Development of a complex arts-based intervention for patients with end-stage kidney disease whilst receiving haemodialysis

Abstract

Background Patients with end-stage kidney disease who receive haemodialysis experience a protracted treatment regimen that can result in an increased risk of depression and anxiety. Arts-based interventions could address this unique issue; however, no arts-based interventions have been developed for delivery within a haemodialysis unit and evaluation within a randomised controlled trials (RCTs). Aim To develop a complex arts-based intervention for patients with end-stage kidney disease whilst receiving haemodialysis. Methods The development process utilised the Arts in Health framework (Fancourt, 2017). The framework was addressed through the establishment of an interdisciplinary advisory group, collaboration and consultation with stakeholders, a scoping and realist review, shadowing of artists-in-residence, personal arts practice and logic modelling. Results The intervention involved six 1-h long, one-to-one facilitated sessions focused on creative writing and visual art. Patients could choose between art form and self-select a subject matter. The sessions had a primary focus on skill development and were delivered using principles derived from the psychological theory of flow. Conclusion The Arts in Health framework provided an appropriate and pragmatic approach to intervention development. Complex arts-based interventions can be developed for the purpose of evaluation within a trial framework. This intervention was designed to strike a balance between standardised components, and a person-centred approach necessary to address existential boredom.

The Experiences of a Complex Arts-Based Intervention for Patients with End-Stage Kidney Disease Whilst Receiving Haemodialysis: A Qualitative Process Evaluation

“…The intervention that was delivered as part of the pilot cluster RCT involved six onehour long one-to-one facilitated art sessions during haemodialysis, provided twice a week over a period of three weeks. The intervention was developed in collaboration with patients and healthcare professionals [21] and was informed by the theory of Flow [7]. During the development of the arts-based intervention it became important to distinguish the arts-based intervention from art therapy.…”

“…The sessions were intended to be person-centred and flexible but underpinned by a focus on skill development. In order to induce flow state, people need to be engaged in an activity that they find challenging but in which they develop the skills to meet that challenge [21].…”

“…Whilst the intervention was developed to ensure ease of implementation in this context [21], there were still a number of barriers to delivery that were identified by participants. One of the main concerns was that vascular access required for haemodialysis frequently meant patients only had a single hand available for the activities.…”

Perspectives of Kidney Transplant Recipients, Transplant Candidates, and Living Kidney Donors on the Role of Patients’ Self-Narratives and Experiences of Creative Writing Workshops: A Qualitative Study

“…We examined the perspectives of KTRs, LKDs, and KTCs on sharing self-narratives, as well as their experiences of participating in creative writing workshops. Patients with kidney failure have been recognized to be at increased risk of depression and anxiety, for which arts-based interventions (including creative writing) have been designed to help with “existential boredom,” 25 a term that describes “the experience of indefinite waiting, causing a person to dwell on existential issues such as illness and mortality.” 26 In a study of pediatric patients with kidney failure, their creative writing was used to gain a better understanding of their lived experience of the illness, 27 but creative writing’s impacts were not studied. We are the first to report empirical data of the impacts of creative writing groups and sharing self-narratives on KTRs, LKDs, and KTCs.…”

Pengaruh Art Therapy Terhadap Kualitas Hidup Pasien Penyakit Ginjal Kronik Dengan Hemodialisis

“…Ada beberapa macam jenis mewarnai, bisa dilakukan diatas kertas kosong, mewarnai area tertentu seperti kotak, mengcopy warna dari pola yang telah disediakan, pewarnaan motif hewan dan alam, dan pewarnaan dalam lingkaran (mandala), 26 Hasil penelitian sebelumnya yaitu intervensi berbasis seni/ Arts-based interventions dapat membantu mengatasi dampak hemodialisis dan meningkatkan kualitas hidup dan kesehatan mental pasien PGK. 27 Art therapy dalam bidang kesehatan memiliki tujuan untuk memelihara kondisi psikososial dengan berfokus kepada psikologis, aspek social kognitif, dan pertumbuhan dan perkembangan emosi, rehabilitasi, dan untuk meningkatkan kesehatan fisik.…”