, their pain scores improved significantly, indicative of a measurable decrease in pain perception. The participants in this study also completed a post-BVAI questionnaire that allowed for written comments and narratives; 20 of 21 participants observed that the BVAI was an overall positive experience; most indicated that they would participate in future art-based interventions.
While sample size was limited and the effect size was challenging, this study does add to the growing evidence that art making experiences can be helpful to hospitalized patients. In particular, this study underscores that art making experiences may be effective in decreasing pain perception, an important concern for medical professionals who help patients through pharmacological and other interventions. Previous studies by art therapists and medical researchers have arrived at similar results over the past two decades. The researchers conclude that: “Given the push towards fulfilling the holistic needs of our patients, that is, addressing disease not as a battery of symptoms but as depths of emotional and physical layers affecting one’s wellness, we must encourage bringing such interventions into the therapeutic practices for our patients. As reflected in the post- BVAI questionnaire, such simple interventions such as the BVAI can have a significant impact that should not be underestimated.”
For professionals reading this research summary may be wondering, “so was that an art therapy intervention?” According to the researchers, they infer "no." However, the researchers did recognize art therapy as a distinct domain of services, but decided to broaden traditional views of who provides art-based services and chose to enlist artist educators to deliver the BVAI. In light of their decision to focus on artist educators as providers of what appear to be successfully delivered bedside art-based services, look for a follow-up discussion of this interesting study with implications for the field of art therapy in my next post.
Saw JJ, Curry EA, Ehlers SL, et al. (2018). Brief bedside visual art intervention decreases anxiety and improves pain and mood in patients with haematologic malignancies. European Journal of Cancer Care. e12852. https://doi.org/10.1111/ecc.12852.