Art therapy among palliative care inpatients with advanced cancer
Art therapy among palliative care inpatients with advanced cancer
复制标题
晚期癌症姑息治疗住院患者的艺术治疗
作者：
W. Rhondali;E. Lasserre;M. Filbet
艺术治疗是一种临床干预，它利用艺术创作的表现力，旨在改善福祉和心理功能。1艺术创作中涉及的创造性过程允许表达可能难以用语言表达的担忧和感受。2，3艺术治疗已证明其在减少癌症患者常见症状方面的有效性。4然而，艺术治疗是一项复杂的干预措施，由于涉及多个组成部分，因此其评估可能具有挑战性。我们的研究的目的是评估混合方法的可行性，以定量地确定艺术治疗会议对晚期癌症患者常见症状的短期影响，并定性地评估这些患者对会议对他们的身体和心理困扰的影响和价值的看法。从姑息治疗病房招募连续住院患者。参与艺术治疗的患者在第一次治疗前被系统地建议参加研究。由专业艺术治疗师为参与者提供1小时的艺术治疗。在会议的前一天，每个病人都被邀请讨论他们想探讨的话题。艺术治疗课程（绘画）每周两次在姑息治疗部进行。绘画的选择允许患者通过颜色和绘画表达他们的感受，并制作艺术品。艺术治疗师的指导主要是技术方面的。我们使用埃德蒙顿症状评估量表（ESAS）来评估身体和心理上的痛苦。我们记录了艺术治疗前后1小时收集的ESAS结果。采用Wilcoxon检验比较干预前后ESAS评分。p值小于0.05表示具有统计学显著性。我们还在艺术治疗后的第二天进行了半定向采访。访谈问题旨在引发开放式的反应，以获取有关患者与艺术治疗会话相关的想法的信息。我们使用扎根理论的方法来分析成绩单，并对数据进行主题分析来推断结果。12例患者被纳入我们的研究。所有受试者均为女性，并有转移。艺术治疗前1小时和治疗后1小时，疼痛（p = 0.002）、疲劳（p = 0.001）、抑郁（p = 0.022）、焦虑（p = 0.027）和幸福感下降（p = 0.015）均有统计学显著改善。在半定性访谈中，患者表示，他们经历了缓解身体疼痛的艺术治疗过程中。他们主要是通过做其他事情（分散注意力）来解释这种解脱。
Art therapy is a clinical intervention that uses the expressive qualities of art making with the aim of improving well-being and psychological functioning.1 The creative process involved in art making allows the expression of concerns and feelings that might otherwise be difficult to express verbally.2,3 Art therapy has demonstrated evidence for its efficacy in reducing common symptoms experienced by cancer inpatients.4 However, art therapy is a complex intervention, and its evaluation can be challenging because of the multiple components involved. The objectives of our study were to evaluate the feasibility of mixed methods to quantitatively determine the short-term effect of an art therapy session on symptoms commonly experienced by patients with advanced cancer and to qualitatively assess these patients’ perceptions of the impact and value of the session on their physical and psychological distress. Consecutive inpatients were recruited from a palliative care unit. Patients involved in art therapy sessions were systematically proposed to participate in the study before their first session. Participants were provided a 1-h art therapy session by a professional art therapist. The day before the session, each patient was invited to discuss the topic they wanted to explore. The art therapy sessions (painting) took place in the palliative care department twice weekly. The choice of painting allowed patients to express their feelings through colors and drawing and to produce an artwork. Guidance from art therapists was mainly toward technical aspects. We used the Edmonton Symptom Assessment Scale (ESAS) to assess physical and psychological distress. We recorded the ESAS results collected 1 h before and after the art therapy session. A Wilcoxon test was used to compare preand postintervention ESAS scores. A p value less than 0.05 indicated statistical significance. We also conducted semidirected interviews the day after the art therapy session. The interview questions were geared toward eliciting open-ended responses to acquire information about the patient’s thoughts associated with the art therapy session. We used a grounded theory approach in analyzing the transcripts and applied a thematic analysis to the data to extrapolate results. Twelve patients were included in our study. All the participants were female and had metastasis. One hour before and 1 h after the art therapy session, there were statistically significant improvements in pain (p = 0.002), fatigue (p = 0.001), depression (p = 0.022), anxiety (p = 0.027), and diminished feeling of well-being (p = 0.015). During the semiqualitative interviews, patients expressed that they had experienced relief from physical pain during the art therapy session. They mainly explained the relief by the fact that they were doing something else (distraction).