Effects of art therapy using color on purpose in life in patients with stroke and their caregivers

Are Art-Based Interventions Effective in Improving Psychological Well-Being Among Informal Caregivers of Cancer Patients? A Systematic Review

Objectives: To systematically synthesize the current evidence on the effects of art-based interventions on improving anxiety, depression, stress, sleep, and well-being of cancer caregivers. Design: A systematic review. Methods: We searched PubMed, EMBASE, Web of Science, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials databases from their inception up to April 2024. Studies exploring the effects of art-based interventions on the psychological symptoms of cancer caregivers were included. We did not restrict the publication to the particular study designs, including randomized controlled trials, quasiexperimental studies, and qualitative studies. Results: Fifteen studies of 607 participants were identified in this systematic review. Overall, the existing studies provided preliminary evidence to suggest that art-based interventions may benefit cancer caregivers in improving anxiety, depression, stress, caregiver burden, and quality of life. However, the relatively low quality of the current evidence limits the efficacy of these findings. Conclusions: According to the existing evidence, the therapeutic benefits of using art-based interventions for improving the psychological well-being of cancer caregivers are uncertain. More high-quality and well-designed studies are still required to confirm the psychological effectiveness of art-based interventions for cancer caregivers in the future.

Seasonal Forest Changes of Color and Temperature: Effects on the Mood and Physiological State of University Students

In this study, we attempted to analyze the effect of color and temperature changes in the forest environment over time on the mood and physiological state of university students. The survey was conducted four times considering forest changes such as new leaf appearance and growth, autumn leaf changes, and fallen leaves. The participants' moods and physiological states were first evaluated in an indoor environment; a second evaluation was conducted after contact with the forest. The color visual information of the forest environment was analyzed through color extraction from photographs taken each survey day. The participants' moods and physiological states were measured using the Korean Profile of Mood States-Brief and a heart rate variability measuring device, respectively. Changes in the forest experience according to the season had an effect on university students' mood states. In particular, the effects of the spring forest experience included the relaxation of tension and the activation of vigor. This result is considered to be influenced by factors such as the season's temperature and the green color, which is predominant in the spring forest. However, no physiological changes were found in the participants according to each season. The results of this study can lead to greater consideration of the role of color in urban forest planning for universities and other public spaces.

Are neuroaesthetic principles applied in art therapy protocols for neurorehabilitation? A systematic mini-review

Art is an instrument created by humans as an alternative way of expression. For this reason, it has found its use in clinical contexts to improve mood, increase participation in therapy, or improve communication for patients with different pathologies. In this systematic mini-review, the Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were adopted. Internet-based bibliographic searches were conducted via major electronic databases (Web of Science and PubMed). We analyzed the quantitative studies in which art figures as a neurorehabilitation treatment to identify whether standard art therapy protocols exist and whether these are based on the principles of neuroaesthetics. Our review identified 8 quantitative and 18 qualitative studies. Although art therapy has been used for more than 20 years as a clinical tool, there are no standard protocols to refer to when planning interventions. Although the effectiveness of using arts as therapy has been reported in many qualitative or feasibility studies, there is still a lack of quantitative studies in which the outcomes of art therapy are directly based on the principles of neuroaesthetics.

A Narrative Review on the Non-Pharmacologic Interventions in Post-Stroke Depression

Stroke is a major cause of death and disability globally. Post-stroke depression (PSD) is a major driver for poor recovery and poor quality of life with extra burden for the patient and the caregiver. We have previously shown the inflammatory basis of PSD with associated bioenergetic failure, disruption of the blood-brain barrier, cell death, and persistent maladapted inflammation, making the PSD a norm rather than the exception, highlighting the unmet need for therapeutic intervention in PSD across the recovery trajectory. In this era, various interventions are focused on pharmacotherapy; however, non-pill-based medication should also be explored as post-stroke patients are likely to suffer from the adverse effects of polypharmacy. This narrated review explores the status of non-pharmacological interventions in managing PSD. We performed a PubMed search using pre-specified keywords looking at various non-pharmacologic approaches for the management of PSD. Worldwide, approaches such as non-invasive brain stimulation, behavioral and psychosocial therapy, as well as exercise, acupuncture, music, literature, and art therapies are available as monotherapy or adjunctive treatment for PSD. While current literature shows convincing results on the benefits of non-pharmacologic interventions, more robust studies are necessary to determine its utility in PSD.

Including Arts in Rehabilitation Enhances Outcomes in the Psychomotor, Cognitive, and Affective Domains: A Scoping Review

OBJECTIVE

The purpose of this scoping review was to analyze the published literature regarding the use of art in the context of rehabilitation for consideration in physical therapy.

METHODS

The CINAHL, PsycArticles, APA PsycInfo, Art Index, Music Index, Cochrane Reviews, and PubMed electronic databases were accessed. Inclusion and exclusion criteria were established and utilized to determine study eligibility. Study details were extracted from each article by researchers using a systematic format. Summation of journal type, participants, dosing and type of intervention, setting and interventionist, outcome domains, and study results were included.

RESULTS

Out of 1452 studies, 76 were included for extraction. Of these studies, most had outcome measures aligned with the psychomotor and affective domains of learning (n = 66). Very few studies had outcome measures with psychomotor and cognitive domains (n = 2) or psychomotor, affective, and cognitive outcome measures (n = 8). Regarding the arts used, music, dance, or both were used in 77 instances. Fewer studies reported using creative arts therapy, singing, theater, writing, and rhythm (n = 17). Of the 76 studies analyzed, 74 reported a within-group treatment effect.

CONCLUSION

The arts effectively enhance physical therapist practice; therefore, it is recommended that physical therapists continue to seek collaboration with art professionals and explore the use of arts in practice.

IMPACT

Findings demonstrate that combining the arts with physical therapist practice amplifies not only psychomotor but affective and cognitive outcomes as well. The arts have applicability across broad populations (eg, chronic pain, neurologic dysfunction, respiratory conditions). This study supports that physical therapist education and practice should embrace the arts as a collaborative modality to promote enhanced psychomotor, affective, and cognitive outcomes.

The overview of utilizing complementary therapy to relieve stress or anxiety in emergency department patients: animal-assisted therapy, art therapy, and music therapy

The Emergency Department could be a stressful environment for patients. Anxiety and depression may develop due to the atmosphere, in addition to patients’ concerns for their health conditions. The condition could potentially affect the experience of the patient in the Emergency Department and the quality of life after the visit. Pharmacological therapy could be administered to the patients. However, adverse effects may be associated with the treatment. Less aggressive complementary treatment approaches are presented in this article. Controlled clinical trials and randomized pilot studies of different complementary therapies, including animal-assisted therapy, art therapy, and music therapy, were conducted. The complementary therapies discussed in this article showed positive outcomes for patients with hospital-induced anxiety and has no adverse effect reported. Hence, hospitals may consider introducing complementary therapies, such as those mentioned in this study, to improve the patients’ experiences in the Emergency Department

Visual Art Intervention for People With Stroke on Holistic Well-Being: A Critical Review

Background: After a stroke, a person usually experiences physical, psychosocial, and spiritual consequences, causing distortion of holistic well-being. Existing studies using visual art interventions found some benefits to physiological, psychosocial, and/or spiritual well-being of people with stroke, but little is known about holistic well-being. Objectives: This critical review to identify how visual art interventions are delivered to people with stroke on holistic well-being. Methods: Databases were searched up to September 30, 2019, for published studies on "stroke" AND "art*/visual art*," AND "holistic well*being." Results: Ten studies were included. Heterogeneity was found in study characteristics, intervention modalities, outcome measures, and methodology issues or a lack of clarity in theoretical application. Most participants were people with stroke, with only two studies recruited older people with stroke. All studies were conducted in rehabilitation units or communities, and none in residential care settings. One study reported the effects on holistic well-being. The appraised quality of the included studies was variable. Conclusion: Stroke impacts the holistic well-being of a person, but little has been known for older people with stroke. It remains unclear how visual art interventions can be delivered and benefit the holistic well-being of older people with stroke in residential care settings.

Psychotherapy and Art Therapy: A pilot study of group treatment for patients with traumatic brain injury

Here we investigated the efficacy of group Psychotherapy and Art Therapy in rebuilding self-identity after traumatic brain injury (TBI), assessing their effects on psychological aspects in twelve patients with severe TBI. Overall, the results show an increased ability to adapt to the experiences of life as well as a higher level of awareness, social functioning and emotional autoregulation. Furthermore, patients exhibited a reduction in depressive symptoms and in the perception of physical problems. Results highlight the importance of treatments focusing on the patients' emotional needs, in addition to the classic rehabilitation (i.e. physiotherapy, cognitive therapy).

Interventions for Psychological Health of Stroke Caregivers: A Systematic Review

Background: The increasing number of stroke patients (SPs) requires informal caregivers to bear a high burden of responsibilities and heavy (di)stress. Moreover, these issues could lead to the development of serious psychological problems (e.g., depressive and/or anxious) that in turn could give rise to poor health-related quality of life outcomes. However, although the value of psychological interventions has been widely recognized for SPs, the scientific literature lacks an updated synthesis of interventions addressing the psychological health of their caregivers. Aim: The aim of this review is to summarize the interventions for the psychological health of stroke caregivers and provide a resume of literature-based evidence of their efficacy. Method: A literature review from 2005 to date was conducted in three online databases: PubMed, Scopus, and Google Scholar. Eligibility criteria for studies were (A) English language, (B) caregivers and patients aged 18 years or above, (C) SP's caregiver beneficiating of a specific intervention, and (D) outcome measures addressing depressive and/or anxiety symptomology, quality of life, well-being, or burden. Results: Across the selected 45 studies, substantial differences are observable in three main categories: (a) type of intervention (b) techniques, and (c) operators. Interventions' advantages and results are discussed. Overall, studies using psychological techniques, such as cognitive-behavioral therapy, coping skill-training, and problem-solving therapy, showed their usefulness and efficacy in reducing the caregivers' depressive and anxious symptoms, and burden. Interventions led by psychologists and tailored to meet caregivers' specific needs showed more positive outcomes. Conclusion: This review underlines the usefulness of psychological interventions aimed at reducing the psychological burden, such as anxious and depressive symptomatology, of SPs' informal caregivers. Hence, psychological interventions for caregivers should be integrated as part of the stroke rehabilitation process to improve informal caregivers' and patients' quality of life and well-being.

Analysis of the concept of powerlessness in individuals with stroke

OBJECTIVES

To identify and analyze the concept of the powerlessness in individuals with stroke, according to the NANDA-I Taxonomy.

METHODS

Concept analysis from online access of four databases using the descriptors: impotence; helplessness, learned; Stroke, depression in languages: Portuguese, English and Spanish.

RESULTS

The critical attributes of the feeling of powerlessness are: fragility, helplessness, lack of control, and power to achieve the proposed results for recovery and adaptation. Eleven new antecedents were found. It is recommended to reformulate three antecedents present in the taxonomy. Fourteen consequent were found. It is suggested to amend three consequential from the review.

CONCLUSIONS

With the analysis, a more complete concept of the powerlessness was elaborated allowing clarifying the critical attributes that, in turn, will help the rehabilitating nurse to recognize the signs and symptoms and to strengthen mechanisms of tolerance and resistance to stress.

Acurácia do diagnóstico de enfermagem “disposição para melhora da esperança” em pacientes renais crônicos

RESUMO Objetivo Analisar a acurácia do diagnóstico “Disposição para melhora da Esperança” em pacientes renais crônicos. Método Estudo transversal com 62 pacientes em clínica de hemodiálise entre agosto a novembro de 2015. Utilizou-se a Escala de Esperança de Herth para a construção das definições das características definidoras da North American Nursing Diagnosis Association International. Analisaram-se medidas de sensibilidade, especificidade, valor preditivo, razão de verossimilhança e odds ratio das características definidoras do diagnóstico. Resultados 82,22% apresentaram o diagnóstico. Verificou-se que as características definidoras “Expressa desejo de intensificar a coerência entre expectativas e desejos” e “Expressa o desejo de reforçar a resolução de problemas para alcançar as metas” aumentou em onze e cinco vezes, respectivamente, a chance de possuírem o diagnóstico. Conclusão “Expressa desejo de intensificar a coerência entre expectativas e desejos” e “Expressa o desejo de reforçar a resolução de problemas para alcançar as metas” apresentaram boas medidas de acurácia.

Creative art therapy to enhance rehabilitation for stroke patients: a randomized controlled trial

Objective:

To examine the efficacy of creative art therapy plus conventional physical therapy, compared with physical therapy only, in increasing cognitive ability, physical functions, psychological status and quality of life of stroke patients.

Design:

Randomized controlled trial with blinded assessor.

Setting:

An in-patient setting

Participants:

One hundred and eighteen stroke patients aged ⩾50 years who could communicate verbally.

Interventions:

All participants received conventional physical therapy five days per week. An intervention group received additional creative art therapy, twice a week for four weeks, in a rehabilitation ward.

Main outcomes:

Cognitive function, anxiety and depression, physical performance and quality of life were measured with the Abbreviated Mental Test, the Hospital Anxiety and Depression Scale, the modified Barthel Index scale and the pictorial Thai Quality of Life questionnaire, respectively.

Results:

Mean differences for the intervention group were significantly greater than the control group for depression (−4.5, 95% CI −6.5, −2.5, p< 0.001), physical functions (1.2, 95% CI 0.1, 2.3, p= 0.043) and quality of life (8.9, 95% CI 3.8, 13.8, p< 0.001).Compared with baseline measures, both groups experienced improved cognition, physical functions and quality of life and reduced anxiety and depression. Eighty-five percent of patients were satisfied with the creative art therapy and most reported improved concentration (68.5%), emotion (79.6%), self-confidence (72.2%) and motivation (74.1%).

Conclusion:

Creative art therapy combined with conventional physical therapy can significantly decrease depression, improve physical functions and increase quality of life compared with physical therapy alone.

Well-being of elderly stroke survivors in Chinese communities: mediating effects of meaning in life

OBJECTIVES

This study aims to examine the role of meaning in life as a mediator for the relationship of physical functioning, social support, and optimism with well-being among elderly Chinese stroke survivors.

METHOD

A cross-sectional study was conducted on 214 community-dwelling older stroke survivors (128 men and 86 women), ranging from 60 to 88 years. The physical functioning, social support, optimism, meaning in life, and subjective well-being of the participants were measured.

RESULTS

Structural equation modeling revealed that meaning in life fully mediates the relationship of physical functioning, social support, and optimism with subjective well-being.

CONCLUSION

This study examines the role of meaning in life in stroke experience from an existential perspective. The modifiable features of meaning in life may offer an intervening angle for improving the well-being of elderly stroke survivors.