Effects of Creative Arts Therapies on Psychological Symptoms and Quality of Life in Patients With Cancer

Abstract

Importance: Creative arts therapies (CATs) can reduce anxiety, depression, pain, and fatigue and increase quality of life (QOL) in patients with cancer. However, no systematic review of randomized clinical trials (RCTs) examining the effects of CAT on psychological symptoms among cancer patients has been conducted.Objectives: To estimate the effect of CAT on psychological symptoms and QOL in cancer patients during treatment and follow-up and to determine whether the effect varied according to patient, intervention, and design characteristics.Evidence Review: We searched ERIC, Google Scholar, MEDLINE, PsycInfo, PubMed, and Web of Science from database inception to January 2012. Studies included RCTs in which cancer patients were randomized to a CAT or control condition and anxiety, depression, pain, fatigue and/or QOL were measured pre-and post-intervention. Twenty-seven studies involving 1576 patients were included. We extracted data on effect sizes, moderators, and study quality. Hedges d effect sizes were computed, and random-effects models were used to estimate sampling error and population variance. Findings: During treatment, CAT significantly reduced anxiety (⌬ = 0.28 [95% CI, 0.11-0.44]), depression (⌬ = 0.23 [0.05-0.40]), and pain (⌬ = 0.54 [0.33-0.75]) and increased QOL (⌬ = 0.50 [0.25-0.74]). Pain was significantly reduced during follow-up (⌬ = 0.59 [95% CI, 0.42-0.77]). Anxiety reductions were strongest for studies in which ( 1) a non-CAT therapist administered the intervention compared with studies that used a creative arts therapist and (2) a waiting-list or usual-care comparison was used. Pain reductions were largest during inpatient treatment and for homogeneous cancer groups in outpatient settings; significantly smaller reductions occurred in heterogeneous groups in outpatient settings.Conclusions and Relevance: Exposure to CAT can improve anxiety, depression, and pain symptoms and QOL among cancer patients, but this effect is reduced during follow-up.

Complementary and Alternative Medicine for Cancer Pain: An Overview of Systematic Reviews

“…The other 34 systematic reviews were about psychosocial interventions [15, 16, 22, 38, 42, 44, 45], massage therapy [17, 21, 24, 33, 46], acupuncture [18, 35, 36, 41, 43], reflexology [23, 30, 32], Chinese herbal medicine [20, 40, 48], music therapy [31, 39], transcutaneous electric nerve stimulation [37], cupping [34], cannabis [27], lycopene [25], Viscum album L (European Mistletoe) [29], Reiki [28], homeopathic therapy (Traumeel) [19], creative arts therapies [47], and internal qigong [26]. …”

“…Six systematic reviews [7, 17, 31, 35, 37, 45] have “a priori” design, four systematic reviews [26, 31, 36, 39] conducted duplicate data extraction, six systematic reviews [17, 22, 38, 40, 43, 45] conducted duplicate study selection, 25 systematic reviews [7, 15–18, 21, 23–26, 29–35, 37, 40, 42–47] have comprehensive literature search, all systematic reviews provided a list of studies (included and excluded), 24 systematic reviews [15–17, 19–21, 24, 26–28, 30–32, 35–37, 39, 40, 42–46, 48] provided the characteristics of the included studies, and five systematic reviews [27, 30, 31, 33, 39] assessed and documented the scientific quality of the included studies. The other details of quality were presented in Table 1.…”

“…For other CAM interventions, lycopene [25], qigong [26], cupping [34], cannabis [27], Reiki [28], homeopathic therapy (Traumeel) [19], transcutaneous electric nerve stimulation (TENS) [37], creative arts therapies [47], and Viscum album L [29], there was only one systematic review for each. Studies showed that lycopene, qigong, cupping, cannabis, homeopathy (Traumeel), creative arts therapies, and Reiki might have beneficial effects on cancer pain.…”

Les bienfaits de l’écriture : étude qualitative portant sur les ateliers communautaires destinés aux survivantes du cancer du sein

“…Les activités créatives (par exemple l'écriture et les arts visuels comme la peinture) sont associées à une diminution des symptômes de dépression, de stress et de fatigue, tout en améliorant le bien-être chez les patients atteints de cancer (Haltiwanger, Rojo et Funk, 2011;Visser et Op'T Hoog, 2008). Une revue systématique d'essais cliniques aléatoires et de différentes activités d'art-thérapie ayant porté sur 1 576 patients cancéreux (total de 27 études) a révélé une diminution de l'anxiété, de la dépression et de la douleur, ainsi qu'une amélioration moyenne à élevée de la qualité de vie (Puetz, Morley et Herring, 2013). Même si cette revue de littérature démontre l'efficacité d'une approche axée sur les arts, la plupart des devis de recherche utilisés dans ces études n'ont utilisé qu'une seule intervention, soit la musicothérapie.…”

Writing toward well-being: A qualitative study of community-based workshops with breast cancer survivors

“…Creative processes (e.g., writing, and visual arts such as painting) have also been shown to reduce symptoms of depression, stress and fatigue, while enhancing well-being in cancer patients (Haltiwanger, Rojo, & Funk, 2011;Visser & Op'T Hoog, 2008). A systematic review of RCTs and various creative arts therapies found reduced anxiety, depression, and pain, as well as improved quality of life (QOL) with medium to large effect sizes across 27 studies involving 1,576 cancer patients (Puetz, Morley, & Herring, 2013). While this review demonstrates the effectiveness of arts-based approaches, most of the studies utilized music therapy, indicating that writing is understudied.…”