Examining the artist-patient relationship in palliative care. A thematic analysis of artist reflections on encounters with palliative patients

"To do and see what happens, instead of planning for something to happen", a qualitative study on how professional artists working in a palliative care setting shape their practice

BACKGROUND

Research has acknowledged the potential benefits of art programs in palliative care settings while also highlighting associated concerns due to the extreme vulnerability of clients. To add to existing research, which predominantly focuses on social and healthcare outcomes of art initiatives, this study examines how artists shape their practice in response to the unique challenges of palliative care and client vulnerability.

METHOD

We conducted ethnographic research, observing and conducting in-depth interviews with nine artists working in a Belgian supportive and palliative daycare centre.

RESULTS

The findings reveal that the artists prioritise providing meaningful artistic experiences and employ a responsive, improvisational approach, emphasising the principle of negotiation.

CONCLUSIONS

Working as an artist in palliative care presents both emotional and artistic challenges. Expectations regarding what art can mean in this context must be held in check, all while keeping the repercussions of interventions on clients firmly in focus.

Researching Compassionate Communities From an Interdisciplinary Perspective: The Case of the Compassionate Communities Center of Expertise

Compassionate Communities are places and environments in which people, networks, and institutions actively work together and are empowered to improve the circumstances, health, and well-being of those facing serious illness, death, dying, and loss. The study of their development, implementation, and evaluation requires an interdisciplinary research approach that has hitherto been lacking. In 2020, 8 research groups from 4 faculties at Vrije Universiteit Brussel united in the interdisciplinary Compassionate Communities Center of Expertise (COCO) to investigate Compassionate Communities. This article describes the first results of COCO: (a) an interdisciplinary mode of collaboration, (b) a shared conceptual understanding and definition of Compassionate Communities, and (c) a shared research agenda on Compassionate Communities.

Examining the Range and Scope of Artists' Professional Practices With Individuals With Palliative Care Needs: An International, Cross-Sectional Online Survey

Background: Internationally, it is recognized that artists facilitate arts engagement with individuals with palliative care needs. There is a gap in the literature describing the range and scope of artists' professional practices in palliative care. The aim of this study was to examine an international range of professional practices among artists who work in palliative care including key professionals' perceptions of these practices. Methods: An international, cross-sectional, online survey was conducted with health professionals, artists, and program coordinators with experience with artists working in palliative care. This survey was part of a larger mixed methods study. An instrument was systematically developed to examine artists' professional practices. Descriptive statistics were reported for the total sample including frequencies, means and standard deviations and open-ended items were analyzed thematically. Results: 101 valid surveys were analyzed. Findings outlined: (1) who delivers the arts; (2) where and with whom; (3) practice descriptors; and (4) perceptions of practice. Themes identified from open-ended items on benefits and risks of practice revealed impacts on patients and artists alike, including: (1) enhanced well-being; (2) vulnerabilities; and (3) facilitators and barriers. Conclusion: Findings demonstrated a wide range of artists' practices in palliative and end-of-life care, featuring notable consistencies in international practice worth further exploration. Ongoing and international efforts examining artists' practices in palliative care contribute to the development of future research, policy and practice.

Arts engagement facilitated by artists with individuals with life-limiting illness: A systematic integrative review of the literature

BACKGROUND

Living with life-limiting illness significantly impacts quality of life. A growing body of evidence suggests that arts engagement facilitated by artists promotes well-being. However, no synthesis of the literature exists to describe arts engagement delivered by artists with individuals receiving palliative care.

AIM

To systematically review and synthesize evidence to identify outcomes and key knowledge gaps to inform future research and practice.

DESIGN

A systematic integrative literature review was conducted using a pre-defined search strategy and reported using PRISMA guidelines. Analysis was conducted iteratively and synthesis achieved using constant comparison to generate themes.

DATA SOURCES

PubMed/MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science, and Embase were searched for studies published between database inception and August 2020. Search terms included variations on arts/artists; patients/service users; and palliative or end-of-life care. Eligibility criteria was applied and study quality assessed.

RESULTS

Seven reviewed studies explored literary, performing, and visual arts engagement in hospitals, hospice and community settings in England, the United States, France, and Canada. Study designs, interventions and findings were discussed. Themes identified across studies associated arts engagement with (1) a sense of well-being, (2) a newly discovered, or re-framed, sense of self, (3) connection with others, and (4) challenges associated with practice.

CONCLUSION

Recommendations for future research were offered in order to maximize benefits, minimize risks and address complexity of artists' engagement in palliative care including: (1) consistency in methods and reporting; (2) inclusion of wider perspectives; and (3) key considerations for adapting the arts by health condition and art form.

The meaning of art in palliative care from the end users' perspective

BACKGROUND

Research concerning art initiatives within palliative care mainly addresses the artist's perspective. Our study brings in the end users' voices.

METHOD

We conducted ethnographic research in the framework of a program that invited professional artists to work at a Belgian palliative and supportive day care center. We examined how the so-called guests (i.e. end users) valued and experienced the artists' presence and activities.

RESULTS

Guests mentioned a positive influence on their personal and social well-being. They also indicated a cultural and artistic value. Art activities offered them something new and unexpected and took them to a different place. Guests felt challenged by activities when their well-being was negatively provoked, when they experienced activities as incomprehensible or in case of logistic hassle.

CONCLUSIONS

Art activities in palliative care settings must be adapted to the interests and abilities of the end users and supported by an educational and logistic framework.

A Retrospective Thematic Analysis of Patient, Family, and Staff Creative Art Tiles Developed on a Tertiary Palliative Care Unit

OBJECTIVES

Clinical use of the creative arts in palliative care is well established, yet there are few evaluation studies of these programs.

METHODS

In this first phase of a 3-phase evaluation of a creative arts program entitled "Tile Tales," we conducted a retrospective thematic analysis of 85 painted tiles and accompanying stories that were publically displayed on a tertiary palliative care unit. Each story was independently coded, using content analysis. Themes were derived through consensus, using the constant comparative method.

RESULTS

Tiles were created by staff (n = 36, 42%), family (n = 32, 38%), patients (n = 9, 11%), or patients and family (n = 8, 9%). Six major themes emerged from the artwork: "Spirituality," "Relationships," "Journey," "Story," "Symbolism," and "Paradox."

SIGNIFICANCE OF RESULTS

These results illustrate how the creative arts can support the expression of diverse palliative care experiences, for patients, their families and palliative care staff, when words alone may not suffice.