A visit to David's World: exploring the impact of a passive art intervention on hospitalized children's wellbeing, engagement, and joy

BACKGROUND

A gap exists in research regarding the impact of passive art on hospitalized children. This descriptive study explored the ability of an intervention using original paintings and the same paintings altered with personalized content to capture the attention of hospitalized children, engage them, and bring them joy.

METHODS

This grounded theory mixed-method exploratory pilot study included interview, observation, Leuven Scales for Involvement and Well-being, and the VAS-Joy Scale. Ten hospitalized children, ages four to 12 years, viewed a painting and later the painting with personalized content.

RESULTS

Leuven scores pre- (M = 4) and post-intervention (M = 4.5) suggested high levels of well-being and involvement, with post scores higher. Joy scores (M = 6.3) obtained post-intervention indicated high levels of joy when viewing the personalized altered painting. Five response themes emerged: (1) Felt special; (2) Brightened mood; (3) Reinforced positive identity; (4) Stimulated imagination; and (5) Revealed homesickness.

CONCLUSIONS

Findings support the emergent theory that passive art interventions using "organic art" can contribute to improving the hospital experience for children.

Color and NICU Design

PURPOSE

The appropriate use of color in healthcare settings has been a topic of interest for designers and researchers, and the need for evidence-based standards evident. The purpose of this article is to summarize recent research on color as applicable to neonatal intensive care units and to propose standards for color in these settings.

BACKGROUND

Research on this topic is limited due to difficulties associated with constructing research protocols, challenges in setting parameters for the independent variable (color), and the need to simultaneously address infants, families, and caregivers.

METHODS

For our literature review, the following research question was developed: Does the use of color in the design of the neonatal intensive care units (NICUs) impact health outcomes in newborn infants, families, and/or staff? Using Arksey and O'Malley's framework for conducting a structured literature review, we (1) identified the research question, (2) identified relevant studies, (3) selected studies, and (4) collated and summarized the results. Only four papers were found regarding NICUs, so the search was expanded to include related healthcare and authors reporting on best practice.

RESULTS

Overall, the primary research focused on behavioral or physiological outcomes including the role of wayfinding and art, the impact of lighting on color, and tools for evaluating the impact of color. Best practice recommendations sometimes reflected the primary research but occasionally provided contradictory advice.

CONCLUSIONS

Based on the reviewed literature, five topics are addressed: palette malleability; the use of the primary colors, blue, red, and yellow; and the relationship between light and color.

Evidence-based art in the hospital

Background

Evidence-based art is the investigation of art effects and art investigated for effects. In this study the evidence regarding patient preferences for art styles and effects of art in nonpsychiatric hospitals and outpatient departments was reviewed.

Methods

Results from original articles were retrieved by a scoping PubMed search and by browsing the internet using the terms “evidence based art”, “evidence based design”, “art and hospital” and “design and hospital”, “art effect”, “design effect”, “landscape preference” and “abstract art figurative art”. The quality of art was not operationalized as a criterion.

Results

Of the articles 7 original sources showed patient preference for natural scenes and figurative art, 2 studies showed no preference, 16 studies showed positive art effects on well-being and behavior and 5 studies showed a positive effect of nature pictures on measurable findings.

Conclusion

Controversial results together with theoretical aspects suggest natural scenes in patient rooms and diverse art in public areas.

Visual Arts in Children's Hospitals: Scoping Review

PURPOSE

The purpose of this work was to review scientific publications related to the use of visual arts in pediatric hospitals.

BACKGROUND

Visual arts, particularly painting, have historically played an important role in the design and atmosphere of healthcare spaces, especially hospitals.

METHODS

From 2000 to 2019, 79 publications located in relevant databases and manual searches were identified and analyzed.

RESULTS

Sixty of these publications include empirical studies and 19 theoretical models, comments, or reflections on the use of art in children's hospitals. Their analysis allows us to differentiate four groups of works: (a) "environmental" includes works whose purpose is to know how visual artistic interventions in the hospital can affect the people who see them, mainly pediatric patients, families, and health workers; (b) "participatory" includes studies aimed at knowing the effect of developing visual arts activities in the hospital; (c) "exploratory" includes works whose purpose was to know more about the children's perspective using their artistic expressions; and (d) "diagnostic" includes those that use children's drawings as a tool to diagnose diverse processes related to the pediatric patients' experience.

CONCLUSIONS

Taken together, the works we analyzed in our study support the use of visual arts in hospitals as a resource to enhance the well-being of children and families and their experience in the hospital. We indicate two particularly relevant aspects in this sense: the importance of the visual arts in improving the symbolic quality of hospitalization settings and the communication processes that occur in these environments.

Aboriginal and Torres Strait Islander preferences for healthcare settings: effective use of design images in survey research

Objective The aim of this study was to develop an effective digital survey instrument incorporating images to investigate Aboriginal and Torres Strait Islander preferences for health clinics and hospitals, design of healthcare settings and the differences between inner regional and remote locations. Methods Design-related constructs developed from qualitative interviews informed the construction of healthcare setting images. These images were embedded in an online survey instrument to elicit data on design preferences and an area-based recruitment strategy ensured participation by Indigenous Australians from three Queensland locations. Logistic regression analyses were used to estimate the odds of preference for a healthcare setting design by location. Results Statistical analysis of data from 602 participants showed a preference for health care at an Aboriginal and Torres Strait Islander clinic. The odds of preference for an in-patient room with a two- versus single-bed design was greater for participants with less education, and lower for participants with a long-term health problem. Conclusions The multidisciplinary approach to developing an online survey instrument with images and the willingness of Indigenous people of all ages to engage with the images demonstrated the effectiveness of this method in providing robust evidence for the design of culturally appropriate healthcare spaces for Indigenous users. What is known about the topic? Evidence-based research influences the design of healthcare buildings, yet the field currently provides negligible evidence on cross-cultural perceptions or experiences of conventional modern hospitals and clinics. Although recent healthcare buildings show signs of acknowledging Indigenous users, general principles in the Australian Health Facility Guidelines give limited specific information about how cultural requirements may translate into architectural design. What does this paper add? The multidisciplinary approach to research design has enabled the development of healthcare design-related constructs from consultation with Indigenous people, the presentation of these constructs as images and the inclusion of these images for comparison and selection in a digital survey instrument. Combined with a culturally appropriate recruitment strategy, this survey provides evidence from a large sample of the Indigenous population. Selected results from analyses of survey responses show the capacity of the methodological approach to address broader questions about Indigenous preferences for healthcare settings by location, age and sex. What are the implications for practitioners? A focus on individual preferences related to healthcare clinics and the combined significance of design and setting can give practitioners a better understanding of Aboriginal and Torres Strait Islander people's preferences and suggest ways to reduce the incidence of poor engagement with healthcare services.

Positioning patient status monitors in a family waiting room

OBJECTIVE

To determine where to place patient status displays for family members in the operating room family waiting room at The Children's Hospital of Philadelphia.

METHODS

We calculated the percentage of seats from which wall monitors placed in hypothetical positions would be usable. We validated the usability of the new monitors by observing nonemployees' use of monitors in the waiting room 1 week before and 1 week after implementation.

RESULTS

Compared to the legacy monitor, the new monitors were observed to be used from more locations within the waiting room and more people were observed to use the new monitors soon after entering the waiting room.

CONCLUSIONS

Seemingly trivial decisions like where in a waiting room to place monitors can be informed by careful data collection and the consequences can observably impact communication between hospital staff and family members waiting for loved ones in surgery.

Art viewing directives in hospital settings effect on mood

OBJECTIVE

The purpose of this study was to determine the effect viewing directives can have when encountering art in hospitals. A secondary objective of the study was to understand the responses of viewers to an art exhibit on the theme of medical student empathy toward patient pain and suffering.

BACKGROUND

Displaying art in hospitals has been credited with increasing well-being of patients, visitors, and staff. Generally, hospital curators have focused on the type of art to display (natural, symbolic, and abstract). This focus has neglected the possibility that in addition to the type of art, the way that viewers engage art may also be responsible for the healing effect.

METHODS

Participants (n = 97) were randomly allocated into one of the viewing directives: (1) reflecting on one artwork, (2) creating a drawing or poem in response to one artwork, or (3) no direction. Prior to looking at the art and immediately after, participants were administered the Brief Mood Introspection Scale (BMIS) and offered an opportunity to participate in an interview.

RESULTS

Pre-post results of the BMIS demonstrated that viewers who received directions achieved some therapeutic effect. Qualitative themes from the post-exhibit interviews identified that the empathy themed exhibit was well received, although there were differences among responses from patients, visitors, and staff.

CONCLUSIONS

The results imply that hospitals may consider offering prompts to help viewers engage with art to enhance mood and exhibiting art that demonstrates empathy for patient suffering.

Nature Contacts

Objective:

This study was designed to ascertain the amount of outdoor, indoor, and indirect nature contact exposures hospital employees have in a workweek.

Background:

Hospital employees have been found particularly vulnerable to work-related stress. Increasing the nature contact exposure for hospital employees can reduce perceived stress; stress-related health behaviors; and stress-related health outcomes from outdoor, indoor, and indirect exposures to nature.

Methods:

Staff on the fourth floor postsurgical unit of a large hospital ( N = 42) were ask to participate in an employee questionnaire “nature contact questionnaire”. This 16-item nature environment questionnaire measures the amount and types of nature contact exposures employees have during a workweek.

Results:

Majority of employees reported few, if any, nature contact exposures, specifically in the area of outdoor nature contacts with limited indoor and indirect contacts. These results indicated that employees on the fourth floor postsurgical floor have limited ability to reduce stress through nature contact exposures which could impact their perceived levels of work stress and stress-related behaviors and health outcomes.

Conclusions:

Nature contact exposures are both a relatively easy and an inexpensive way to improve employee stress. These findings indicate limitations to employees’ exposure to nature contacts. Healthcare environments would benefit from a concerted effort to provide increased outdoor, indoor, and indirect nature contact exposures for employees.

A Hospital's Contemporary Art Collection: Effects on Patient Mood, Stress, Comfort, and Expectations

OBJECTIVE:

It is not firmly established whether an art collection of diverse subject matter, media, and imagery in the hospital environment can play a significant role in mitigating the psychological stresses and physical pain associated with a hospital visit, or whether it improves patients' satisfaction with their care. The variety of contemporary art displayed in the institution investigated in this paper served as a case study to assess the qualitative and quantitative effects of such a collection on patient health and experience. We sought to assess whether the diversity in subject matter, imagery, and media would positively affect patient mood, comfort level, stress level, and expectation of visit.

BACKGROUND:

Previous research concluded that nature art (i.e., representational depictions of nature) has positive effects on patient health outcomes. Studies to date have assessed the effects of individual units of artwork rather than that of an art collection as a whole.

METHODS:

A survey was sent to 4,376 members of an online Patient Panel, comprised of patients who volunteer to evaluate their experiences at Cleveland Clinic. For this study, Panel members were screened based on whether they had been to the Main Campus in the past 12 months.

RESULTS:

A majority of respondents noticed the artwork, had improved moods and stress levels due to the artwork, and reported that the art collection positively impacted their overall satisfaction and impression of the hospital.

CONCLUSIONS:

Our findings demonstrate that this particular collection has a significant effect on the patient experience and on self-reported mood, stress, comfort, and expectations. These results suggest that patients may respond positively to the diversity of the collection, and to other types of art in addition to nature art.