Danila Maria I, Melnick Joshua A, Mudano Amy, Flood Kellie, Booth Katrina, Kirklin Kimberly, Saag Kenneth G
Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham.
Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham.
Innov Aging. 2018 Jun;2(2):igy013. doi: 10.1093/geroni/igy013. Epub 2018 Jun 18.
Arts in medicine programs have emerged as a patient-centered approach that aims to improve health-related quality of life for patients in U.S. hospitals. Storytelling and poetry/monologue recitation are forms of arts-based experiences designed to enhance healing and are delivered by an artist-in-residence. We evaluated the effect of a storytelling/poetry experience on delirium screening scores and patient satisfaction in hospitalized older adults.
We conducted an observational pre-post study with a control group in the Acute Care for the Elders (ACE) unit at an academic medical center. A convenience sample of 50 participants was recruited to participate and complete two questionnaires measuring pain, anxiety, general well-being, and distress at hospital admission and at hospital discharge. Multivariable regression models were used to compare delirium screening score (primary outcome) between the control and intervention groups and to adjust for the differences in baseline characteristics between groups.
At baseline participants in the intervention group were younger and had significantly lower cognitive impairment compared with those in the control group. Participants exposed to the storytelling/poetry intervention had a lower delirium screening score at hospital discharge compared with those in the control group. The result remained significant after adjusting for age, baseline cognitive impairment, and general well-being. Participants in the intervention group reported a high level of satisfaction with the interaction with the artist delivering the intervention.
An artist in residence-delivered storytelling/poetry experience was associated with a lower delirium score at discharge in this pilot study. Further larger studies in diverse inpatient settings are needed to examine whether storytelling/poetry interventions or other types of arts in medicine programs can prevent or reduce delirium in hospitalized older adults.
医学艺术项目已成为一种以患者为中心的方法，旨在改善美国医院患者与健康相关的生活质量。讲故事以及诗歌/独白朗诵是基于艺术的体验形式，旨在促进康复，由驻院艺术家进行。我们评估了讲故事/诗歌体验对住院老年人谵妄筛查分数及患者满意度的影响。
我们在一家学术医疗中心的老年急性护理（ACE）病房进行了一项设有对照组的观察性前后对照研究。招募了50名便利样本参与者，让他们参与并完成两份问卷，分别测量入院时和出院时的疼痛、焦虑、总体幸福感和痛苦程度。使用多变量回归模型比较对照组和干预组之间的谵妄筛查分数（主要结果），并对两组之间基线特征的差异进行调整。
在基线时，与对照组相比，干预组的参与者更年轻，认知障碍程度显著更低。与对照组相比，接受讲故事/诗歌干预的参与者在出院时的谵妄筛查分数更低。在对年龄、基线认知障碍和总体幸福感进行调整后，该结果仍然显著。干预组的参与者对与提供干预的艺术家的互动满意度很高。
在这项试点研究中，驻院艺术家进行的讲故事/诗歌体验与出院时较低的谵妄分数相关。需要在不同的住院环境中进行进一步的大型研究，以检验讲故事/诗歌干预或其他类型的医学艺术项目是否可以预防或减少住院老年人的谵妄。
