Art Therapy in Palliative Care: Study of Identification and Understanding of the Mechanisms of Change in the Patient

Study Overview
=================
Brief Summary
-----------------
This study evaluates from the patient's perspective which elements of the own artistic creative process are the source of a beneficial change for him/her and how those elements influence in their end of life experience.

Detailed Description
-----------------
In previous quantitative studies about the effect of an art therapy intervention in adult cancer inpatients of the Palliative Care Unit, the investigators evidenced significant improvements in the symptom control of malaise, anxiety, depression and pain. This study is designed to deepen the understanding of specific action mechanisms which lead to those therapeutic benefits and quality of life implications for patients with life-threatening illness in which a situation of suffering is frequently detected. The investigators will determine from the subjective patient's experience which specific elements of the artistic creative process (including production of art and art products) may lead to changes in the symptom perception, in meaning and healing process and in the personal perspective about the end of life situation.

Official Title
-----------------
Art Therapy in Palliative Care: Study of Identification and Understanding of the Mechanisms of Change in the Patient

Conditions
-----------------
Psychological Stress, Suffering, Advanced Cancers

Intervention / Treatment
-----------------
* Behavioral: art therapy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: advanced-cancer adult inpatients of the Palliative Care Unit informed consent Exclusion Criteria: altered cognitive function (Mini-Mental Test < 24) physical decline (palliative care team's criteria) that impedes the art therapy process

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: art therapy<br>Individual 30-60 minutes art therapy sessions, twice a week, offering visual arts materials. | Behavioral: art therapy<br>* Patient's creativity is stimulated by visual arts materials and various art therapy techniques including punctual use of music, poetry and body expression. The intervention, based on the investigators previous experience, is founded on: humanistic phenomenological focus transpersonal therapeutic bound transdisciplinarity in the artistic approach integrative-relational specialized counseling of the grief, loss and trauma aspects.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reflect Interview (RI) using audio recording. | An art based interview is administered and involves the patients selecting 2 significant artworks from their art therapy productions. The patient is asked by the art therapist for a narrative of how one artwork relates to the other in the context of his/her lived experience. The art therapy dialogue from the RI is transcribed and subjected to thematic analysis. | After the making of a minimum of 5 art pieces, an average of 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Art therapy process from the art therapist perspective. | Detailed notes and photographical register. | Every day of art therapy session, with an average of 2 sessions a week, over a period of 2 years. |