Abstract
BackgroundStroke causes lasting brain damage that has numerous impacts on the survivor’s physical, psychosocial, and spiritual well-being. Young survivors (< 65 years old) tend to suffer more because of their longer overall survival time. Expressive arts-based intervention is considered a holistic approach for stroke rehabilitation because it allows participants to express their thoughts and emotions through the arts. The group environment also promotes mutual support among participants. The creative art-making process helps expand participants’ creativity and imagination as well as promote a sense of aesthetic appreciation. Previous studies have shown the effectiveness of the arts-based intervention in managing stroke and its psychosocial-spiritual comorbidities. Nevertheless, a systematic study has not been conducted, including in young survivors. This trial plans to investigate the effectiveness of an expressive arts-based intervention on bio-psychosocial-spiritual outcomes in young Chinese stroke survivors.Methods/designA single-blind, two-arm cluster randomised control trial with a waitlist control design will be adopted. One hundred and fifty-four stroke survivors, aged 18–64 years with modified Rankin Scale scores of 1–4, will be screened and randomised to either an expressive arts-based intervention group or a treatment-as-usual waitlist control group. The intervention group will receive a 90-min session once a week for a total of 8 weeks. All participants will be assessed three times: at baseline, 8 weeks, and 8 months after the baseline. Study outcomes include measures of depression and anxiety, perceived stress, perceived social support, hope, spiritual well-being, quality of life, salivary cortisol, blood pressure, and heart rate.DiscussionThis study is expected to contribute to the current knowledge on the effectiveness of an arts-based intervention on the holistic wellness of young stroke survivors. The findings will help stroke survivors and healthcare professionals make better choices in selecting practices that will yield maximum benefits, satisfaction, adherence, and sustainability. In addition, the examination of the relationships between bio-psychosocial-spiritual variables will help contribute to the development of holistic care for the survivors.Trial registrationClinicalTrials.gov, NCT03729648. Registered 31 October 2018 - Retrospectively registered, (329 words)
Highlights
Stroke causes lasting brain damage that has numerous impacts on the survivor’s physical, psychosocial, and spiritual well-being
To help young stroke survivors address their unique psychosocial-spiritual concerns, which have been found to be crucial for rehabilitation adherence and achieving favourable recovery outcomes [11, 19], there is a need for a holistic rehabilitation programme, the nonpharmacological one, as an adjuvant to conventional physical and occupational rehabilitation to buffer against mental health issues, reduce psychosocial stress, resume social connections, and re-instill hope [6, 8, 20,21,22,23,24,25]
A systematic study related to artsbased intervention has not yet been conducted, including among younger stroke survivors, who may experience greater and longer-term impacts in the psychophysiological and social-spiritual aspects
Summary
Stroke causes lasting brain damage that has numerous impacts on the survivor’s physical, psychosocial, and spiritual well-being. Expressive arts-based intervention is considered a holistic approach for stroke rehabilitation because it allows participants to express their thoughts and emotions through the arts. Stroke causes lasting brain damage that impairs several body functions, resulting in restrictions in all aspects of life [1] It does not merely affect one’s independence and one’s psychosocial well-being and quality of life [2,3,4,5,6,7,8,9,10,11]. An expressive arts-based intervention is uniquely equipped to take advantage of utilising all art modalities, such as visual art, music, dance/movement, drama, and writing [33], to address the psychosocial-spiritual needs of stroke survivors [18]. Systematic research on its effectiveness is still limited, including on young survivors [27, 34, 35]
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