Arts in Health Research
GraduateON project with St Richard’s Hospital, Chichester 1/1/2011
The research undertaken for this report was commissioned by the University of Chichester as part of a body of work that intends to support the development of Arts in Healthcare within the undergraduate and postgraduate curricula of the Fine Art department.
The report outlines the preliminary development that has taken place between the Fine Art department of the university, and St Richard’s hospital.
There follows a brief overview of the current state of Arts in Healthcare in England, with reference to work taking place in the USA.
The report then focuses on the academic and economic barriers that are hindering further development of Arts in Healthcare, despite political recognition of its value.
To conclude, suggestions are made about possible avenues for the University of Chichester to explore.
This preliminary research has been undertaken by Dr Diana Brighouse, BM MA (Spirituality) FRCA FFPMRCA AdDip Psychotherapy, BA(Hons) Fine Art
Arts in Health Graduate Research Project (GraduateON project T1254)
The potential contribution of the art world to health and wellbeing has been recognised for many years. The first major review of medical literature exploring the relationship of the arts to healthcare was published by Staricoff for Arts Council England in 2004. This review of 385 publications
offers strong evidence of the influence of the arts and humanities in achieving effective approaches to patient management and to the education and training of health practitioners. It identifies the relative contribution of different artforms to the final aim of creating a therapeutic healthcare environment. (1)
A more recent extensive publication from the University of the West of England, funded by the Department of Health (2) has further emphasised the potential healthcare benefits of the arts, with the major focus of this work being on the role of arts in mental healthcare.
The previous government set up a working party to review arts in health, which reported in 2007 and reached the following conclusions:
arts and health are, and should be firmly recognised as being, integral to health, healthcare provision and healthcare environments, including supporting staff
arts and health initiatives are delivering real and measurable benefits across a wide range of priority areas for health, and can enable the Department and NHS to contribute to key wider Government initiatives
there is a wealth of good practice and a substantial evidence base
the Department of Health has an important leadership role to play in creating an environment in which arts and health can prosper by promoting, developing and supporting arts and health
the Department should make a clear statement on the value of arts and health, build partnerships and publish a Prospectus for arts in health in collaboration with other key contributors. (3)
Despite interest from different disciplines, active engagement by some practitioners in community, primary and secondary healthcare, and recognition by central government, the arts for health movement remains relatively informal and uncoordinated. In some parts of the country there appears to be more than one arts in health charity with overlapping aims (and presumably competition for funding). In other geographic regions there is a paucity of provision. The Society for the Arts in Healthcare was founded in Washington DC in 1991, and has hosted an international journal since 2009, but there is no equivalent organisation in the UK. The Journal of Applied Arts and Health has recently (2010) been launched from the University of Northampton, but it is as yet unclear how this will relate to the UK Arts for Health agenda.
Locally the West Sussex Arts and Health network was launched informally in 2008, and the first one-day conference was held in November 2010. The future of the group is uncertain due to uncertainty of funding following the change in government in 2010, as the County Council are withdrawing funding for the Arts and Health Coordinator. The Council’s website has not been updated since autumn 2010 with regard to arts for health. The West Sussex conference was well attended, attracting a wide range of arts practitioners (but no clinicians) from across the county. As the day progressed it became clear from both formal presentations and informal discussions that many of the attendees were unaware of the existence or working practices of others. Practitioners were variously funded from social service departments, a variety of grants and charitable institutions, through primary care trusts, through a large secondary care trust (outside West Sussex) and through independent practice. This reflected the range of clients and patients with whom they were working. Interestingly, although there is a body of literature relating to art within the structural healthcare environment, it seemed that all attending the conference were engaged in ‘hands-on’ work with individuals or patient groups. The total absence of any clinicians or secondary care nursing staff may have partly reflected inadequate advertising of the event within hospitals and GPs surgeries, but anecdotal evidence suggests that awareness of arts for health activity is minimal amongst acute care providers.
The two most well known and longstanding hospital arts facilities are the Chelsea and Westminster Hospital Arts (4) and Lime, working with Central Manchester University Hospitals NHS Foundation Trust (5). Other hospital trusts have been developing arts facilities over the past decade, and these vary considerably in extent and content. There are currently estimated to be over 100 hospital arts coordinators in the UK (6) but as with other aspects of arts in healthcare the arts coordinator role is ill-defined.
The current situation in Chichester
The University of Chichester Fine Art department has begun to develop a relatively informal partnership with St Richard’s hospital, and completed a project for the neurological rehabilitation unit (Donald Wilson House) in 2009. A further project for the cancer care centre (the Fernhurst Centre) is currently under development. The projects are undertaken by second year undergraduates at the university, and arrangements have been made for the work to become part of work assessed for the second year degree marks. Interestingly both projects have been undertaken by mature students, although there has been considerable interest from a range of students.
The process by which each project developed differed slightly, but in each case there was a discussion with interested students which included provisional time frames, the assessment process, and the project brief. Students who maintained an interest then had the opportunity to visit the relevant part of the hospital and meet with staff and patients.
Students then developed proposals for the work and returned to present and discuss these. A series of meetings ensued with the students providing more detailed samples to enable a final decision to be made. The successful student(s) (in the case of the Donald Wilson house project Eileen Maspero and Chris Wittington worked collaboratively) were then left to make the final work.
The work for the Fernhurst Centre is still in development (January 2011).
Benefit to students from working in the hospital environment.
All the students involved in these projects gained new knowledge about the very different considerations required when making art for a hospital environment. On a practical level these included durability and longevity against the elements for the outdoor work being produced for the Fernhurst Centre, and for Donald Wilson house the necessity for the work to withstand rigorous hospital cleaning. Health and safety concerns were major considerations for all the proposals.
The work also brought students into direct contact with both hospital staff and patients; for some students this may have been their first contact with a hospital environment. Issues such as infection control were directly relevant, and the importance of maintaining confidentiality (second nature to hospital staff) was highlighted when photographing proposed sites for work, and when talking to patients. The problems that patients in the two units present with (need for rehabilitation after major neurological injury at Donald Wilson house, and need for ongoing cancer treatment at the Fernhurst Centre) can provoke questions and anxieties about one’s own mortality for those not engaged with these issues on a daily basis.
There was a clear sense of engaging in ‘the real world’ as opposed to producing work for academic staff, and obviously involvment in the hospital projects is beneficial to students when seeking employment after university. The following account is by Eileen Maspero and Chris Wittington, who created the work for Donald Wilson house.
To be involved in the Donald Wilson House project was, to say the least, a challenge from the start. The fact that we chose to work together on the project, and that our material practices are so different, we decided that whatever we made should be kept separate from our studio practice. And although we were encouraged by the tutors to just “work in your own style” we were well aware, after meeting with staff and patients at DWH, that this would not work, as they also had ideas on what they wanted and it wasn’t what we were making at university.
The collaboration between us and DWH, both in the initial stages of the project, as well as after we were chosen, was crucial to us. It made us aware of the importance of working alongside others, taking into account their views, criticisms, aspirations, and preferences, as well as being able to present our ideas in a professional way.
The feedback on our ideas, from both staff and patients was invaluable, and enabled us to produce a piece of artwork that we were all happy with. Although it wasn’t all plain sailing. We originally presented ideas which incorporated ceramic, copper enamelling and fused glass on a metal framework. The ceramic and copper would have been easy to attach to the metal without any visible signs of fixing, but as it was the glass that was chosen, we had to research fixings and adhesives extensively to find the best method of fixing the glass to the metal rod. Also, because of the hygiene issues and cleaning of the artwork, we also had to research ways of making the metal washable without it rusting.
We both feel that the experience gained during this project, helped us to move forward as artists because of the confidence gained from being chosen and the realization that people actually liked, and valued, what we made, and also that they were willing to pay us for it! It also helped us to expand our studio practice and not stay in our ‘comfort zone’, because by now we were getting used to listening to others and adapting our ideas in a way in which we felt appropriate, we started to push boundaries and enjoy the challenge. Instead of thinking ‘I know how this works’ it was ‘what if…….’.
But more than anything else the confidence boost, and the little bit of money that we gained from the project, enabled us to start on a venture that we had in mind for some time, but had never gotten around to doing anything about. This venture was Decima Designs, which was born just one month after the artwork was installed in DWH. Since October 2009, Decima Designs has grown from us teaching one pottery group a week, in a hired studio, to us now renting our own studio premises, teaching 5 regular weekly art/craft classes as well as day workshops, and to our own work being sold successfully through retail outlets in the local and surrounding areas. We are now looking for outlets further afield and hope to have more of these by 2011.
Looking back now on the artwork, although we are still very proud of what we achieved, as always there are things that we feel we could improve on if we did this project again, but hindsight is a wonderful thing. But, there again, we now have a lot more experience as artist/makers and our skill and confidence has improved since the DWH project. We still marvel at what we achieved in the sense that making public art was something completely alien to us, and the location of the artwork was not an easy area to work with. (Personal communication, November 2010)
Benefits to hospital staff.
The vast majority of interaction took place between students and the lead tutor from the Fine Art department, Geoff Matthews (the St Richard’s arts consultant), and nursing and paramedical staff in the two hospital units involved. There was not any active engagement with medical staff, although the lead clinicians in each unit had approved the projects.
Like the students, the hospital staff engaged with the unique problems of placing artworks in a ward environment, and often led the discussions on health and safety requirements, problems associated with hospital cleaning routines, and most importantly approval of the design of the chosen projects. The latter proved interesting for both students and hospital staff, with both groups being much more cautious than the patients who were involved in the discussions.
Several reports from American medical centres during the past twenty years have repeatedly suggested that neutral landscapes and calm, smiling figurative art is more appropriate for hospitals than abstract art. However, they all refer solely to paintings when discussing art, and the evidence-base of their findings has been queried (7).
The following examples from Chelsea & Westminster Hospital Arts are representative of many works in the collection, and on their website they are explicit that ‘the emphasis for the selection of art has always focused on bright, colourful abstract work’ (8).
Sacred Lake, Janet Nathan
Disc with Strings (Sun) opus 485
Dame Barbara Hepworth
Arc & Vessel
Lucy Le Feuvre
Blue White Line
Neither of the hospital projects chosen in Chichester were paintings, nor figurative, although at least one of the proposals put forward for Donald Wilson house was a figurative painting of horses, which according to the American literature should have been the most suitable.
Anecdotally the hospital staff reported that they enjoyed working with the university teams on the artworks for their units. A frequent complaint of NHS staff, particularly non-consultant clinical staff, is that things are ‘done’ to them without consultation or warning. Each of these projects has progressed slowly, with the consultation process taking many weeks rather than days, and this has given the hospital staff a sense of ownership which is likely to benefit morale.
Benefits to patients.
This is extremely difficult to quantify, and the problems of doing so will be addressed later in this report. Donald Wilson house is a rehabilitation unit whose patients stay for relatively long periods of time compared with the majority of those on an acute hospital site. The unit has a much greater feeling of community than, for exampe, an acute surgical ward, and there is a high level of integration of nursing, physiotherapy and occupational therapy staff. At the planning meetings patients contributed significantly to the discussions, and continued to be actively involved and interested in progression of the work.
The results of a questionnaire distributed on the unit one year after the work was installed are awaited; this canvassed the opinions of both hospital staff working on the unit and patients currently receiving treatment.
Donald Wilson house is a rehabilitation ward, and the project for the Fernhurst Centre is for outside the building rather than on the ward, so there has not as yet been any experience of introducing art work to the acute wards, outpatient departments, operating theatres, critical care areas or the maternity unit. Working with these departments would create different challenges for both the artists and the hospital staff involved.
A major problem that has arisen both during planning and execution of the projects, and in following up the work in Donald Wilson house, has been time. Coordinating the Fine Art team has not always been easy because of academic schedules, but dovetailing into the hospital staff duties has often been very difficult. Clearly the senior nursing staff often have managerial responsibilities in addition to their clinical work, and are understandably reluctant to attend further meetings in their own time (although it must be emphasised that they have done so). The inevitable delays, including interruptions by university vacations, has resulted in both projects taking longer to complete than originally anticipated, and as previously stated, the Fernhurst Centre work is still in the final stages of production (January 2011).
One of the intentions of this research was to establish a cross-disciplinary discussion group, meeting perhaps twice each semester. It quickly became apparent that this could not be achieved at this stage. NHS efficiency savings mean that trained nursing and paramedical staff have strictly regulated non-clinical professional development time, and are certainly not available during clinical shifts. Nursing students at St Richard’s (potentially the obvious group to have discussions with Fine Art students) are on clinical secondment from the University of Surrey, and any non-clinical work that they do is regulated by the School of Nursing at Surrey.
The potential for cross fertilisation of ideas and knowledge when working in Arts for Health is enormous and has not been exploited. This applies within the arts, and was apparent at the West Sussex one-day conference of the Arts for Health Network, where there was a clear enthusiasm for discovering what other arts practitioners in West Sussex were doing. Lack of a central training, regulating (although this is controversial) and coordinating body makes it very difficult for individual arts practitioners who work within the healthcare system. Equally many of those who work with patients are outside the NHS, working within social services, addiction services, and for independent healthcare providers. These problems are outside the remit of the University to address, but are likely to become more acute as County, City and District Councils reduce or withdraw funding for arts coordinators.
The second, and much larger opportunity for cross-disciplinary knowledge transfer is between arts practitioners and the healthcare professions.
Knowledge transfer partnerships (KTP).
A Knowledge Transfer Partnership is a UK government initiative to enhance knowledge and skills transfer between Universities and Companies stimulating innovation through collaborative projects by employing a graduate to facilitate change. (9)
The KTP scheme was set up by the previous government in 2003:
The aims of each KTP programme are to facilitate the transfer of knowledge and technology and the spread of technical and business skills to the company, stimulate and enhance business-relevant research and training undertaken by the knowledge base, and enhance the business and specialist skills of a recently qualified graduate (10).
There are now numerous and extremely disparate KTPs in existence in the UK, but none within the arts for health arena. There is a programme based with the Faculty of Health and Social Care at the University of Plymouth, which is investigating information resources for complementary therapies provided cancer patients, but this does not appear to involve frontline medical and nursing staff. (9)
More locally the School of Medicine in Southampton has a strong record in KTP, but this is firmly within scientific disciplines.
The SETsquared Partnership is a collaboration of the Universities of Southampton, Bath, Bristol and Surrey, and represents the largest single source for academic knowledge transfer in the UK, with a collective research base of more than 6,500 researchers. The partnership generates quality spin-outs from research discoveries; prepares students and staff with business skills; links established companies with university experts and facilities; facilitates international research collaborations; and supports science and technology entrepreneurs with business mentoring, affordable office space and routes to funding. (11)
A web search confirms that many faculties of medicine in the UK have KTPs with associated scientific, technological or pharmacological industries, and large arts faculties have KTPs with businesses that encourage introduction of creativity into business, but there appear to be no KTPs between university departments of the arts and the NHS. This may in part be a funding issue, although the KTP remit specifically states that the ‘business’ can be a public body.
By far the largest issue that has arisen during the research undertaken for this report is the lack of communication between the disciplines of art and medicine. With a very few exceptions doctors are suspicious of arts in health, and although anecdotally many will say that ‘it may be a good thing, and it can’t do any harm’ it is not taken seriously. This attitude is not confined to hospital professionals, and although a joint Arts Council/ Department of Health report in 2007 stated that:
A significant level of support for public art exists within the health sector and this is primarily based on a growing body of evidence that suggests the work of artists has a positive impact on people’s health and wellbeing (12)
it is not clear from where the evidence of public support derives. An article in the weekend Guardian at the end of 2006, whilst deliberately provocative, is not unrepresentative of many overheard conversations amongst ‘the chattering classes’.
I always want to ask – did nobody, nobody at all in the long chain of decision-makers that must surely stretch out behind the existence of this cripplingly expensive rock [ a £70,000 sculpture by John Aiken acquired by UCL] ever think to stop and ask whether there was not some way that this cash, or the energies – the well-intentioned though hopelessly misguided energies – that went into raising it could have been diverted into researching the causes of leukaemia, say, or into raising awareness of the fact that the NHS is about to break under the strain of imbecilities like this? (13)
A response to this article, by the ex-director of the arts programme at the Chelsea & Westminster hospital, was not well-received by contributors to the online Guardian forum; the following comment is representative: ‘Claiming an improved outcome requires a pretty serious study, likely using multiple centres, taking pains to screen out confounding factors, and using some sort of placebo or other control. None of which Ms. Loppert appears to have done.’ (14)
The Centre for Medical Humanities at Durham University was established in 2000 with an ambitious research remit which may address the significant scepticism that exists within the scientific and medical communities about the role of arts in hospitals.
Leading [research] questions are:
· understanding more fully the divergence between scientific and experiential accounts of human nature, health and flourishing
· understanding more fully the effects that this divergence has upon clinical healthcare and health policy
· developing a conception of clinical health care that acknowledges the foundational place of the humanities within it
· exploring the ways in which scientific and experiential understandings can better reflect each other’s ideas and practices. (15)
but they do not appear to have any research in place that addresses the different research methodologies used by the arts and the sciences.
Research undertaken for the Society for the Arts in Healthcare in the USA has identified multiple reasons for healthcare institutions to invest in the arts; and makes it clear that ‘the arts’ can encompass several disciplines. The following tables are extracted from their 2009 report (16) based on a survey of over 1800 healthcare institutions, of which 61% were hospitals. Contrary to possible UK expectation only 5% of the institutions were involved in long term patient care, and only 4% provided hospice or palliative care.
Why Healthcare Institutions Invest in the Arts
Benefit Patients 80%
Contribute to a healing
Help patients & families
deal with serious illness 59%
Part of psychosocial recovery 58%
Benefit patients’ families 52%
Build Community Relations 48%
Benefit healthcare staff 43%
Part of physical recovery 41%
health information 31%
Part of multicultural outreach 31%
Part of neurological recovery 28%
Attract favorable publicity 26%
Attract new donors 18%
Types of art practice used in healthcare
Art therapists 14%
Music therapists 11%
Visual artists 9.5%
Dance/Movement therapists 3.5%
Drama therapists 1.5%
Poetry therapists 1%
This extensive report outlines the problems with research arts in healthcare. The authors state that much of the published research to date has been qualitiative, using surveys, interviews and observational data. This is true of the UK literature as well as that of North America. However, as the authors later state:
because efficacy of any treatment or procedure in a healthcare setting is generally proven by scientific methods and quantitative research, a limited amount of this type of research, e.g., controlled investigation with a strict protocol and clearly defined measures, is taking place in arts in healthcare research. Findings from quantitative research would likely capture more attention from hospital and other healthcare institutions’ decision-makers and thus help practitioners garner more credibility and support. (16)
These views are echoed in a paper from the MRC Social and Public Health Sciences Unit in Glasgow, in which the authors suggest that there is a lack of adequate evaluation and appropriate methodology in the published data about arts in health in the UK. Although they express some sympathy for the view that the scientific method may not always be the most appropriate for evaluation of arts in health, they still conclude that recognition and credibility within the healthcare professions is only likely to follow from its use.
In the health field, proper recognition of the health effects of interventions and resources, are likely only to follow from good evidence that they achieve their intended health and well-being outcomes. In the absence of evaluation there always will be much uncertainty over benefits, harms and value for money. A scientific approach to evaluating the arts may help move the debate about the arts and health beyond anecdote and opinion. (17)
The words ‘anecdote and opinion’ reveal the underlying suspicion of alternative methodologies that is commonly held by practitioners of the scientific method. A paper published over 15 years ago in the British Medical Journal accurately summarised the problems face by researchers wishing to use qualitative (non-scientific) methodologies:
In the health field–with its strong tradition of biomedical research using conventional, quantitative, and often experimental methods–qualitative research is often criticised for lacking scientific rigour. To label an approach “unscientific” is peculiarly damning in an era when scientific knowledge is generally regarded as the highest form of knowing. The most commonly heard criticisms are, firstly, that qualitative research is merely an assembly of anecdote and personal impressions, strongly subject to researcher bias; secondly, it is argued that qualitative research lacks reproducibility–the research is so personal to the researcher that there is no guarantee that a different researcher would not come to radically different conclusions; and, finally, qualitative research is criticised for lacking generalisability. It is said that qualitative methods tend to generate large amounts of detailed information about a small number of settings. (18)
Since this (and an accompanying paper) were published there have been virtually no publications in the mainstream medical literature addressing use of relevant methodologies. The arts in healthcare world appears divided between those who feel that they have to somehow adopt scientific methodologies in order to survive, and those whose views are summarised by one of the participants at the recent West Sussex Arts in Health Network meeting; ‘why do they [healthcare professional and funders] always expect us to work in their way?’
In recent years a few academic courses (Aston, London and Oxford Universities) have started that address research methodologies in healthcare, usually lasting a few days and offering credits towards further postgraduate education. The Oxford short course appears highly relevant to arts in healthcare, but unfortunately with fees of over £1700 for the five day course it seems unlikely that many arts practitioners will attend.
There is increasing recognition that a wide range of social, political and economic factors may influence improvements in healthcare systems and outcomes. Experimental methods are not necessarily the most effective mechanism for answering research questions aimed at unpacking this complexity. Qualitative research can help bridge the gap between scientific evidence and clinical practice by exploring the attitudes, beliefs, and preferences of both patients and practitioners.
Qualitative research can address questions such as
What are the barriers to the use of evidence-based medicine?
How does the relationship between doctor and patient influence compliance?
What factors influence health behaviours?
How do patients and practitioners make sense of treatment regimens?
In short, qualitative research explores how people make sense of their lives. (19)
In addition to these courses there has been recognition from the Department of Health that qualitative research has an important role to play in evaluation of healthcare services:
qualitative methods are now utilised to address the well-documented ‘gap’ between evidence-based approaches based on the findings of randomised control trials and the practice of clinical decision-making in individual cases. Indeed, the more individualised an intervention becomes, the greater the role for qualitative work in its evaluation. Recognising that diverse types of evidence can contribute to systematic reviews of clinical effectiveness was acknowledged in the guidance published by the NHS Centre for Reviews and Dissemination in 2001, which went on to give explicit consideration to qualitative research. This suggests [….] that the rigid insistence on controlled trials as the sole source of evidence on effectiveness that characterised the beginnings of the evidence based healthcare movement is coming to end. This view is also consistent with other recent recommendations concerning the contribution of qualitative evidence to healthcare evaluation. (20)
Despite the introduction of postgraduate courses, and nominal political recognition, there continues to be an assumption that funding for arts in healthcare work is increasingly dependent on an ability to produce high quality research and evaluation – and that ‘high quality’ is synomynous with quantatitive research.
The existing goodwill and collaboration between St Richard’s hospital and the Fine Art department of the University of Chichester provides an excellent basis for developing more formal programmes of work in the arena of arts in healthcare.
The exisiting hospital arts programmes in the UK tend to be multidisciplinary. The Fine Art department has good links with the departments of Dance and Music, and it would seem appropriate that they become involved in longer term planning.
There are currently no senior medical or managerial staff at St Richard’s directly involved with the arts programme. Identification of a suitably senior and committed person would be vital for the future of any arts in health scheme.
As outlined in the report, development of an arts in healthcare scheme requires funding, which will be dependent on ongoing rigorous evaluation. My previous and current experience in both medicine and the arts and humanities leads me to believe that there is a poor understanding of research methodologies amongst both academics and practitioners in most disciplines. I suggest that alongside development of a practical arts programme with St Richard’s, the university could support an academic programme investigating and evaluating research methods used in arts in healthcare. Such a programme could potentially be aimed at multidisciplinary groups of arts, nursing and medical students.
Chichester is possibly uniquely positioned to take a lead in arts for health on the south coast. The university has a strong arts faculty, and it is equidistant from Southampton and Brighton Medical Schools. There are two large new hospital builds recently or nearly completed in Portsmouth and Worthing, as well as the established relationship with our neighbouring hospital, St Richard’s.
The lead tutor in the Fine Art department (Rachel Johnston) has developed the existing projects in collaboration with Geoff Matthews, the art consultant at St Richard’s, who has extensive experience in the art world, and a decade of experience at St Richard’s. The nursing and paramedical staff at St Richard’s have been enthusiastic and supportive of the current projects.
The West Sussex arts in health coordinator, Anna Barzotti, has previous experience of working with, evaluating, and achieving funding for arts in health programmes in the Midlands. Her present appointment is due to end in 2011 and she is keen to be involved with future developments.
The Fine Art graduate researcher (Diana Brighouse) has 18 years experience as a consultant in the NHS (in Southampton) and is a qualified psychotherapist. She also undertook a module in research methodologies as part of an MA in comparative spirituality, and has experience in medical research.
This report has outlined the current relatively informal relationship between the Fine Art department at the University of Chichester, and St Richard’s hospital.
It has offered a limited overview of the state of arts in healthcare in the early 21st century, and has suggested that despite considerable literature attesting to its benefits, there is still an underlying degree of scepticism about its role.
The report has highlighted that one of the major problems associated with evaluating (and hence funding) arts in healthcare research concerns the use of appropriate methodologies. There continues to be an elevation of the scientific method, and a poor grasp generally of qualitative methodologies.
The report has suggested that consideration should be given to making future development of arts in healthcare by the University of Chichester two-pronged; a practical programme which would develop a wider arts programme for St Richard’s, and a theoretical programme aimed at delivering a research methodologies module to students from different disciplines.
Funding is clearly limited in the present economic climate. Theoretically it should be possible to develop a Knowledge Transfer Partnership between the university and St Richard’s (which would be with the Western Sussex Hospitals NHS Trust). Most hospital arts in health programmes are charitably funded, but details about establishing a charitable fund is beyond the remit of this report.
It is suggested that evaluation of the development of the proposed programme could form the basis of a doctoral thesis. Ongoing evaluation of and involvement with the practical programme could be included in the Fine Art Master’s programme.
A brief questionnaire distributed in Donald Wilson house in December 2010 in an attempt to obtain some responses to the art work after the initial novelty of its arrival had worn off.
The actual questionnaire was on one side of an A4 sheet; the other side carried an introduction.
Art work in Donald Wilson House
I am writing a report for the University of Chichester to help the Fine Art department evaluate the collaborative work that has been undertaken between art students and St Richard’s hospital.
I would be very grateful if you could spare a few minutes to complete this questionnaire. Please feel free to add any comments or to contact me if you would like to discuss anything further.
Diana Brighouse, Graduate Fine Art Researcher. firstname.lastname@example.org
It would be very helpful if you could put a ‘P’ at the top of the questionnaire if you are a patient, and an ‘S’ if you are staff.
- 1. Are you aware of the art work in the day room of Donald Wilson House?
(please circle appropriate answer).
Yes No Not sure
[If the answer to Q1 is ‘no’ please go to Q4.]
- 2. Have you ever heard patients comment on it?
Yes No Not sure
- 3. Do you like the work?
Yes No Not sure
- 4. Are you aware of any other art work in the hospital?
Yes No Not sure
- 5. Do you ever go to see any exhibitions of visual arts?
Yes No Not sure
- 6. Do you think that having art work in the hospital makes a difference to staff as well as patients?
Yes No Not sure
- 7. Is there any particular type of art that you would like to see in the hospital?
(Please circle all that apply and feel free to add any comments).
Painting Photography Textile work
Sculpture Film/ video Sound
Installation Interactive work
Please add any comments that seem relevant
Nine replies were received; four from staff members, three from patients, and two which did not provide that information.
Q1. Eight respondents were aware of the DWH art work, one member of staff was not.
Q2. Four respondents had heard patients comment on the work, and one was unsure about this. Both patients and staff responded positively to this question.
Q3. Two respondents (one patient and one staff member) were unsure about whether they liked the work; all others said that they did.
Q4. All the respondents with the exception of the person unaware of the DWH art work were aware of other art work in the hospital.
Q5. Five respondents go to see exhibitions of visual art; perhaps surprisingly this included the respondent who was unaware of any art work in DWH or the rest of the hospital.
Q6. All the respondents thought that having art work in the hospital makes a difference to staff as well as patients.
Q7. In total the returned questionnaires circled each of the eight suggested art forms as being ones that would be nice to see in the hospital.
One respondent commented that it was difficult to see art works hung on the wall because of blurred vision after a stroke.
There was a specific comment that interactive art would be good in DWH.
One commented that ‘the hospital provides a great showcase for artists to display their work’. Another staff member commented that they would welcome the opportunity to display their own work, and similarly there was a comment that there should be opportunities for patients’ work to be displayed: ‘If a patient is able to express themselves best via a certain visual media, I believe there should be a way for them to do this and a place where this art can be displayed as an inspiration to others or for use as a communication tool.’
Clearly it is impossible to draw any firm conclusions from a very small survey such as this, particularly as no professional advice was sought in constructing the questionnaire. The intention was to provide a snapshot that might provoke ideas for the direction of further work at St Richard’s. The survey suggests that the staff and patients at the hospital appear to have a relatively high level of ‘art awareness’ and could be a valuable resource when planning further work.
- Staricoff, Rosalia L. (2004). Arts in Health: A Review of the Medical Literature. Research Report 36, London: Arts Council England
- Prevalence of Arts in Healthcare Programs in the United States. 2009 State of the Field Report: Arts in Healthcare. www.arts.ufl.edu/cahre/State%20of%20the%20Field%20report.pdf
- Hamilton C, Hinks S, Petticrew M. (2003). Arts for health: still searching for the Holy Grail. J Epidemiol Community Health; 57: 401–402
- Mays N, Pope C. (1995). Qualitative Research: Rigour and Qualitative Research. BMJ; 311: 109