Purpose/Objectives: To determine the preferences of patients with cancer for viewing photographic art in an inpatient hospital setting and to evaluate the impact of viewing photographic art.
Design: Quantitative, exploratory, single-group, post-test descriptive design incorporating qualitative survey questions.
Setting: An academic medical center in the midwestern United States.
Sample: 80 men (n = 44) and women (n = 36) aged 19-85 years (X = 49) and hospitalized for cancer treatment.
Methods: Participants viewed photographs via computers and then completed a five-instrument electronic survey.
Main Research Variables: Fatigue, quality of life, performance status, perceptions of distraction and restoration, and content categories of photographs.
Findings: Ninety-six percent of participants enjoyed looking at the study photographs. The photographs they preferred most often were lake sunset (76%), rocky river (66%), and autumn waterfall (66%). The most rejected photographs were amusement park (54%), farmer's market vegetable table (51%), and kayakers (49%). The qualitative categories selected were landscape (28%), animals (15%), people (14%), entertainment (10%), imagery (10%), water (7%), spiritual (7%), flowers (6%), and landmark (3%). Some discrepancy between the quantitative and qualitative sections may be related to participants considering water to be a landscape.
Conclusions: The hypothesis that patients' preferences for a category of photographic art are affected by the psychophysical and psychological qualities of the photographs, as well as the patients' moods and characteristics, was supported.
Implications for Nursing: Nurses can play an active role in helping patients deal with the challenges of long hospital stays and life-threatening diagnoses through distraction and restoration interventions such as viewing photographic images of nature.
Knowledge Translation: Nurses can use photographic imagery to provide a restorative intervention during the hospital experience. Photographic art can be used as a distraction from the hospital stay and the uncertainty of a cancer diagnosis. Having patients view photographs of nature is congruent with the core nursing values of promoting health, healing, and hope.
References
Berman, M. G., Jonides, J., & Kaplan, S. (2008). The cognitive benefits of interacting with nature. Psychological Science, 19, 1207-1212. doi:10.1111/j.1467-9280.2008.02225.x
Brown, P. D., Decker, P. A., Rummans, T. A., Clark, M. M., Frost, M. H., Ballman, K. V., … Buckner, J. C. (2008). A prospective study of quality of life in adults with newly diagnosed high-grade gliomas: Comparison of patient and caregiver ratings of quality of life. American Journal of Clinical Oncology, 31, 163-168. doi:10.1097/COC.0b013e318149f1d3
Butt, Z., Wagner, L. I., Beaumont, J. L., Paice, J. A., Peterman, A. H., Shevrin, D., … Cella, D. (2008). Use of a single-item screening tool to detect clinically significant fatigue, pain, distress, and anorexia in ambulatory cancer practice. Journal of Pain and Symptom Management, 35(1), 20-30. doi:10.1016/j.jpainsymman.2007.02.040
Cimprich, B. (1993). Development of an intervention to restore attention in cancer patients. Cancer Nursing, 16(2), 83-92. doi:10.1097/00002820-199304000-00001
Cirino, P. T., Chin, C. E., Sevcik, R. A., Wolf, M., Lovett, M., & Morris, R. D. (2002). Measuring socioeconomic status: Reliability and preliminary validity for different approaches. Assessment, 9, 145-155. doi:10.1177/10791102009002005
Diette, G. B., Lechtzin, N., Haponik, E., Devrotes, A., & Rubin, H. R. (2003). Distraction therapy with nature sights and sounds reduces pain during flexible bronchoscopy: A complementary approach to routine analgesia. Chest, 123, 941-948. doi:10.1378/chest.123.3.941
Felsten, G. (2009). Where to take a study break on the college campus: An attention restoration theory perspective. Journal of Environmental Psychology, 29, 160-167. doi:10.1016/j.jenvp.2008.11.006
Geue, K., Geotze, H., Buttstaedt, M., Kleinert, E., Richter, D., & Singer, S. (2010). An overview of art therapy interventions for cancer patients and the results of research. Complementary Therapies in Medicine, 18, 160-170. doi:10.1016/j.ctim.2010.04.001
Han, K. (1999). A proposed landscape assessment framework: A connection of theories and practical techniques. Journal of Architecture and Planning Research, 16, 313-327.
Han, K. (2003). A reliable and valid self-rating measure of the restorative quality of natural environments. Landscape and Urban Planning, 64, 209-232. doi:10.1016/SO169-2046(02)00241-4
Han, K. (2007). Responses to six major terrestrial biomes in terms of scenic beauty, preference, and restorativeness. Environment and Behavior, 39, 529-556. doi:10.1177/0013916506292016
Hartig, T., Korpela, K., Evans, G. W., & Gärling, T. (1997). A measure of restorative quality in environments. Scandinavian Housing and Planning Research, 14, 175-194. doi:10.1080/02815739708730435
Hathorn, K., & Ulrich, R. S. (2001). The therapeutic art program of Northwestern Memorial Hospital. Creating environments that heal: Proceedings of the Symposium on Heathcare Design (CD-ROM). Inmark Communications in association with the Center for Health Design.
Herzog, T. R., Black, A. M., Fountaine, K. A., & Knotts, D. J. (1997). Reflection and attentional recovery as distinctive benefits of restorative environments. Journal of Environmental Psychology, 17, 165-170. doi:10.1006/jevp.1997.0051
Kaplan, R., & Kaplan, S. (1989). The experience of nature: A psychological perspective. New York, NY: Cambridge University Press.
Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of Environmental Psychology, 15, 169-182. doi:10.1016/0272-4944(95)90001-2
Kaplan, S. (2001). Meditation, restoration, and the management of mental fatigue. Environment and Behavior, 33, 480-506. doi:10.1177/00139160121973106
Lawson, E. D., & Boek, W. E. (1960). Correlations of indexes of families' socio-economic status. Social Forces, 39, 149-152. doi:10.2307/2574153
Lembo, T., Fitzgerald, L., Matin, K., Woo, K., Mayer, E. A., & Naliboff, B. D. (1998). Audio and visual stimulation reduces patient discomfort during screening flexible sigmoidoscopy. American Journal of Gastroenterology, 93, 1113-1116. doi:10.1111/j.1572-0241.1998.00339.x
Locke, D. E., Decker, P. A., Sloan, J. A., Brown, P. D., Malec, J. F., Clark, M. M., … Buckner, J. C. (2007). Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. Journal of Pain and Symptom Management, 34, 628-638. doi:10.1016/j.jpainsymman.2007.01.016
Marberry, S. O. (Ed.). (1995). Innovations in healthcare design. New York, NY: Wiley.
Miller, A. C., Hickman, L. C., & Lemasters, G. K. (1992). A distraction technique for control of burn pain. Journal of Burn Care and Rehabilitation, 13, 576-580. doi:10.1097/00004630-199209000-00012
Nanda, U., Eisen, S. L., & Baladandauthapani, V. (2008). Undertaking an art survey to compare patient versus student art preferences. Environment and Behavior, 40, 269-301. doi:10.1177/0013916507311552
Nanda, U., Hathorn, K., & Neumann, T. (2007). The art-cart program. Healthcare Design, 7(7), 10-13.
Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., McFadden, E. T., & Carbone, P. P. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5, 649-655.
Schneider, S. M., Ellis, M., Coombs, W. T., Shonkwiler, E. L., & Folsom, L. C. (2003). Virtual reality intervention for older women with breast cancer. Cyberpsychology and Behavior, 6, 301-307. doi:10.1089/109493103322011605
Schneider, S. M., & Hood, L. E. (2007). Virtual reality: A distraction intervention for chemotherapy. Oncology Nursing Forum, 34, 39-46. doi:10.1188/07.ONF.39-46
Ulrich, R., & Gilpin, L. (2003). Healing arts: Nutrition for the soul. In S. B. Frampton, L. Gilpin, & P. A. Charmel (Eds.), Putting patients first: Designing and practicing patient-centered care (pp. 117-146). San Francisco, CA: Jossey-Bass.
Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224, 420-421. doi:10.1126/science.6143402
Ulrich, R. S. (1991). Effects of interior design on wellness: Theory and recent scientific research. Journal of Health Care Interior Design, 3, 97-109.
Wong, K. K. (1989). Scenic quality and cognitive structures of urban environments: The role of scene attributes and respondent characteristics (Unpublished doctoral dissertation). State University of New York, Syracuse.
