The impact of engagement with the arts on the health and wellbeing of hospital inpatients with dementia

Abstract

The global rise of dementia has provoked a multidimensional response from research, policy, and practice sectors. Care for dementia in hospital settings is of particular concern given the outsized lengths of stay and readmission rates. To respond to the resulting care needs, arts in health programmes are increasingly implemented in hospitals, with a central focus on supporting those with dementia. This PhD aimed to explore patterns of engagement with the arts and their psychosocial effects on hospital inpatients with dementia, with a particular focus on the differences in psychological impact between traditional and digital modes of engagement. The study used a sequential mixed methods design organised across three inter-related studies. Study 1, a cross-sectional study of 123 inpatients, used a questionnaire battery consisting of validated measures for loneliness, quality of life, and depression alongside questions regarding current, past-year, and life course engagement with different art forms and cultural activities. High rates of loneliness and depression were measured among participants, but current individual engagement with the arts was associated with less loneliness and increased quality of life. Notably, passive and solitary activities such as reading and watching television were associated with lower levels of loneliness. Study 2, a focused ethnographic study of 43 participants, focused on digital and traditional arts and music programmes at an acute care NHS trust. This study found that the novelty of digital art led to focused individual engagement while traditional art groups were more likely to engage socially. Additionally, this study presented a model for patient experience of hospital art groups describing the discrete and interactive effects of arts engagement, social interaction, and environment. Study 3, a 3-arm controlled study with 90 participants, compared validated before and after measures of anxiety and wellbeing for traditional art, digital art, and control activities. This study found short term improvements in wellbeing in both digital and traditional art groups and lowered anxiety in the traditional art group compared with a control group. The thesis triangulates data from the studies to explicate patterns of arts engagement and their effects. A methodological contribution is made by using both qualitative and quantitative methods to connect intra-activity data with outcome measures. Theoretical contributions include considerations of the balance between novelty and familiarity in arts engagement, the roles of the environment and social engagement in a hospital setting, and the use of art for both reminiscence and expression in dementia.