Author: Pang, Chui Ping Phyllis
Title: A visual art intervention molace for enhancing the holistic well-being of older people with stroke in residential care homes : a feasibility study
Advisors: Cheung, Daphne (SN)
Chiang, Vico (SN)
Degree: DHSc
Year: 2022
Subject: Art therapy
Cerebrovascular disease -- Patients -- Rehabilitation
Psychotherapy for older people
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: x, 159 pages : color illustrations
Language: English
Abstract: Background
The person holds three spheres: body, mind, and spirit, which are interdependent and interconnected. Holistic well-being is the connectedness of body-mind-spirit, while the person will strike to balance body-mind-spirit when it is upset (Gonzalo, 2021). After a stroke, a person usually experiences physical, psychosocial and spiritual consequences, causing distortion of holistic well-being. Existing studies using visual art interventions found some benefits to physiological, psychosocial and/or spiritual well-being of people with stroke, but little is known about holistic well-being. Older person with stroke were at greater disadvantage to adjust, hence, they become more vulnerable and despair if relocated to residential care homes. The knowledge gap identified found preliminary evidence with more qualitative studies, variation in dosage, studies not involving other stake-holders, lace of systematic way through a rigorous research design and a lack of clarity of theoretical application. This was a feasibility trial of a visual art intervention programme for older people with stroke in residential care homes (RCH) on a local context.
This study aimed to test the feasibility using a visual art intervention for older people with stroke in RCH and to explore the preliminary efficacy on holistic well-being.
This was a single-blinded two-arm randomised controlled feasibility study. Participants were older people with stroke in residential care facilities. The MOLACE visual art intervention programme included a structured art-making programme of filling colour on a body template, clay making, colouring on a face mold, candle jelly decoration, decorating a photo frame and telling a story about the photo, drawing a lifeline in three time frames, making a gift to you, and publicly displaying the art-pieces. Key parameters of the feasibility testing were evaluated, including recruitment, retention, demand, and implementation of the intervention. Two measurements: Holistic Well-Being Scale (HWBS) and Caring Factor Survey (CFS) were conducted at three time points: before, mid-point, and immediately after intervention. A generalized estimating equations (GEE) statistical approach was performed to evaluate the group and time effects on the measurements (p<0.05).
One hundred and thirty seven residents were invited where 115 invited residents joining eligibility verification and 22 declined. Sixty-one participants consented to participate and randomised into intervention group (n=31) and control group (n=30). Recruitment rate was at 44.53%, while retention in intervention group at 93.55%. Parameters of feasibility on demand evaluated perceived demand, expressed interest and actual use. Perceived demand looked at 137 residents being invited and screened divided by 1452 overall capacity of participating RCH giving a rate at 9.44%. Expressed interest represented by 115 invited residents who joined eligibility verification over 1452 overall capacity of participating RCH at 7.92%. Actual use was the 62 residents who consented and participate out of 137 invited residents at 44.53%. Reasons for invited residents not joining the study were categorized as invited but declined before eligibility verification (28.95%), lack of eligibility (53.95%), and eligible but did not consented (17.11%). Implementation looked at speed of intervention at 721.29 minutes per programme in intervention group, and costs for intervention programme at HK$990.42 per head/programme. Moreover, difficulties/challenges encountered in implementing were evaluated and discussed, while CFS and narrative feedback collected by informal interviews served as indicators for process evaluation. Positive feedback were collected by informal interviews. There was no significant found in CFS, but greater magnitude of changes over time in the intervention group.
Moreover, there was no evidence showing that the intervention can improve holistic well-being. However, an observable direction of magnitude was noted over time in intervention group than control group on factors of HWBS including emotional vulnerability, bodily irritability, non-attachment, and mindful awareness.
This is a study using a visual art intervention programme for older people with stroke in residential care settings. Findings of the study indicated the MOLACE visual art intervention was clinically feasible, but its preliminary efficacy on holistic well-being remained to be confirmed.
Rights: All rights reserved
Access: restricted access

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