Cultural activities and health : Singer, patient, and healthcare staff perspectives. From feelings to biology

Objectives. The aim of this thesis was to explore and illuminate possible associations between various cultural activities and assessments of well-being, health, stress and emotions in a didactic setting and healthcare settings for singers, patients, and healthcare staff.  Material and methods. Paper I describes an empirical intervention study with repeated measures from a small cohort of singers, before, during and after a singing lesson. Physiological and endocrinological measures, as well as self-ratings were used. A two-way analysis of variance (ANOVA), as well as non-parametric tests were used. Paper II describes a randomised controlled trail for women with exhaustion symptoms participating in an intervention called the “culture palette”, consisting of six different cultural activities. Exhaustion, alexithymia, sense of coherence and self-rated health with standardised scales were assessed. A Linear Mixed Models were used. Paper III describes a study using a phenomenological hermeneutical method in analysing focus group interviews with women with burnout symptoms and cultural producers and separate interviews with health care managers to elucidate the experiences of participating in the culture palette. Paper IV describes a study with a phenomenological hermeneutical method analysing focus group interviews with healthcare staff members about their experiences of participating in self-chosen cultural activities. Results. The analysis of paper I showed increased wellbeing and joy in amateur singers. The professional singers showed better cardio-physiological fitness during singing. Both groups experienced more energy and relaxation after the singing lesson. The analysis of paper II showed decreased symptoms of exhaustion, alexithymia and increased self-rated health in the women after participation in the cultural activities. However, there was no significant differences between intervention and control groups regarding sense of coherence (SOC). Paper III describes the analysis of the interviews and shows three themes, where the culture palette impacted on the level of the body, group and indirectly on the managers and healthcare organisation. Paper IV describes the analysis of the interviews and shows three themes where cultural activities had a positive impact on the physical/psychological level, and enhanced work relations. Challenges in implementing cultural activities in the healthcare organisation were illuminated.  Conclusion. The cultural activities included in these studies show beneficial effects on health for individuals and groups, as well as for healthcare organisations. The multimodal components integrated in cultural activities exhibit possibilities of enhancing health, wellbeing and preventing and managing stress reactions. Cultural activities can enable the development of a more sustainable healthcare and eventually a more sustainable society.

Cultural activities and health : Singer, patient, and healthcare staff perspectives. From feelings to biology

Objectives. The aim of this thesis was to explore and illuminate possible associations between various cultural activities and assessments of well-being, health, stress and emotions in a didactic setting and healthcare settings for singers, patients, and healthcare staff.  Material and methods. Paper I describes an empirical intervention study with repeated measures from a small cohort of singers, before, during and after a singing lesson. Physiological and endocrinological measures, as well as self-ratings were used. A two-way analysis of variance (ANOVA), as well as non-parametric tests were used. Paper II describes a randomised controlled trail for women with exhaustion symptoms participating in an intervention called the “culture palette”, consisting of six different cultural activities. Exhaustion, alexithymia, sense of coherence and self-rated health with standardised scales were assessed. A Linear Mixed Models were used. Paper III describes a study using a phenomenological hermeneutical method in analysing focus group interviews with women with burnout symptoms and cultural producers and separate interviews with health care managers to elucidate the experiences of participating in the culture palette. Paper IV describes a study with a phenomenological hermeneutical method analysing focus group interviews with healthcare staff members about their experiences of participating in self-chosen cultural activities. Results. The analysis of paper I showed increased wellbeing and joy in amateur singers. The professional singers showed better cardio-physiological fitness during singing. Both groups experienced more energy and relaxation after the singing lesson. The analysis of paper II showed decreased symptoms of exhaustion, alexithymia and increased self-rated health in the women after participation in the cultural activities. However, there was no significant differences between intervention and control groups regarding sense of coherence (SOC). Paper III describes the analysis of the interviews and shows three themes, where the culture palette impacted on the level of the body, group and indirectly on the managers and healthcare organisation. Paper IV describes the analysis of the interviews and shows three themes where cultural activities had a positive impact on the physical/psychological level, and enhanced work relations. Challenges in implementing cultural activities in the healthcare organisation were illuminated.  Conclusion. The cultural activities included in these studies show beneficial effects on health for individuals and groups, as well as for healthcare organisations. The multimodal components integrated in cultural activities exhibit possibilities of enhancing health, wellbeing and preventing and managing stress reactions. Cultural activities can enable the development of a more sustainable healthcare and eventually a more sustainable society.

"You Can´t Feel Healthier than Your Caregiver" : The Ripple Effect of Trust and Empathy for Patients and Health Care Staff, Cultivated through Cultural Activities

Introduction: Stress-related problems, including burnout, cause personal suffering, disability and result in costly sick leave. The use of different cultural activities within a health care system may help to prevent burnout, but very few studies have focused on what happens after such activities. Methods: Interventions with different cultural activities were conducted for burn out patients in four primary health care settings during three months. Focus group interviews were conducted with patients, cultural producers and health care nurses. The aim was to provide a description of the participant’s experiences after the activities. Results: The cultural activities were found to affect both participants' emotions and behaviour and created a sense of belonging and equality among them. Positive 'spill-over' effects were also seen on nurses of health care management. Conclusion: We find that the cultural activities help to create a trustful and empathic health care environment where the wellbeing of staff and that of patients have an impact on each other. We suggest the incorporation of arts into health care as a possible contributor to the development of a sustainable health care system

Arts as an ecological method to enhance quality of work experience of healthcare staff : a phenomenological-hermeneutic study

This paper explores the impact of self-chosen arts-based recreational activities, as opposed to the traditional arts therapy activities, on the well-being of healthcare providers. Three qualitative case studies of programs in which arts-based activities were used to work with healthcare providers, lasting for 10 weeks each, are phenomenological-hermeneutically evaluated using interviews and focus groups. The findings show what we refer to as an "ecological" ripple of effects: (1) the arts-based activities helped to reduce individual stress and to enhance mood over time, (2) the activities helped to transform workplace relationships within wards, and (3) the arts humanized the overall work climate in the healthcare setting. These effects go beyond those of using the art production as a strategy for stress reduction and imply potential for a more encompassing role for the arts within healthcare