“…I shall never forget the rapture of fever patients have over a bunch of bright colored flowers. People say the effect is only on the mind. It is no such thing. The effect is on the body too. …Variety of form and brilliancy of colour in the objects presented to patients is an actual means of recovery.”
Over a century after Florence Nightingale wrote these words the idea of arts in healthcare is slowly gaining ground among healthcare providers.
Research conducted over the last twenty years has become an underpinning of an evidence-based design movement whose fundamental goal is to create healing environments that are not only functionally efficient, but also nurturing and supportive of family involvement. Nature and appropriate arts applied either as a therapy tool or integrated with the design, are increasingly recognized as part of patient-centred care.
Which arts are appropriate? According to Dr. Roger Ulrich, a behavioural scientist and Director of the Center for Health Systems and Design at Texas A&M University, there are recognizable patterns of perception and reaction to visual arts. An overwhelming majority of adult patients prefer representational images of nature, landscapes and gardens. Images of people in natural settings with friendly facial expressions and gestures also tend to be positively received.
Although aesthetics are important qualities, the desired attribute of healthcare art is to elicit positive responses and reduce stress. Most abstract art and challenging or unsettling images are to be avoided.
Several research projects have been undertaken to obtain “hard data” to support a vast body of anecdotal evidence.
A three-year ground-breaking study in Chelsea and Westminster Hospital in London, conducted by research scientist Dr Rosalia Staricoff in 2002, produced revealing results that are difficult to ignore even by hardened skeptics. The study evaluated the influence of music and visual arts on clinical outcomes as well as user and staff attitudes.
Almost half of interviewed patients claimed visual arts were a distraction from medical worries. 80% of patients reported improvement in mood, and stress level was lowered in 65% of patients. Depression levels of chemotherapy patients were 34% lower among those exposed to artwork, in comparison to those who were not.
Two-thirds of the staff participating in the study pointed out that their decision to apply or stay in their current job was significantly influenced by the hospital’s working environment.
With the UK and the USA at the forefront, there are signs of a growing movement for arts in healthcare in this country.
This appears to be the idea behind the Bloorview MacMillan Children’s Centre, a care and research facility that is currently under construction in Toronto. The flow between indoor and outdoor, man-made and natural, the symbiosis of the functional and the aesthetic will create a space conducive to physical rehabilitation and spiritual healing of children. Art installations in the new building will help to create a welcoming healing environment where individual experiences and community spirit connect.
Art, as both a therapeutic tool and as part of the design, has traditionally been present at the Centre. The design and creative activities in the Spiral Garden epitomize the idea of patient-centred care and a holistic approach to rehabilitation. “When people enter here, they feel it’s a space that has been paid a lot of attention toÉ they feel comfortable and balanced almost through osmosis … ,” says Jan MacKie who has been coordinating Spiral Garden for almost twenty years and is now working to bring similar arts programming into the new building.
The annual conference of The Society for the Arts in Healthcare, coming up in June 2005, will take place in Edmonton, a hub of arts in healthcare in its own right. The Manitoba Artists in Health Care program facilitates participatory arts programs in hospitals, and advocates incorporating arts in facility design (Hospital News, August 2004). The Artists-on-the-Wards program and an onsite art gallery are an integral part of the University of Alberta Hospital.
Art is often looked upon as a nice-to -have extra in times when hospitals are undercapitalized and struggling. Still, it is undeniable that soothing music or nature images take patients’ thoughts away from pain and anxiety. Happy patients require shorter hospitalization, need less medication and communicate better with the staff. All these factors affect the bottom line. If this does not make a good case for art as a “must-have”, then what does?