Healing Stitches: A Scoping Review on the Impact of Needlecraft on Mental Health and Well-Being

Figures & data

Table 1. PubMed Search strategy.

(mindfulness [mh] OR anxiety [mh] OR Hobbies [mh] OR relaxation therapy [mh] OR well-being [tiab] OR Psychological Well-Being [mh] OR mental health [mh] OR happiness [mh] OR Pleasure [mh] OR Personal Satisfaction [mh] AND (english[Filter])) AND (sewing [tiab] OR crochet [tiab] OR Knit* [tiab] OR quilt* [tiab] AND (english[Filter])) NOT tight NOT Close

Figure 1. PRISMA flow diagram describing record inclusion through different stages of screening (Page et al., 2021).

Table 2. Summary of included studies.

Author, year, country	Aims	Participants	Study design and data collection	Data analysis	Key findings
Brooks et al. (2019) Canada	To understand the role of knitting in the lives of passionate knitters and their experience of how knitting contributes to health, well-being, and occupational identity	21 guild knitters, 19 women and 2 men, age: 27–84 years	Phenomenology Interviews, field notes and observations of guild meetings	Phenomenological analysis	Five themes: Implications for mental health and well-being; Cognitive health benefits; Social value of knitting with others; Occupational identity as a knitter; Knitting as a creative outlet.
Burns and Van Der Meer (2021) 87 countries	To explore perceived links between crochet and well-being	8, 391 participants, age: 41–60 years, 99% women	Quantitative, online survey with one open-ended question	Descriptive statistics and free text analysis	Reasons for crocheting: creative (82.1%); relaxing (78.5%); and accomplishment (75.2%). Significant improvement in mood after participating in crochet (p < .001). Five major themes: (1) health benefits (felt calmer, happier, more useful, good for memory); (2) process of crochet (texture of yarn, repeating rhythmic nature is calming & meditative); (3) personal connection with past and future generation; (4) crochet as a contribution; and (5) online crochet communities.
Burt and Atkinson (2012) UK	To explore the meanings of quilting in order to identify its potential for enhancing cognitive, emotional and social well-being	29 women from a quilting group	Semi-structured interviews, face-to-face or by telephone	Thematic analysis	Cognitive, emotional and social processes; quilting is a productive use of time, free creativity, uplifting, challenging, learning new skills, strong social network and friendships, and boosted self-esteem. Quilting is useful in maintaining well-being in older people.
N. A. Clarke (2020) Multiple countries	To explore and foreground the experiences of people aged 40 years and under who engage in sewing for leisure	78 participants, age: ≤40 years	Qualitative study, using Individualized creative research methods: photos; online written narratives; interviews; and sewn items. Data collection online and through interviews	Thematic analysis	Feelings of pride and accomplishment, calmness, social interactions, self-awareness, and flow.
Clave-Brule et al. (2009) Canada	To determine whether the visuospatial task of knitting influences the anxious preoccupation experienced by inpatients with anorexia nervosa	38 women with anorexia nervosa in a specialized treatment facility	Prospective interventional cohort study, self-report questionnaire	Descriptive statistics	The visuospatial task of knitting is a useful distraction to reduce food anxiety. Knitting is an inexpensive treatment with no side effects, which reduces anxiety and fear preoccupation. Knitting results in satisfaction, a sense of pride and accomplishment.
Collier (2011) Multiple countries	To better understand the specifics of how women use textiles to cope with difficult moods in their daily lives	821 women, age: ≥18 years	Online survey using Likert-scale questions and several validated well-being survey tools	Descriptive and inferential statistics	Women who used textile handcrafts to change mood reported more success, rejuvenation, and engagement than women who did not use textile methods to cope (p < .001). The rationale for engaging in textile handcraft was the esthetics, feeling grounded, and to cope.
Court (2020) UK	To explore how knitting makes links between people	30 local women	Qualitative study, using email questionnaire, participant observation and interviews	Grounded theory	The main motivation for both online and in-person group participation is social interaction. The benefits of participation include feeling part of a community, technical and personal support, and forming meaningful friendships.
Dickie (2011) USA	To investigate whether the therapeutic aspect of quilting was part of the quilting dialogue	18 women from 9 quilting guilds interviewed at 5 quilt shows and in 5 quilting stores, age: 35–86 years	Ethnographic: 2 years of data from participant observations at quilting shows and public venues, reviewed quilting websites, and interviewed participants	Qualitative analysis	Two types of self-generated well-being therapies were identified: mundane - part of women’s daily routine (occupational quilting); and exceptional – quilting in response to difficult events. Quilting is routinely used for well-being both as a daily activity and in times of crisis.
Emanuelsen et al. (2020) Canada	To examine the role of sewing in Inuit women’s health	30 Inuit women, aged: 18–80+ years	Qualitative, semi-structured face-to-face interviews	Content analysis	Sewing generates pride and a sense of accomplishment, cultural identity, relaxation, decompression (healing), socialization, spirituality, and healing. Sewing is an expression of cultural identity taught to the younger generation by the older generation.
Gaspar da Silva (2023) Canada	To explore immigrant women’s stories, to understand the lived experiences and cultures behind those stories	10 Portuguese-speaking immigrant women, age: 34–57 years	Qualitative narrative inquiry design, feedback questionnaires, and artworks with narrative statements	Thematic analysis	Female immigrants share common stressors, but each has their own unique personal stories. Combining artwork with storytelling improves psychological well-being. Group work embroidery helps immigrants develop a sense of belonging and feeling supported by establishing social relationships.
Kaipainen and Pöllänen (2021) Finland	To depict the reasons for garment sewing as a leisure craft in the narratives of female textile craft makers and describe the meanings behind the activity	781 participants, age: 19–91 years	Qualitative using written narratives published in regional newspapers	Hermeneutic approach and thematic categorization: abductive qualitative content analysis for 100 narratives and automated search analysis for the whole cohort	Distinguish between utility sewing (repairing garments: negative attitude toward sewing), process-centred sewing (designing and creating garments: positive participant attitude) and product-centred sewing (using up waste fabrics: positive participant attitude). Motivation for sewing included enhanced the well-being, the end product symbolizing self-fulfillment, skill, tradition, empathy, and personal growth. Also, participants were motivated by a need to recycle and to resist over-consumption.
Kausch and Amer (2007) USA	To identify the relationship between self-transcendence and depression in individuals who lost loved ones due to HIV/AIDS	18 men and 13 women who lost or had terminally ill loved ones, due to AIDS; 14 participants made quilt panels and 17 did not	An across-method, triangulation, descriptive correlation design using telephonic/in-person interviews based on Self-Transcendence Scale	Statistical and thematic analysis	Quilting is a therapeutic means of self-transcendence (re-establishing well-being) for those who have lost loved ones through AIDS. There was an inverse relationship between self-transcendence and depression in both groups (panel and non-panel makers, r = −.46, p < .001). The data from the panel makers revealed five themes: providing validation; creating a living memory; liberating acceptance of loss; community of survivors; and connection to a higher power.
Kenning (2015) Australia	To examine how lace making contributes to well-being	16 women, members of the Lace Study Center, Powerhouse Museum; age: 45–90 years	Qualitative using unstructured interviews	Thematic analysis	Four themes: Health and well-being; Self and identity; Community, sharing, and belonging; and Learning, growth, and transition.
Maita (2018) Indonesia	To investigate the influence of knitting on reducing stress among female prisoners	84 women prisoners, 42 in the intervention group and 42 in the control group	Quasi-experiment using a pre- and post-test design with questionnaire	Univariate and bivariate statistical analysis	Knitting significantly reduced the level of stress in the intervention group compared to the control group, which did not participate in the knitting activity (p < .05).
Mayne (2016) UK	To investigate the impact of craft makers’ online community involvement on well-being, isolation, and connectedness	Women who post and comment on images of their knitting and crochet work on Facebook	Qualitative ethnographic study, comments and narrative on social media	Thematic analysis	Yarn craft provides a sense of community and shared social identity, promoting individual well-being. Crafting is both pleasurable and empowering, enhancing self-esteem and a sense of self-worth.
Nevay et al. (2019) Ireland	To measure well-being resulting from traditional and e-textile art	15 women participating in e-textile or traditional art workshops, age: 17–60 years	Mixed-methods, case study; quantitatively: before-&-after study survey data using WEM well-being Scale; qualitatively: workshop photos; questionnaire; and recordings of conversations	Descriptive statistics and thematic analysis	There was a significant increase in the WEH well-being score after participating in the workshops compared to before participation (t(13)= −3.26, p < .01). Well-being was expressed as connectedness and social interactions; opportunity to learn from peers and help each other.
Piercy and Cheek (2004) USA	To investigate how quilting contributes to relationships of middle and older-aged Amish, Appalachian, and Latter Day Saints women	Amish, Appalachian, and Latter Day Saints, 10 women from each group, age: >40 years	Kahn and Antonucci’s convoy model of social relations; semi-structured interviews	McCracken’s five-step method for analysis of long interviews	Quilting impacts the lives of participants; is a generative behavior which forges deep friendships and horizontal and vertical connections to others, teaching their skills to others. Building bonds with grandchildren through quilting and leaving legacies through their creative work. Quilting contributes to the lives of others and to their own lives.
Pöllänen and Voutilainen (2018) Finland	To explore the meaning and intension behind leisure craft activities amongst stay-at-home mothers	An online community of 34 stay-at-home mothers, age: 23–40 years	Qualitative study, written narrative submitted by participants	Hermeneutic phenomenographical analysis	Participation motivators: creating a personal fingerprint (personal creative identity); crafting is a mental resource; it facilitates personal growth and social relationships. Crafting is a means of escaping daily worries and enhance self-realization. Participants describe crafting as a mental resource, a form of therapy, giving participants solitude to deal with their worries.
Reynolds (2000) UK	To examine the role of needlecraft in depression self-management	39 women with chronic depression who participate in needlecraft, age: 18–70 years	Qualitative using written narratives and face-to-face interviews	Miles and Huberman’s template	Creative activities are used to manage depression. Needlecraft is regarded as a place of safety, away from worldly stresses. It is relaxing, forms social bonds, and provides a sense of self-mastery. The intense concentration required during needlecraft is a distraction from worries and reduces depression.
Riley et al. (2013) 31 countries	To identify the therapeutic benefits of knitting on individual and social well-being	Online community of 3, 514 knitters, 99% women, modal age 21–30 years	Online survey	Descriptive statistics and thematic analysis	Participants reported knitting for relaxation, stress relief and creativity. A significant relationship was found between the frequency of knitting and feeling calm, happy and achieving higher cognitive functioning (p < .001). Knitting in a group significantly (p value) impacted on perceived happiness (p = .015), and improved social contact and communication with others.
Rusiñol-Rodriguez et al. (2020) Spain	To explore the effect of knitting in a natural group, and to examine the impact that the purpose of the item created might have on the motivation to knit	13 members of a knitting group who knitted for self or for others, 1 man, 12 women from 6 nationalities	Mixed method explanatory sequential design, online survey, personal diaries and semi-structured interviews	Thematic analysis and inferential statistics	Knitting gave participants a sense of well-being and relaxation, group work promoted learning and teaching. Knitting with others is more meaningful than knitting alone due to the importance placed on others. Knitting for others is more meaningful than knitting for oneself. However, it can be stressful, given the pressure to achieve perfection. Curiosity was a significant motivator when knitting for others (p = .011) as was “shows that the activity is special” (p = .005).
Sjöberg and Porko-Hudd (2019) Finland	To discuss how craft, and especially yarn techniques, like knitting and crocheting, can provide a meaningful leisure activity, enhance mental well-being and help to untangle demanding situations in life	Participants of the World Wide Knit in Public Day: 40 women and 1 man, age: 40–69 years	Questionnaire; data collection via questionnaire during the World Wide Knit in Public Day	Descriptive statistics and free hand results	Knitting can be a counterbalance to the stresses of life. Knitting is a solitary activity but knitters enjoy each other’s company (social interactions), most knit for relaxation.
Wolk and Bat Or (2023) Israel	To explore the experiences of adolescent girls with emotional disorders who participate in embroidery art therapy	13 boarding school adolescent girls, age: 15–18 years, post-hospitalization for emotional disorders	Phenomenological; focus groups, in-depth interviews and observations	Thematic analysis	Embroidery facilitates a dialogue regarding self, group and cultural identity as part of the mental health recovery process. Five themes related to embroidery: (a) control (sense of structure seen in following an embroidery pattern) versus release/freedom (flexibility to create); (b) calmness that comes from the repetitive action and focus; (c) the experience of being exceptional versus conventional (an exceptional therapeutic treatment instead of a conventional treatment); (d) the “stitch through time” experience, which involves a dialogue about the past, present, and future through embroidery (in the context of finding self-identity); and (e) the overt-latent layers of consciousness (self-awareness and expression).
York et al. (2022) USA	To examine how crochet that was embedded in a STEM summer camp impacted participants’ sense of belonging, creativity, well-being, and STEM learning	37 adolescent school girls participating in a STEM summer camp	Qualitative case study; 2 qualitative surveys and discord conversations	Content analysis	Crocheting enhances students’ sense of belonging (communicating with peers, helping each other), creativity (having fun), well-being (calming effect of repetitive movement when dealing with anxiety, stress and depression) and helps with STEM learning (mathematical patterns in the crochet design).
Yuwen et al. (2021) Japan	To assess the impact of community knitting on post-traumatic growth, health-related quality of life and subjective happiness	195 women survivors of the 2011 Great Japanese Earthquake: 98 women attended Yarn Alive (YA - exposure group), 97 non-YA attendees (control group)	Quantitative retrospective correlational study. Cross-sectional survey using standardized well-being tools (PTGI, SF-8, subjective happiness scale)	Statistical analysis: descriptive statistics and multiple regression analysis	Participating in the YA program had a higher subjective happiness (p < .0001) and quality of life score (p = .013). However, YA participants did not have higher post-traumatic growth scores than the control group (p = .252).

Table 3. Concept mapping of themes and subthemes.

	Mental well-being					Social connection, sense of value & belonging			Sense of purpose, achievement & satisfaction			Self-identity, family, culture & legacy
	Calming, relaxation, & managing stress	Therapeutic, well-being	Diversion & coping	Contentment	Meditative flow & the sensory aspect of the materials	Socializing & sense of community, friendships, feeling valued	Sharing & collaboration, sense of belonging	Mutual learning & encouragement	Sense of purpose, achievement and pride in the resulting handiwork	Satisfaction through gifting & creating gifts	Sense of accomplishment through new learning	Self-identity & self-expression through creative work, creating a legacy	A purposeful break	Self-development, empowerment & self-confidence, being in control	Connection to family & cultural, past & future generations
1. Brooks et al. (2019)	x	x	x	x	x	x	x	x	x	x	x	x	x	x	x
2. Burns and Van Der Meer (2021)	x	x	x	x	x	x	x		x			x	x	x	x
3. Burt and Atkinson (2012)	x	x	x	x	x	x	x	x	x	x	x	x	x	x
4. N. A. Clarke (2020)	x	x	x	x	x	x	x	x	x	x	x	x	x	x	x
5. Clave-Brule et al. (2009)	x		x		x	x			x					x
6. Collier (2011)	x	x	x	x	x	x				x		x	x		x
7. Court (2020)						x	x	x	x				x
8. Dickie (2011)		x	x		x	x	x	x				x	x	x
9. Emanuelsen et al. (2020)	x	x	x	x		x	x	x	x	x	x	x	x	x	x
10. Gaspar da Silva (2023)	x	x	x	x		x	x	x	x			x		x	x
11. Kaipainen and Pöllänen (2021)			x	x	x	x	x		x	x	x	x		x	x
12. Kausch and Amer (2007)		x				x	x	x	x			x
13. Kenning (2015)	x	x	x	x		x	x	x	x	x	x	x	x	x	x
14. Maita (2018)	x
15. Mayne (2016)	x	x			x	x	x	x	x				x	x	x
16. Nevay et al. (2019)		x		x	x	x	x	x	x		x			x
17. Piercy and Cheek (2004)	x					x	x	x		x		x	x		x
18. Pöllänen and Voutilainen (2018)	x	x	x	x	x	x	x	x	x	x	x	x	x	x	x
19. Reynolds (2000)	x	x	x	x	x	x	x	x	x			x	x	x
20. Riley et al. (2013)	x	x	x	x	x	x	x	x	x	x	x		x	x	x
21. Rusiñol-Rodriguez et al. (2020)	x	x	x	x		x		x		x	x		x	x	x
22. Sjöberg and Porko-Hudd (2019)	x	x		x		x	x	x	x		x	x	x	x	x
23. Wolk and Bat Or (2023)	x	x	x		x		x			x	x	x	x	x	x
24. York et al. (2022)	x		x	x	x	x	x	x	x	x		x		x
25. Yuwen et al. (2021)		x		x		x	x					x

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