Effectiveness Not Established

Art Making/Art Therapy

for Fatigue

Art therapy encourages participants to express emotions through drawing and is aimed at triggering thoughts and feelings for communication. Trained art therapists assist participants to reflect on and explore the thoughts and feelings exposed in the creative expression. This activity is seen to promote the participant's understanding of him- or herself and the situation encountered. Art therapy has been studied in patients with cancer related to management of anxiety, depression, and fatigue.

Art making is the provision of the opportunity and materials for individuals to create various types of artistic items. Art making can be seen as a diversional activity. It differs from art therapy because it does not involve interaction with a trained art therapist and does not necessarily engage the participant in exploring thoughts and feelings through the creative expression.

Research Evidence Summaries

Bar-Sela, G., Atid, L., Danos, S., Gabay, N., & Epelbaum, R. (2007). Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Psycho-Oncology, 16, 980–984.

Intervention Characteristics/Basic Study Process

The intervention consisted of once weekly art therapy sessions to teach patients to act in a more conscious way by painting with water-based paints. The intervention was provided by an art therapist. The duration of the sessions varied. Those who completed four or more sessions (n = 19) were compared to those who participated for two weeks or less (n = 41).

Sample Characteristics

  • The sample was comprised of 60 adult ambulatory patients (77% female, 23% male) who were undergoing chemotherapy.
  • Mean age was 77 years (range 25–72).
  • Patients were excluded from the study if they had severe anemia; were treated with an epoetin; had changed their opiate, non-selective serotonin reuptake inhibitor (SSRI) antidepressant, or anxiolytic in the past three weeks; or had changed their SSRI antidepressant in the past six weeks.

Setting

The study was conducted in an ambulatory setting of a cancer center in northern Israel.

Study Design

The study used a single-arm, open-label design.

Measurement Instruments/Methods

  • Brief Fatigue Inventory (BFI), competed weekly before each session
  • Hospital Anxiety and Depression scale (HADS), competed weekly before each session

Results

  • Median BFI score decreased from 5.7 to 4.1 in the intervention group (p = 0.24).
  • Median HADS decreased from 9 to 7 in the intervention group (p = 0.21); anxiety was normal.

Limitations

  • The control group had greater fatigue and may not have been able to participate.
  • The study lacked randomization.
  • The study did not provide control data related to patient drop-out or chemotherapy.
  • Cycle or day-in-cycle assumptions regarding mediating the effect of decreased emotional distress were untested.

Nursing Implications

For treatment with art therapy, a patient requires referral to an art therapist.

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