ARTICLE - CANDIDATE TRANSITION VARIABLES

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Id 939
Author Morris J.H., Kelly C., Joice S., Kroll T., Mead G., Donnan P., Toma M., Williams B.
Title Art participation for psychosocial wellbeing during stroke rehabilitation: a feasibility randomised controlled trial
Reference
Morris J.H., Kelly C., Joice S., Kroll T., Mead G., Donnan P., Toma M., Williams B.; Art participation for psychosocial wellbeing during stroke rehabilitation: a feasibility randomised controlled trial ;Disability and Rehabilitation vol:41.0 issue: 1 page:9

Link to article https://www.scopus.com/inward/record.uri?eid=2-s2.0-85028528712&doi=10.1080%2f09638288.2017.1370499&partnerID=40&md5=676d9cb16444427a61dfa44a96010a3d
Abstract Purpose: To examine the feasibility of undertaking a pragmatic single-blind randomised controlled trial (RCT) of a visual arts participation programme to evaluate effects on survivor wellbeing within stroke rehabilitation. Methods: Stroke survivors receiving in-patient rehabilitation were randomised to receive eight art participation sessions (n = 41) or usual care (n = 40). Recruitment, retention, preference for art participation and change in selected outcomes were evaluated at end of intervention outcome assessment and three-month follow-up. Results: Of 315 potentially eligible participants 81 (29%) were recruited. 88% (n = 71) completed outcome and 77% (n = 62) follow-up assessments. Of eight intervention group non-completers, six had no preference for art participation. Outcome completion varied between 97% and 77%. Running groups was difficult because of randomisation timing. Effectiveness cannot be determined from this feasibility study but effects sizes suggested art participation may benefit emotional wellbeing, measured on the positive and negative affect schedule, and self-efficacy for Art (d = 0.24–0.42). Conclusions: Undertaking a RCT of art participation within stroke rehabilitation was feasible. Art participation may enhance self-efficacy and positively influence emotional wellbeing. These should be outcomes in a future definitive trial. A cluster RCT would ensure art groups could be reliably convened. Fewer measures, and better retention strategies are required.Implications for Rehabilitation This feasibility randomised controlled trial (RCT) showed that recruiting and retaining stroke survivors in an RCT of a visual arts participation intervention within stroke rehabilitation was feasible. Preference to participate in art activities may influence recruitment and drop-out rates, and should be addressed and evaluated fully. Art participation as part of rehabilitation may improve some aspects of post-stroke wellbeing, including positive affect and self-efficacy for art. A future definitive cluster RCT would facilitate full evaluation of the value art participation can add to rehabilitation. © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.


Results:

Candidate transition variables
Positive affect represents pleasurable engagement and includes emotions such as enthusiasm and alertness. .
The study demonstrated improved depression, quality of life and cognition, compared to usual care, following visual art-making combined with meditation and singing. .
Art participation may enhance self-efficacy and positively influence emotional wellbeing. .
Arts programmes led by professional artists focus on benefits to wellbeing through artwork creation, by enabling people to realise their creative potential. .
Qualitative work to inform this study suggested art participation may foster positive resources that contribute to wellbeing, and guided outcome selection. .
Art participation as part of rehabilitation may improve some aspects of post-stroke wellbeing, including positive affect and self-efficacy for art. .
Models of psychological care after stroke 11 suggest activities including art participation within stroke rehabilitation, may enhance wellbeing, preventing escalation to more serious psychological problems. .
Whilst retaining the primary purpose of a creative experience with artists, elements of art therapy, particularly techniques known to be effective at improving positive emotions could be included..
The Positive and Negative Affect Scale reflected the positive emotional changes anticipated by art participation. .
The focus on positive affect reflects the selected definition of emotional wellbeing and the potential impact of art identified from previous literature. .
Perception of control over recovery was identified in earlier qualitative work as a positive benefit of art participation. .
Positive affect and self-efficacy for art appeared to be enhanced in this feasibility study however study adjustments would be important for a definitive trial. .
A future definitive cluster RCT would facilitate full evaluation of the value art participation can add to rehabilitation. .
The benefits of participating in meaningful leisure activities to address wellbeing after stroke, are becoming recognised 8 . .