Walsh, S.M., Martin, S.C., & Schmidt, L.A. (2004). Testing the efficacy of a creative-arts intervention with family caregivers of patients with cancer. Journal of Nursing Scholarship, 36, 214–219.

To test hypotheses that family caregivers would experience reduced stress and anxiety and have increased positive emotions from an art-making intervention

Art-making supplies were taken to patients’ bedsides or to the outpatient chemotherapy site to show patients and caregivers items that could be made. Caregivers decided on one or more activities that they could do with or without the patients’ involvement. Caregivers were given supplies and shown how to complete the activity. The artist–nurse intervention team then left the area and returned to monitor progress and offer assistance every 15–30 minutes. Participants completed study questionnaires prior to and immediately after the intervention.

• The sample was comprised of 40 family caregivers.
• Mean caregiver age was 51.43 ± 15.38 years.
• Of the sample, 78% were the primary caregivers for the patients, 75% were women, and most were spouses.
• Most caregivers had provided care for six months or less.

• Single site 
• Multiple settings
• Florida, United States

Mutliple phases of care

A pretest/post-test quasi-experimental design was used.

• Mini Profile of Mood States (miniPOMS)
• Beck Anxiety Inventory
• Derogatis Affects Balance Scale

The presession stress score mean was 13.27 ± 6, and the postscore was 9.85 ± 5.84 (p < 0.001). Cohen’s d calculation on stress scores was d = 0.44, suggesting a large effect size. Postintervention anxiety scores declined but were not reported to be statistically significant. Significantly more positive emotions were reported in the post-test evaluation  (p < 0.001). It was noted that individuals who participated in the hospital inpatient units had multiple interruptions.

Involvement in art making was associated with reduction in stress and increased positive emotions immediately after the involvement. Participation at the bedside in the inpatient area was complicated by multiple interruptions.

• The sample was small, with less than 100 participants.
• Risk of bias existed due to no control group, no binding, no random assignment, and no appropriate attentional control condition.
• Whether the nature of art making itself, or any type of distracting activity, was responsible for the changes seen is not clear.

Involvement in art making may be helpful for short-term stress reduction in caregivers of patients with cancer. Further well-designed research in this area is needed to evaluate this approach.