Complex arts-based interventions for patients receiving haemodialysis: A realist review

ABSTRACT

Many patients with end-stage kidney disease require haemodialysis, a treatment that requires attending hospital three times a week for four hours each visit. This treatment impacts profoundly on mental health. Arts-based interventions for patients receiving haemodialysis could address the impact of this treatment; however, there is no consensus on methods of implementation and mechanisms underlying these interventions in specific clinical contexts. Using a realist approach, relevant articles were synthesised to inform theory relating to the mechanism and implementation of complex arts-based interventions for haemodialysis patients. The theoretical framework includes two implementation phases, firstly delivery of person-centred art activities during haemodialysis and secondly, display of completed artwork. This intervention triggers mechanisms including flow and social capital. Implementation is hindered by constraints of the haemodialysis unit and patients' lack of confidence in their artistic skills. These issues can be addressed through aflexible approach to implementation and support from healthcare professionals.

KEYWORDS:

• Arts-based intervention
• arts in medicine
• haemodialysis
• arts in health
• end-stage kidney disease
• realist synthesis

Acknowledgments

The authors would like to thank the members of the interdisciplinary advisory group for their support and input for this review. This includes, in no particular order, Mr William Johnston, Mr Christopher Johnston, Ms Jenny Baxley-Lee, Ms Jean Michelo, Dr Robert Mullan, Mr Michael Matthews, Dr Jenny Elliot, Ms Libby Weatherup, Rev Norman Harrison, Ms Anne Quail, Ms Andrea Spencer and Ms Grainne Kielty.

The authors would also like to thank Richard Fallis, the subject librarian for Biomedical Sciences, Dentistry and Medicine at Queen’s University Belfast for their guidance on the electronic database search strategy.

Authors’ contributions

All authors reviewed and revised the manuscript and approved the submitted version.

CC contributed to the conception and design of the work, the analysis and interpretation of data and the drafting of the manuscript.

JR contributed to the conception and design of the work, the scoping of the literature and development of the search strategy, the interpretation of the data and revised the manuscript.

IW contributed to the conception and design of the work, the scoping of the literature and development of the search strategy, the interpretation of the data and revised the manuscript.

HMcA contributed to the interpretation of the data and revised the manuscript.

JBL contributed to the development of the search strategy, the interpretation of the data and revised the manuscript.

HN contributed to the conception and design of the work, the scoping of the literature and development of the search strategy, the interpretation of the data and revised the manuscript.

Disclosure statement

The authors declare that they have no conflicts of interest.

Additional information

Funding

No funding was obtained to conduct this review. The review informed a larger study where funding was obtained from Northern Ireland Kidney Patient Association and Kidney Care UK to purchase items for an arts-based intervention.