Exploring the ability of a drawing by proxy intervention to improve quality of life for hospitalized children

Abstract

Objective: The primary objective of this study was to explore the ability of a one-time drawing by proxy intervention to improve perception of quality of life for hospitalized children. Methods: The quantitative/qualitative study used a one-group pre-test/posttest design with 50 hospitalized children (ages 6-19 years), who participated in a 45 -60 minute intervention based on The Moon Balloon book. The PedsQLe Present Functioning VAS, a Parent Survey, and participatory observation were used to measure results. Results: Findings revealed a statistically significant improvement in perceptions of the child's momentary quality of life. Most parents reported learning something about their child that they had not known before. Children used imagery to express feelings about when images speak the unspoken, of beauty, of stress, and of transformation. Conclusions: Drawing by proxy improved children's perceptions of their present quality of life, and provided an effective method for expressing their thoughts and feelings. Studies are needed to determine the intervention's effectiveness in other settings and the characteristics individuals require for facilitating effective drawing by proxy interventions.

Effectiveness of art therapy with pediatric populations affected by medical health conditions: a systematic review

“…Five studies were described as Randomized Control Trials (RCTs) and of these, three involved non-active controls (Stinley et al, 2015;Beebe et al, 2010, Siegel et al, 2016, one compared an active control (Colwell et al, 2005), and one study included a three-arm design with active and non-active control conditions (Broome et al, 2001). The other seven studies employed a variety of designs, including three within group studies with no comparators (Strafstrom et al, 2012;Rollins et al, 2012;Wilk et al, 2010) and a single subject design (Bordonaro & Gaelynn, 2003).…”

“…However, to provide a systematization of identified outcomes, the effects of visual art therapy interventions on psychological and medical conditions were clustered in two areas (Archibald et al, 2014): 1) interventions aimed at enhancing an attribute or a construct associated with targeted medical diseases; and 2) interventions aimed at reducing an attribute or a health-related condition. Within the former area, positive outcomes included measurements of self-esteem (Mueller et al, 2011), self-efficacy (Mueller et al, 2011), self-concept (Colwell et al, 2005;Strafstrom et al, 2012), quality of life (Rollins et al, 2012;Beebe et al, 2010), perceived locus of control (Bordonaro & Gaelynn, 2003), coping skills (Favarra-Scacco et al, 2001;Broome et al, 2001), emotional response to hospitalization (Siegel et al, 2016), and speech production (Wilk et al, 2010). Within the second area, the benefits of visual art therapy were found with respect to depression (Mueller et al, 2011), emotional/behavioral problems (Mueller et al, 2011), PTSD symptoms (Chapman et al, 2001), pain experience (Stinley et al, 2015), and anxiety (Favarra-Scacco et al, 2001;Bordonaro & Gaelynn, 2003).…”

“…Quality of research assessment is presented in Table 2 and demonstrates considerable weakness in the methodological rigor of the studies included. Two studies were assessed as having a strong global rating for methodological quality (Stinley et al, 2015;Mueller et al, 2011) and ten studies were rated as weak (Siegel et al, 2016;Rollins et al, 2012;Strafstrom et al, 2012;Beebe et al, 2010;Wilk et al, 2010;Colwell et al, 2005;Bordonaro & Gaelynn, 2003;Favara-Scacco et al, 2001;Chapman et al, 2001;Broome et al, 2001). Common methodological areas of weakness were found in the reporting of and controlling for confounders, with all the studies (except Mueller, 2011 andBordonaro &Gaelynn, 2003) failing to address baseline group imbalances.…”

“…Ten out of the twelve studies reported significant improvements relating to at least one stated child outcome. Significance was reported in comparison to care as usual controls (Stinley et al, 2015;Mueller et al, 2011;Favara-Scacco et al, 2001), wait-list controls (Siegel et al, 2016;Beebe et al, 2010), active controls (Colwell et al, 2005;Broome et al, 2001) and within group design with no comparators (Rollins et al, 2012;Wilk et al, 2010;Bordonaro & Gaelynn, 2003). Effect sizes were infrequently reported and relevant data was often missing or inconsistent.…”

“…art therapy and the duration of these sessions varied with the longest being 90 minutes (Siegel et al, 2016). Low intensity programs predominantly involved mixed health conditions: out of the 6 low intensity studies only Favara-Scacco et al 2001was specifically related to Leukemia, whereas three studies (Siegel et al, 2016;Stinley et al, 2015;Rollins et al, 2012) did not provide any details. Interventions were frequently carried out on a one-to-one basis with the participant.…”