The meaning and value of taking part in a person-centred arts programme to hospital-based stroke patients: findings from a qualitative study

Abstract

Purpose: The importance of addressing mental well-being while stroke patients are in hospital has been recognized by policy makers but there is a gap between rhetoric and reality. This study explored the potential for using a person-centred, artist facilitated, one-to-one arts programme to improve the emotional and mental well-being of patients, which may be adversely affected as a result of the negative experiences arising from stroke and hospitalization. Method: The study focused on those patients remaining in hospital for above average durations and included patients with functional, cognitive and speech or language impairments. After participation in the arts programme and before discharge, semi-structured interviews were undertaken with sixteen patients, and in the case of two patients with severe cognitive loss, a relative, as a proxy, was interviewed. Interviews explored the experience of stroke and hospital stay and the meaning and value of taking part in Time Being Stroke and the data was analysed thematically. To underpin and contextualize the interview material, clinical status and treatment information routinely collected by the multi-disciplinary stroke team was obtained and analysed; in addition material on the content of each session was recorded by artists and analysed. Results: Patients’ accounts suggest that participation in a person-centred arts programme contributed to their mental well-being. As might be expected from a person-centred intervention, benefits varied across the sample, but the most commonly mentioned positive aspects of participation included the experiences of: pleasure and enjoyment, a sense of connection with the artists, mental stimulation, learning and creativity, engagement in purposeful occupation and relief from boredom, and reconnection with valued aspects of the self. These experiences of participation contrast strongly with the acute and chronic distress associated with stroke, impairment, and spending long periods of time in hospital. Conclusions: Arts interventions such as the one implemented and evaluated in this study provide a positive and valuable experience for longer staying stroke patients, contributing to their mental well-being during an otherwise distressing illness and hospital stay.

Implications for Rehabilitation

• Stroke and the resulting impairments and long stays in hospital cause considerable distress to patients, and a high proportion of patients experience depression and anxiety.

• Addressing emotional and mental distress in patients is a priority for patients and relatives, and for hospital trusts and policy makers, but clinicians rarely have the time to address the emotional aspects of stroke.

• Participation in a one-to-one person-centred arts intervention facilitated by artists with experience of vulnerable patients can offer enjoyment, learning and mental stimulation.

• Through these a contribution to patients’ mental well-being during hospital stay can be made, which may address emotional distress.

Keywords::

• Arts
• mental health
• person centred
• stroke

Acknowledgements

The authors would like to thank the patients, clinicians, and artists who took part in the study, members of the advisory group, and the study funder (Her Majesty’s Treasury). Additionally we would like to thank Matrix Insight (part of Matrix Knowledge Group) – lead contractor for the research.

Declaration of Interest: Healing Arts, a Department within the Isle of Wight NHS Primary Care Trust received funding through a HM Treasury Invest to Save Budget for the development, implementation and evaluation of a programme of “arts in health” research and development entitled “A Lifetime’s Health Delivered Creatively”. TBS was developed and implemented by Healing Arts with support from Simon Peck (Isle of Wight NHS) and Matt Baumann (Independent Researcher) who also designed and delivered the evaluation. The evaluation was managed by Matrix Insight under contract to Healing Arts Isle of Wight NHS Primary Care Trust and was one of three evaluations undertaken as part of A Lifetime’s Health Delivered Creatively. The production of all programme and study outputs (including this article) was funded by Healing Arts.