Creative Arts-Based Therapies for Stroke Survivors: A Qualitative Systematic Review

Abstract

Background: Stroke is a life-threating cerebrovascular disease. Without proper and immediate treatment, it can cause long-term disabilities and even death. While current rehabilitation focuses on functional needs, it does not fully address the psychosocial issues. Creative arts-based therapies, however, may have the potential to be of assistance.Methods: A systematic review was conducted to synthesize the qualitative findings of the stroke survivors' positive and negative experiences in participating in creative arts-based therapies. A systematic literature search was conducted across diverse databases. A thematic synthesis was adopted to analyze the results from different qualitative studies and mix-method studies.Results: Among the 367 studies extracted from various databases, 11 studies met the inclusion criteria and were of acceptable quality. The following five analytical themes were identified: functional restoration, psychological support, social engagement, spiritual experience, and short-comings and barriers.Conclusion: Creative arts-based therapies have demonstrated their strengths in addressing psychosocial needs for stroke survivors. Different art modalities are perceived to be useful in achieving different therapeutic goals. Therapies based on a single art modality or combined modalities have different specialties and characteristics. Further research is needed to demonstrate the differential benefits or special advantages of using single or multiple art modalities as well as having qualified therapists in creative arts-based therapies.

Discapacidad y determinantes sociales de la salud en personas con enfermedad cerebrovascular, San Juan de Pasto (Colombia)

“…Esta situación presupone que las personas con ingresos y niveles educativos bajos resulten menos beneficiadas para acceder a recursos y con menos posibilidad para gozar de buena salud. Esta situación podría influenciar la prevalencia de la ecv y la discapacidad, más aún cuando "a nivel mundial existe un desafío creciente relacionado con el número de personas que sobreviven a una ecv y que a largo plazo conducirá a un aumento de personas con discapacidad" [26].…”

Evaluation of a community-based performance arts programme for people who have experienced stroke in the UK: protocol for the SHAPER-Stroke Odysseys study

“…The evidence summarised above suggests that there is a need for more holistic rehabilitation programmes, especially non-pharmacological and non-invasive modalities, to address the psychosocial needs and improve the quality of life of stroke survivors. 12 Arts-based programmes (such as 'Stroke Odysseys (SO)' discussed below) are one such approach that shows promising results in enhancing the well-being, self-esteem, social life and rehabilitation experiences of patients with stroke. 13 Indeed, over the past decade, several studies conducted in this patient population have consistently shown a positive impact of different art modalities on psychological (eg, enhancement in confidence and a better sense of control), social (eg, increased social interactions and peer support) and functional (eg, improvement in physical abilities) outcomes.…”

“…13 Indeed, over the past decade, several studies conducted in this patient population have consistently shown a positive impact of different art modalities on psychological (eg, enhancement in confidence and a better sense of control), social (eg, increased social interactions and peer support) and functional (eg, improvement in physical abilities) outcomes. 12 Nonetheless, despite the growing body of research on the benefits of art interventions, the process of scaling-up these interventions, embedding them into healthcare and its associated challenges are not yet well established. Preliminary data indicate that SO (discussed below) is received positively by those who take part, 14 however, identifying barriers to implementation and exploring ways to overcome these obstacles are essential to successfully and sustainably embed SO into clinical pathways and roll out the programme at a wider scale.…”

A randomised controlled trial of expressive arts-based intervention for young stroke survivors

“…Young stroke survivors (< 65 years old) are more likely to suffer to a greater extent than their older counterparts because of their longer overall survival time. They often report unmet psychosocial-spiritual needs [ 7 , 10 , 12 – 18 ]. To help young stroke survivors address their unique psychosocial-spiritual concerns, which have been found to be crucial for rehabilitation adherence and achieving favourable recovery outcomes [ 11 , 19 ], there is a need for a holistic rehabilitation programme, particularly the non-pharmacological one, as an adjuvant to conventional physical and occupational rehabilitation to buffer against mental health issues, reduce psychosocial stress, resume social connections, and re-instill hope [ 6 , 8 , 20 – 25 ].…”

“…The non-verbal communication and symbolic expression through art media during the art-making process can further enhance engagement and help express feelings or thoughts that are difficult to verbalize. An expressive arts-based intervention is uniquely equipped to take advantage of utilising all art modalities, such as visual art, music, dance/movement, drama, and writing [ 33 ], to address the psychosocial-spiritual needs of stroke survivors [ 18 ]. Nevertheless, systematic research on its effectiveness is still limited, including on young survivors [ 27 , 34 , 35 ].…”