Feature

Visual art intervention reduces pain and anxiety, improves mood among individuals with blood cancers

Alexandra P. Wolanskyj-Spinner, MD
Alexandra P. Wolanskyj-Spinner

A bedside visual art intervention improved mood while reducing pain and anxiety among patients with hematologic malignancies, according to study results.

Alexandra P. Wolanskyj-Spinner, MD, professor of medicine and consultant in the division of hematology at Mayo Clinic in Rochester, Minnesota, and colleagues assessed whether a 30-minute art intervention could benefit individuals with cancer.

Wolanskyj-Spinner and colleagues measured the outcomes using the visual analog scale, State-Trait Anxiety Inventory, and the Positive and Negative Affect Schedule (PANAS) scale.

The study included 21 patients (19 women).

Researchers reported significant improvements in positive mood (P = .003) and pain scores (P = .017), as well as significant decreases in negative mood (P = .016) and anxiety (P = .001).

The majority (95%) of patients perceived the intervention as positive, and 85% indicated they would participate in future art-based interventions.

“This accessible experience, provided by artists within the community, may be considered as an adjunct to conventional treatments in patients with cancerrelated mood symptoms and pain,” Wolanskyj-Spinner and colleagues wrote. “Future studies with balanced gender participation may support the generalizability of these findings.”

HemOnc Today spoke with Wolanskyj-Spinner about the study and the potential benefits of a bedside visual art intervention.

Question: W hat made you consider testing a bedside visual art intervention for individuals with cancer?

Answer: Mayo Clinic has developed a number of humanities-centered, art-based experiences for patients in the outpatient setting. However, there were no options for patients who were hospitalized. This untapped need really was the inspiration. We thought about what we could bring to the bedside to incorporate the arts and, more importantly, to effectively offer alternatives to standard management of patients who are experiencing cancer symptoms.

Q: How did you develop and conduct the study?

A: The study population included those in the inpatient hematology ward, as well as our bone marrow transplant ward. These patients experience symptoms such as anxiety, depression and pain, so we targeted those as our outcome measures. Members of the primary health care team identified patients who they thought might enjoy participating in the study.

We worked in partnership with an artist educator who came to the patients’ bedsides with materials such as pastels and watercolors. Patients were encouraged to participate in an art intervention if they wanted to, or they could simply watch the artist. Every patient chose to actively participate and, in conjunction with the artist, they created an art piece. The materials were then left with the patients to continue with the art experience at their own pace.

Q: Can you describe what you found?

A: We observed statistically significant improvement in all of our outcome measures. Patients experiencing pain at baseline reported about a 35% reduction in these symptoms. Among those who were feeling anxious at baseline, anxiety levels dropped by about 22%. We also saw improvements in positive mood and reductions in negative mood.

Q: Did the results surprise you?

A: We invited 31 patients to participate, and there was a slight bias in who was identified, leaning more toward female than male. Of the 21 patients who participated, 19 were female. That was surprising. We also were surprised that the results were so incredibly positive, and that we had such strong improvement in all of these measures and at such a high level of statistical significance. I'm delighted to say that, following the study and through the generous donation of development donors at Mayo Clinic, we have been able to continue offering this to patients at both of our main hospitals in Rochester, Minnesota.

Q: Do you think other cancer centers should consider implementing this type of intervention?

A: Yes, very much so. The intervention was designed to be brief and easy to implement. Hospitals can partner with individuals in the community who teach art, such as a high school teacher or educators at the local art center. The artist can come to the bedside and potentially have a similar impact on patients. This intervention is inexpensive and accessible, and can serve as a complement to standard care to significantly benefit patients experiencing cancer-related symptoms. Ideally, the study should be repeated with a control group and at other centers. We have begun to offer music and creative writing at the bedside as well. Our patients are very appreciative of these humanities-based experiences. – by Scott Buzby

Reference:

Saw JJ, et al. Eur J Cancer Care. 2018;doi:10.1111/ecc.12852.

For more information:

Alexandra Wolanskyj -Spinner , MD, can be reached at wolanskyj.alexandra@mayo.edu.

Disclosures: The Knowles-Kolden family, McBrien family, Mayo Clinic Dolores Jean Lavins Center for Humanities in Medicine, and Rochester Art Center provided support for this study. Wolanskyj-Spinner reports no relevant financial disclosures.

Alexandra P. Wolanskyj-Spinner, MD
Alexandra P. Wolanskyj-Spinner

A bedside visual art intervention improved mood while reducing pain and anxiety among patients with hematologic malignancies, according to study results.

Alexandra P. Wolanskyj-Spinner, MD, professor of medicine and consultant in the division of hematology at Mayo Clinic in Rochester, Minnesota, and colleagues assessed whether a 30-minute art intervention could benefit individuals with cancer.

Wolanskyj-Spinner and colleagues measured the outcomes using the visual analog scale, State-Trait Anxiety Inventory, and the Positive and Negative Affect Schedule (PANAS) scale.

The study included 21 patients (19 women).

Researchers reported significant improvements in positive mood (P = .003) and pain scores (P = .017), as well as significant decreases in negative mood (P = .016) and anxiety (P = .001).

The majority (95%) of patients perceived the intervention as positive, and 85% indicated they would participate in future art-based interventions.

“This accessible experience, provided by artists within the community, may be considered as an adjunct to conventional treatments in patients with cancerrelated mood symptoms and pain,” Wolanskyj-Spinner and colleagues wrote. “Future studies with balanced gender participation may support the generalizability of these findings.”

HemOnc Today spoke with Wolanskyj-Spinner about the study and the potential benefits of a bedside visual art intervention.

Question: W hat made you consider testing a bedside visual art intervention for individuals with cancer?

Answer: Mayo Clinic has developed a number of humanities-centered, art-based experiences for patients in the outpatient setting. However, there were no options for patients who were hospitalized. This untapped need really was the inspiration. We thought about what we could bring to the bedside to incorporate the arts and, more importantly, to effectively offer alternatives to standard management of patients who are experiencing cancer symptoms.

Q: How did you develop and conduct the study?

A: The study population included those in the inpatient hematology ward, as well as our bone marrow transplant ward. These patients experience symptoms such as anxiety, depression and pain, so we targeted those as our outcome measures. Members of the primary health care team identified patients who they thought might enjoy participating in the study.

We worked in partnership with an artist educator who came to the patients’ bedsides with materials such as pastels and watercolors. Patients were encouraged to participate in an art intervention if they wanted to, or they could simply watch the artist. Every patient chose to actively participate and, in conjunction with the artist, they created an art piece. The materials were then left with the patients to continue with the art experience at their own pace.

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Q: Can you describe what you found?

A: We observed statistically significant improvement in all of our outcome measures. Patients experiencing pain at baseline reported about a 35% reduction in these symptoms. Among those who were feeling anxious at baseline, anxiety levels dropped by about 22%. We also saw improvements in positive mood and reductions in negative mood.

Q: Did the results surprise you?

A: We invited 31 patients to participate, and there was a slight bias in who was identified, leaning more toward female than male. Of the 21 patients who participated, 19 were female. That was surprising. We also were surprised that the results were so incredibly positive, and that we had such strong improvement in all of these measures and at such a high level of statistical significance. I'm delighted to say that, following the study and through the generous donation of development donors at Mayo Clinic, we have been able to continue offering this to patients at both of our main hospitals in Rochester, Minnesota.

Q: Do you think other cancer centers should consider implementing this type of intervention?

A: Yes, very much so. The intervention was designed to be brief and easy to implement. Hospitals can partner with individuals in the community who teach art, such as a high school teacher or educators at the local art center. The artist can come to the bedside and potentially have a similar impact on patients. This intervention is inexpensive and accessible, and can serve as a complement to standard care to significantly benefit patients experiencing cancer-related symptoms. Ideally, the study should be repeated with a control group and at other centers. We have begun to offer music and creative writing at the bedside as well. Our patients are very appreciative of these humanities-based experiences. – by Scott Buzby

Reference:

Saw JJ, et al. Eur J Cancer Care. 2018;doi:10.1111/ecc.12852.

For more information:

Alexandra Wolanskyj -Spinner , MD, can be reached at wolanskyj.alexandra@mayo.edu.

Disclosures: The Knowles-Kolden family, McBrien family, Mayo Clinic Dolores Jean Lavins Center for Humanities in Medicine, and Rochester Art Center provided support for this study. Wolanskyj-Spinner reports no relevant financial disclosures.