The arts, well‐being and society

Feasibility study of the effects of art as a creative engagement intervention during stroke rehabilitation on improvement of psychosocial outcomes: study protocol for a single blind randomized controlled trial: the ACES study

Background

Benefits of art participation after stroke are becoming increasingly recognized. Qualitative studies suggest that participation in visual arts creative engagement interventions (CEIs) during rehabilitation after stroke may improve mood, self-esteem, hope and some aspects of physical recovery. This study examines the feasibility of undertaking a randomized controlled trial of a CEI delivered by artists within in-patient stroke rehabilitation to test effectiveness.

Methods/Design

This trial is a two arm, single-blind, randomized controlled feasibility trial within in-patient stroke rehabilitation. We will recruit 80 patients receiving stroke rehabilitation in two stroke units in a health board area of Scotland (40 patients in each arm). Intervention arm participants will receive a visual-arts based CEI facilitated by experienced artists. Artists will follow an intervention protocol with specific components that enable participants to set, achieve and review artistic goals. Participants will receive up to eight intervention sessions, four within a group and four one-to-one with the artist. Control group participants will receive usual care only.

Data collection will occur at baseline, post-intervention and three-month follow-up. Stroke-related health status is the primary outcome; mood, self-esteem, self-efficacy, perceived recovery control and hope are secondary outcomes. Semi-structured interviews will be conducted with purposively selected patients, artists and healthcare staff to elicit views and experiences of the intervention and feasibility and acceptability of trial processes. Recruitment rates, retention rates and patient preference for art participation will also be collected. Data will indicate, with confidence intervals, the proportion of patients choosing or refusing participation in the CEI and will allow calculation of recruitment rates for a future definitive trial. Summary data will indicate potential variability, magnitude and direction of difference between groups. Findings will inform sample size calculations for a definitive trial. Thematic analysis of qualitative data will be managed using the Framework Approach. Framework is an analytical approach for qualitative data, commonly used in policy and medical research.

Discussion

If shown to demonstrate effects, this intervention has the potential to address aspects of stroke recovery previously. Not routinely addressed in rehabilitation.

Trial registration

Registered with Clinical Trials.Gov: NCT02085226 on 6th March 2014.

Electronic supplementary material

The online version of this article (doi:10.1186/1745-6215-15-380) contains supplementary material, which is available to authorized users.

Creativity as openness: improvising health and care 'situations'

Creativity has become an oft-used word in UK public policy, but perhaps it is also under-imagined. This paper contends that there is an instrumental tendency to narrowly frame creativity as innovation, implying a reproducible product, instead of more openly as improvisation, a situational, embodied and temporal process. This is not a simple dichotomy (innovation and improvisation, product and process, can be mutually informing concepts), nor is it specifically a question of definition; rather, it relates to an ontological orientation, and related to that are issues of epistemological implications. In particular the paper is concerned with the value of the arts in public policy, as situated in the social, and therefore human, spaces of health and care; and more generally the arts in society. The paper brings together a broad discussion from across disciplines, not in an interdisciplinary attempt to solve a problem, or to be reductive in the analysis, but to begin to approach a reorienting of understandings of creativity and the human value and foundation of the arts in society.