Moula Zoe, Powell Joanne, Karkou Vicky
Research Centre for Arts and Wellbeing, Edge Hill University, Lancashire, United Kingdom.
Front Psychol. 2020 Dec 15;11:586134. doi: 10.3389/fpsyg.2020.586134. eCollection 2020.
Over the last decades there has been a change in the way schooling is perceived recognizing that children's learning is closely linked to children's health. Children spend most of their time at school, which is often the place where problems are identified and interventions are offered, not only for treatment but also prevention. Embedding arts therapies into the educational system may help address children's emerging needs and have a positive impact on their wellbeing.
A pilot cross-over randomized controlled design was employed to investigate the effectiveness of an arts therapies intervention on a series of child- and teacher-reported outcome measures, specifically, health related quality of life (assessed using a HRQOL scale; EQ-5D-Y), wellbeing and life functioning (assessed using the child outcome rating scale; CORS), emotional and behavioral difficulties (assessed using the strengths and difficulties questionnaire; SDQ), as well as duration of sleep (assessed using Fitbits). Sample size calculations for future large-scale studies were also performed, and the sustained impact of the intervention was evaluated at 3, 6, and 12 months follow-up. The pluralistic theoretical and therapeutic framework of this intervention was informed by a systematic review on school-based arts therapies interventions and is presented in detail in the study protocol. Participants were 62 children with mild emotional and behavioral difficulties.
Improvements in HRQOL and CORS were greater in those engaged in the arts therapies intervention than the control groups and were maintained at the follow-up stages. Significant improvements were only found for duration of sleep ( = 0.002) and SDQ ( = 0.008). Minimal clinically important differences (MCIDs) as defined in the published protocol were found for CORS, SDQ and duration of sleep, but not HRQOL.
Findings indicate that the arts therapies interventions were having a clinically significant effect on life functioning, duration of sleep, emotional and behavioral difficulties. Findings also indicate a small effect size for health related quality of life, suggesting the intervention was having a small positive effect on this outcome measure. The study indicates that all outcome measures assessed here would be suitable for inclusion in a larger randomized controlled study utilizing these arts therapies interventions, and that a sample size of 225 participants would be required if these outcome measures were used.
在过去几十年里，人们对学校教育的认知发生了变化，认识到儿童的学习与儿童的健康密切相关。儿童大部分时间都在学校，学校往往是发现问题并提供干预措施的地方，这些干预措施不仅用于治疗，也用于预防。将艺术疗法融入教育系统可能有助于满足儿童新出现的需求，并对他们的幸福感产生积极影响。
采用一项试点交叉随机对照设计，以一系列儿童和教师报告的结果指标来调查艺术疗法干预的效果，具体包括与健康相关的生活质量（使用健康相关生活质量量表；EQ-5D-Y进行评估）、幸福感和生活功能（使用儿童结果评定量表；CORS进行评估）、情绪和行为困难（使用长处和困难问卷；SDQ进行评估）以及睡眠时间（使用Fitbits进行评估）。还进行了未来大规模研究的样本量计算，并在3个月、6个月和12个月的随访中评估了干预措施的持续影响。该干预措施的多元理论和治疗框架基于一项关于学校艺术疗法干预的系统评价，并在研究方案中详细介绍。参与者为62名有轻度情绪和行为困难的儿童。
参与艺术疗法干预的儿童在健康相关生活质量和儿童结果评定量表方面的改善比对照组更大，且在随访阶段得以维持。仅在睡眠时间（P = 0.002）和长处和困难问卷（P = 0.008）方面发现了显著改善。在已发表的方案中定义的最小临床重要差异（MCID）在儿童结果评定量表、长处和困难问卷以及睡眠时间方面被发现，但在健康相关生活质量方面未发现。
研究结果表明，艺术疗法干预对生活功能、睡眠时间、情绪和行为困难具有临床显著效果。研究结果还表明，与健康相关的生活质量的效应量较小，表明该干预措施对这一结果指标有较小的积极影响。该研究表明，此处评估的所有结果指标都适合纳入一项利用这些艺术疗法干预的更大规模随机对照研究，如果使用这些结果指标，则需要225名参与者的样本量。
