Ford Karen, Tesch Leigh, Dawborn Jacqueline, Courtney-Pratt Helen
ADON Research and Practice Development, Royal Hobart Hospital, School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia.
Clinical Senior Lecturer, School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia.
Int J Older People Nurs. 2018 Jun;13(2):e12186. doi: 10.1111/opn.12186. Epub 2018 Jan 24.
To evaluate the impact of an arts in health programme delivered by a specialised artist within an acute older person's unit.
Acute hospitals must meet the increasingly complex needs of older people who experience multiple comorbidities, often including cognitive impairment, either directly related to their admission or longer term conditions, including dementia. A focus on physical illness, efficiency and tasks within an acute care environment can all divert attention from the psychosocial well-being of patients. This focus also decreases capacity for person-centred approaches that acknowledge and value the older person, their life story, relationships and the care context. The importance of arts for health and wellness, including responsiveness to individual need, is well established: however, there is little evidence about its effectiveness for older people in acute hospital settings. We report on a collaborative arts in health programme on an acute medical ward for older people.
The qualitative study used collaborative enquiry underpinned by a constructivist approach to evaluate an arts programme that involved participatory art-making activities, customised music, song and illustration work, and enlivening the unit environment.
Data sources included observation of art activities, semi-structured interviews with patients and family members, and focus groups with staff. Data were transcribed and thematically analysed using a line by line approach.
The programme had positive impacts for the environment, patients, families and staff. The environment exhibited changes as a result of programme outputs; patients and families were engaged and enjoyed activities that aided recovery from illness; and staff also enjoyed activities and importantly learnt new ways of working with patients.
An acute care arts in health programme is a carefully nuanced programme where the skills of the arts health worker are critical to success. Utilising such skill, continued focus on person-centeredness and openness to creativity demonstrated positive impacts for patients, families, staff and the ward environment.
This study affirms the contribution of an arts in health program for older persons in an acute care setting in challenging the dominance of a task based medical model and emphasising person-centred care and outcomes.
评估由专业艺术家在急性老年病房开展的健康艺术项目的影响。
急性医院必须满足患有多种合并症的老年人日益复杂的需求，这些合并症通常包括认知障碍，这可能与他们的入院直接相关，也可能是长期病症，如痴呆症。在急性护理环境中，对身体疾病、效率和任务的关注可能会转移对患者心理社会福祉的注意力。这种关注还会降低以患者为中心的方法的能力，而这种方法承认并重视老年人、他们的生活经历、人际关系和护理环境。艺术对健康和幸福的重要性，包括对个体需求的响应，已得到充分证实：然而，几乎没有证据表明其在急性医院环境中对老年人的有效性。我们报告了一项针对老年急性内科病房的合作性健康艺术项目。
这项定性研究采用了以建构主义方法为基础的合作性探究，以评估一个艺术项目，该项目包括参与性艺术创作活动、定制音乐、歌曲和插画作品，以及活跃病房环境。
数据来源包括对艺术活动的观察、对患者和家属的半结构化访谈，以及与工作人员的焦点小组讨论。数据被转录并采用逐行分析的方法进行主题分析。
该项目对环境、患者、家属和工作人员都产生了积极影响。由于项目成果，环境发生了变化；患者和家属参与并享受有助于疾病康复的活动；工作人员也喜欢这些活动，重要的是还学到了与患者合作的新方法。
急性护理健康艺术项目是一个精心设计、细微差别显著的项目，艺术健康工作者的技能对其成功至关重要。利用这些技能，持续关注以患者为中心以及对创造力的开放态度，对患者、家属、工作人员和病房环境都产生了积极影响。
本研究肯定了健康艺术项目在急性护理环境中对老年人的贡献，它挑战了基于任务的医疗模式的主导地位，并强调了以患者为中心的护理和结果。
