Background & Aims

Despite the high prevalence of chronic pain in older adults, chronic pain management in this population is challenging because of their unique biopsychosocial characteristics related to chronic pain. Currently, pain experts support the biopsychosocial model of pain, suggesting holistic, non-pharmacological approaches as a first line of pain management. Art making is a holistic approach closely related to the biopsychosocial approach. Moreover, art making has accumulated empirical evidence as a health intervention for various health concerns. In older adults, however, art making intervention has been mostly used for physical/functional or cognitive health. Our team, therefore, developed an art making intervention for older adults as a potential pain management strategy. In this poster, we will introduce both our systematic approach to designing an art making intervention and our proposed future study of art making as a chronic pain management strategy for older adults.

Methods

The systematic approach in developing this art making intervention included (1) preliminary intervention design, (2) interim evaluation and revision and (3) final evaluation. Four experts were recruited to design the preliminary intervention: (1) a nurse scientist whose interest focuses on chronic pain management in older adults using creative activity, (2) an art professor who studies the creative art process, and (3) two art educators who have worked with older adults. Eleven community dwelling older adults who experience chronic pain (e.g., back and neck) participated in a descriptive qualitative study sharing their experiences using this intervention over 3 weeks. We used both directed and conventional content analysis to understand their experiences. For the final evaluation, five experts (pain, pain psychology, gerontology, art, and older adults) were surveyed regarding their level of satisfaction with and overall impressions of the intervention after thoroughly reviewing it.

Results

Intervention development: Our team designed a preliminary art making intervention in the form of an art making book including three visual art making activities (i.e., drawing, painting, and craft) at three skills levels (i.e., beginner, intermediate, and advanced).

Descriptive qualitative study: We identified two themes directly related to the quality of the preliminary intervention (i.e., ‘easy and helpful format,’ and ‘intervention instructions lacked needed details’) and four themes related to older adults’ experiences while creating artwork (e.g., ‘art making is actively engaging and distracting from their pain,’ ‘pain decreases during the intervention, but may be exacerbated based on pain location’). Based on our findings, we revised the intervention.

Expert evaluation and final intervention: A survey of experts reported high levels of both satisfaction with (4/5) and overall impressions (4/5) of the revised intervention. Experts suggested adding video instructions.

Conclusions

Our final art making intervention includes 20 art making activities (5 activities each for drawing, painting, collage, and craft). This intervention will be delivered in an individual format using an art making activity book and a YouTube channel. The activity book will provide textual and visual instruction to help older adults create each artwork. The YouTube channel will provide short 3 to 5 minutes video clips on techniques related to each art making activity. Our next step with this newly developed art making intervention is to examine neuroplastic change in the brains of older adults with chronic back pain after their use of this intervention as a creative activity over 10 weeks. Further, we will examine how these changes are related to pain intensity reduction. Designing the art making intervention paves the way for our future study addressing a possible mechanism for perceived pain intensity in older adults with chronic back pain through creative art making activity.

References

1.Schwan, J., Sclafani, J. & Tawfik, V. L. Chronic Pain Management in the Elderly. Anesthesiol. Clin. 37, 547–560 (2019).
2.Emerson, K., Boggero, I., Ostir, G. & Jayawardhana, J. Pain as a Risk Factor for Loneliness Among Older Adults. J. Aging Health 30, 1450–1461 (2018).
3.Miaskowski, C. et al. A Biopsychosocial Model of Chronic Pain for Older Adults. Pain Med. Malden Mass 21, 1793–1805 (2020).
4.Monti, D. A. et al. A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. Psychooncology. 15, 363–373 (2006).
5.Morris, J. H. et al. Feasibility study of the effects of art as a creative engagement intervention during stroke rehabilitation on improvement of psychosocial outcomes: study protocol for a single blind randomized controlled trial: the ACES study. Trials 15, 380 (2014).
6.BA, C. E. B. & PhD, S. J. R. Effect of Art Production on Negative Mood: A Randomized, Controlled Trial. Art Ther. 24, 71–75 (2007).
7.Savazzi, F. et al. “Art, Colors, and Emotions” Treatment (ACE-t): A Pilot Study on the Efficacy of an Art-Based Intervention for People With Alzheimer’s Disease. Front. Psychol. 11, 1467 (2020).
8.Chan, S. C. C. et al. Chinese Calligraphy Writing for Augmenting Attentional Control and Working Memory of Older Adults at Risk of Mild Cognitive Impairment: A Randomized Controlled Trial. J. Alzheimers Dis. 58, 735–746 (2017).
9.Aguiñaga, S. & Marquez, D. X. Feasibility of a Latin Dance Program for Older Latinos With Mild Cognitive Impairment. Am. J. Alzheimers Dis. Dementias® 32, 479–488 (2017).
10. National Pain Strategy Task Force. National Pain Strategy: A Comprehensive Population
Health-Level Strategy for Pain. Washington Interagency Pain Research Coordinating
Committee (IPRCC), National Institutes of Health (NIH) 2015. Available at:
https://www.iprcc.nih.gov/node/5/national-pain-strategy-report

Presenting Author

Kyung Soo Kim

Poster Authors

Kyung Soo Kim

RN

University of Iowa

Lead Author

E-mail

Maichou Lor

University of Wisconsin-Madison

Lead Author

E-mail

Jerianne Richardson

BSN student

College of Nursing University of Iowa

Lead Author

E-mail

Lauren Linahon

MEd

College of Education University of Iowa

Lead Author

E-mail

Clar Baldus

PhD

College of Education University of Iowa

Lead Author

E-mail

Topics

  • Treatment/Management: Complementary and Alternative therapies