Expressive Arts Therapy Combined with Progressive Muscle Relaxation following Music for Perioperative Patients with Gynecological Malignancies: A Pilot Study

Abstract

Objective. We aimed to assess the impact of an expressive arts therapy combined with progressive muscle relaxation following music on mental health (anxiety and hope) in patients with gynecological malignancies undergoing surgery. Methods. This was a nonrandomized controlled trial. Eligible patients had a primary or recurrent gynecological malignancy scheduled to be treated with surgery. The intervention consisted of three sessions (preoperation, postoperation, and predischarge) during the perioperative period. Firstly, before starting the first session of intervention, all patients completed three questionnaires including a Hospital Anxiety and Depression Scale (HADS), a Herth Hope Index (HHI), and a State Anxiety Inventory (SAI), and the intervention group patients also had to complete the SAI questionnaire again after completing the intervention. Secondly, after the second session of intervention, all patients completed the SAI questionnaire, with the intervention group completed the SAI questionnaire before the intervention. Thirdly, after the third session of intervention, all patients completed HHI and SAI questionnaires, with the intervention group completed the SAI questionnaire before the intervention. Also, to subjectively rate the benefit of expressive arts therapy, the intervention group additionally completed a separate, supplemental questionnaire. Results. A total of 116 patients were enrolled and 110 included in the final analysis. No group differences were found for HHI scores between the intervention and control participants (Cohen’s d = 0.19, P = 0.31 ), although there was a substantial improvement in intervention participants’ HHI scores compared to the standard care control participants. There was a statistically significant improvement in intervention participants’ SAI from preintervention to postintervention of preoperation (Cohen’s d = −0.23, P = 0.002 ) and postoperation (Cohen’s d = −0.34, P ≤ 0.001 ). However, no differences were observed for the predischarge period (Cohen’s d = −0.09, P = 0.118 ). Besides, a supplemental questionnaire indicated that 52 (98%) patients felt that expressive arts therapy was beneficial. Conclusions. Expressive art therapy combined with progressive muscle relaxation under music may be of some effect on alleviating perioperative anxiety in patients with gynecologic malignancies. Therefore, further relevant studies with large samples and multicenters are urgently needed to provide a reliable evidence-based basis for perioperative psychological care of patients with gynecologic malignancies and to promote rapid recovery of patients. It is recommended that further art therapy studies to examine the impact of patient-tailored arts therapy interventions on spiritual well-being in patients with gynecological malignancies, especially in the perioperative period.

Pre-Operative Anxiety Related to Major Urogynecologic Surgery: Insights from Perioperative Survey Data in Maine

“…The video intervention, which had focused on minor surgeries, did significantly decrease anxiety levels [23]. Another four studies explored the use of music and/or art therapy and found that the interventions significantly decreased pre-operative anxiety levels [24][25][26][27]. Two studies that explored the use of anxiolytics had mixed results, but they did find success with metoprolol for short-term perioperative anxiety [28,29].…”

The Psychological Recovery of Patients in the Context of Virtual Reality Application by a Complementary Medicine Scheme Based on Visual Art

“…It became an important theoretical basis for imagery connectivity in art treatment. Under the guidance of the theory of unconscious repression and the theory of collective unconscious imagery, Margaret Naumburg proposed art psychotherapy [ 6 ]. She encouraged the use of spontaneous artistic expression of consciousness as a medium of self-therapy to directly express dreams, illusions, and other inner experiences in the form of images rather than verbal language to solve the transference relationship in therapy and to transfer the patient's dependence on the therapist to artwork attention.…”