ART DURING HAEMODIALYSIS TREATMENT IMPROVES PATIENTS’ MENTAL HEALTH AND SENSE OF WELLBEING
Patients on maintenance haemodialysis (MHD) suffer a loss of physical wellbeing and are vulnerable to depression. We investigated the effect of introducing creative arts to patients on MHD on quality of life (QoL) and their experience of dialysis treatment.
Patients on maintenance haemodialysis (MHD) suffer a loss of physical wellbeing and are vulnerable to depression. We investigated the effect of introducing creative arts to patients on MHD on quality of life (QoL) and their experience of dialysis treatment.
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<strong>ART</strong> <strong>DURING</strong> <strong>HAEMODIALYSIS</strong> <strong>TREATMENT</strong> <strong>IMPROVES</strong> <strong>PATIENTS’</strong> <strong>MENTAL</strong> <strong>HEALTH</strong><br />
<strong>AND</strong> <strong>SENSE</strong> <strong>OF</strong> <strong>WELLBEING</strong>.<br />
Y Mun Woo 1 , Kirsty Stansfield 2 , Belinda Guidi 2 , Sharon Kane 2 , Barbara Gulliver 2 , Julie Tortolano 1 , R<br />
Stuart Rodger 1 , Colin Geddes 1 .<br />
1 Renal Unit, Inverclyde Royal Hospital, Greenock.<br />
2 Art in Hospital, Blawarthill Hospital, 129 Holehouse Drive, Glasgow.<br />
Background Patients on maintenance haemodialysis (MHD) suffer a loss of physical wellbeing and are<br />
vulnerable to depression. We investigated the effect of introducing creative arts to patients on MHD on<br />
quality of life (QoL) and their experience of dialysis treatment.<br />
Method Professional artists were engaged for 8 weeks to provide creative arts to MHD patients during<br />
their dialysis treatment which included painting, photography and mixed media. At the end of project,<br />
patients and staff completed questionnaires for evaluation of the art programme. In addition, the Short<br />
Form health survey with 36 questions (SF36) was used to evaluate QoL status in patients at the beginning<br />
and end of the study period.<br />
Results Fifty-two patients were eligible for participation in the art programme. Median age was 67 years<br />
(range 21-92) with 58% male patients. Median duration of renal replacement therapy was 3.8 years (0.2 –<br />
28.9) and 25% of patients were waiting for renal transplantation. Twenty-nine patients (56%) participated<br />
in the art programme. Patient demographics were similar in the group who participated (<strong>ART</strong>) compared to<br />
the group who did not (NON<strong>ART</strong>). 90% of patient evaluation questionnaires were returned (93% <strong>ART</strong>,<br />
87% NON<strong>ART</strong>). Reasons for not participating were no interest in art (60%), ‘just want to get through<br />
dialysis’ (15%), too tired (5%) and low mood (5%). In the <strong>ART</strong> group, only 37% were interested in art at<br />
the start of programme and 26% were keen to try something new. Four patients reported difficulties<br />
performing art during dialysis treatment in relation to having only one moveable arm (other arm attached to<br />
dialysis machine by blood lines). 48% in the <strong>ART</strong> group reported looking forward to attending dialysis as a<br />
result of the art programme and 52% reported a positive change in their attitude towards dialysis treatment.<br />
The vast majority (85%) reported direct personal benefit from the programme by reduction of physical<br />
symptoms, improved mood and reduced anxiety on dialysis. 59% believed the programme facilitated<br />
patient social interaction within the unit. No patients in the NON<strong>ART</strong> group reported disruption to their<br />
dialysis experience. 87% of patients attending the unit have asked for the programme to be continued.<br />
Dialysis unit staff reported no disruption to their work pattern, no increase in workload and an<br />
improvement in work atmosphere. Forty-six (88%) SF36 questionnaires were available for analysis (<strong>ART</strong><br />
93%, NON<strong>ART</strong> 83%). The SF36 scores are summarized in the table below. In the <strong>ART</strong> group, SF36 scores<br />
were higher after the art programme, particularly in the Mental Health dimension (2-tailed paired t-test<br />
p=0.02). In contrast, lower scores were reported in all three dimensions in the NON<strong>ART</strong> group.<br />
Conclusion Provision of a creative arts programme to patients on MHD improves their experience of<br />
dialysis treatment. Furthermore, this simple, non-invasive and safe intervention has provided our patients<br />
enormous enjoyment and satisfaction and has been associated with a significant improvement in their<br />
mental health.<br />
SF36 Physical Health score: (mean ± SD)<br />
pre- art programme<br />
post- art programme<br />
SF36 Mental Health score: (mean ± SD)<br />
pre- art programme<br />
post- art programme<br />
SF36 Total score: (mean ± SD)<br />
pre- art programme<br />
post- art programme<br />
<strong>ART</strong> group (n=27)<br />
40.0 ± 21.3<br />
42.5 ± 21.6<br />
47.8 ± 20.9<br />
56.4 ± 18.7<br />
45.0 ± 20.4<br />
51.8 ± 19.1<br />
NON <strong>ART</strong> group (n=19)<br />
47.4 ± 19.1<br />
41.6 ± 20.3<br />
58.4 ± 22.0<br />
50.9 ± 23.9<br />
54.7 ± 19.8<br />
48.3 ± 22.3