Conversations about creativity and chronic illness II: Textile artists coping with long-term health problems reflect on the creative process

This qualitative study explored the origins of interest in textile arts among a group of women living with long-term health problems. The part that illness played in motivating engagement in creative arts was of particular concern. Twenty four women were interviewed, aged between 29-72 years. Most were hobbyists and but the sample included some publicly acclaimed textile artists. A minority had engaged in art continuously since their earlier years. Most of the women had discovered (or re-discovered) textile arts, in middle and later life. Several factors facilitated this. The narratives indicated that the women’s pre-existing resilient personality as well as extensive support structures may have encouraged a reflective attitude and a problem-solving approach to living with illness. The experience of biographical disruption, stemming from the crisis of illness, dissatisfaction with unproductive time and a growing need for self-fulfilment, appeared to create a search for a meaningful occupation. The discovery of textile art as a meaningful occupation (as opposed to other ways of living with illness) appeared to be encouraged by early role models, enjoyment of art at school, the discovery that adult personal and professional interests could be expressed through artwork, and chance events. Textile art at school appeared to provide a form of ‘cultural capital’ for these women, who returned to this art medium and the skills learned earlier, when crisis occurred. The findings indicate that a negative event such as illness may have life-enhancing effects. Rehabilitation specialists might focus more on the arts as a resource for adults living with illness

Occupational therapy for children with attention deficit hyperactivity disorder (ADHD), Part 2: A multicentre evaluation of an assessment and treatment package

In this study, a family-centred, occupational therapy assessment and treatment package was delivered to improve the behavioural patterns of children with ADHD aged 5-10 years. There were two principal research questions: 1. Is a defined family-centred occupational therapy assessment and treatment package carried out over 3 months effective in producing significant changes in the behavioural patterns of children with ADHD aged between 5 and 10 years? 2. Does a family-centred care approach elicit positive parental perceptions of the care that they and their children have received

Narratives of art-making in chronic fatigue syndrome/ myalgic encephalomyelitis: Three case studies

This paper explores the narratives of three women who had lived with severe chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) for many years, and who engaged in art-making as a leisure activity rather than for psychotherapy. Three distinct narratives about the role of art-making in CFS/ME were inferred. One participant represented art as a way of filling time rather than having further psychological significance. In her narrative, art provided satisfaction but also functioned as a witness to time and opportunity that had been lost to an unchanging illness. The second participant narrated both illness and art-making as intertwined journeys towards a more able and useful self. Her narrative had features of the quest described in previous typologies. The third participant also provided a quest narrative, but her struggle focused inwards on understanding her feelings about her illness and its effects on her life. The analytic focus on narrative revealed the distinctive constructions of illness and art-making that are usually submerged when qualitative analysis focuses on themes common to groups of participants. These narratives of art-making in CFS/ME have relevance to understanding the multi-faceted therapeutic benefits of art

Coping with chronic illness and disability through creative needlecraft

Chronic illness and impairment commonly restrict the individual's access to work and leisure activities. Furthermore, if increasingly dependent upon family care, the individual may experience loss of valued roles and self- esteem. A qualitative study was carried out on the written narratives of 35 women, aged 18 to 87 years. All had acquired a disability or chronic illness in adulthood, and although facing different health problems, they shared needlecraft as a common leisure pursuit. The narratives explored the circumstances in which needlecraft had been adopted as a leisure pursuit, and the personal benefits experienced. Most of the women had taken up this activity in adulthood to cope with the crisis of illness. Needlework activities were commonly viewed as providing a means of managing pain, unstructured time, self-image and reciprocal social roles. The women's accounts confirm the value of creative activity for patients learning to cope with chronic conditions

Some relationships between perceived control and women’s reported coping strategies for menopausal hot flushes

Objectives: This questionnaire study compared the patterns of reported coping strategies of women high and low in perceived control over hot flushes. Method: A volunteer sample of 38 women fully completed a postal questionnaire. Perceived control was measured by a standardised scale (Reynolds 1997a) and respondents provided qualitative accounts of coping. Results: Consonant with previous findings that higher perceived control is associated with lower distress, the data indicated that women high in self-rated perceived control tended to describe more numerous coping strategies to manage both the physical and socio-emotional discomfort of flush episodes. Preventive strategies were infrequently adopted in both groups. However, the links between distress, control and coping were complex and subject to several influences. Those feeling low in control tended to report rather more numerous flushes (although the differences did not quite reach significance). Also qualitative analysis of coping strategies suggested that it is not always coping behaviour per se that differentiates more and less distressed women, but attitudes towards these behaviours. A coping strategy (such as wearing cotton fabrics) that seems satisfactory to one woman may fundamentally challenge the body-image of another, increasing distress by making her feel drab and different from her pre-menopausal self. Also women often make reference to situational influences on their coping choices. Conclusion: The data support further enquiry into the role of psychological interventions to enhance strategies for coping with hot flushes

Perceived control over menopausal hot flushes: Exploring the correlates of a standardised measure

Objectives: A substantial minority of women report considerable distress during hot flushes. Coping with various chronic health problems has been related to perceived control in previous studies. Hence this study developed a standardised measure to investigate whether perceived control is associated with less distress during menopausal hot flushes. Method: The study presented a suitably re-worded 15-item scale (the Arthritis Helplessness Index, originally developed by Nicassio et al (1985). Scoring was reversed so that high scores signified greater perceived control. A volunteer sample of 43 women (mean age 51 years) completed the scale together with several further measures. Thirty five women returned 12 month follow-up questionnaires. Results: the Perceived Control Index (PCI) scores correlated with standardised measures of self-esteem and simple self-ratings (0-100) of perceived control, and remained very stable over 12 months. Self-rated distress during flush episodes was more closely related to perceived control than to more objective factors such as flush frequency and chronicity. Conclusion: These findings support further investigation into whether subjective coping with flushes may be improved by psychological interventions that enhance perceived control and self-esteem

Managing depression through needlecraft creative activities: A qualitative study

This qualitative study explored the personal meanings of needlecrafts and their role in the self-management of depression. Written and spoken narratives from 39 women were studied. Respondents described themselves as experiencing chronic or episodic depression (e.g. associated with stressful work situations, bereavement or caring for an ill relative). Some had received treatment for depression but most had not. When analysing the therapeutic effects of creative activity, most women described the experience of intense concentration in the task as providing distraction from worry and relief from depressive thoughts. Creative activity was often described as enhancing self-esteem. The adaptability of the occupation to suit time available, mood and other factors facilitated a sense of empowerment or control. Creative arts activities could also challenge depression from enabling social contacts. Most respondents had taken up their favoured creative activity in adulthood, commonly in response to stressful life events and with some self-awareness of its therapeutic potential. The diversity of subjective benefits support further research into the self-management of depression through creative activities, in both patient and non-patient groups. Managin

Distress and coping with hot flushes at work: Implications for counsellors in occupational settings

This study explored whether mid-life women regard hot flushes at work as a substantial stressor. A sample of 29 working women reporting hot flushes for at least 12 months rated the degree to which each of ten work situations influenced flush distress or discomfort. Ratings were compared with qualitative accounts of coping with flushes at work. Results showed that women differed markedly in the work situations that they regarded as most problematic, but flush distress was commonly magnified during formal meetings, in hot enclosed spaces and in the presence of male colleagues. A substantial minority viewed colleagues as conveying negative attitudes towards menopausal problems, which jeopardised general confidence at work as well as creating specific difficulties during flush episodes. Flush distress was higher among those reporting embarrassment and difficulties disclosing menopausal status to others. Respondents made suggestions for ways in which the working environment could be improved to assist women in managing hot flushes. Coping with flushes was largely seen as an individual rather than organisational responsibility. Other stigmatising health problems may present similar subjective problems at work and this needs further study. Some implications for counsellors working in organisational settings are explored

Exploring the meanings of artistic occupation for women living with chronic illness: A comparison of template and interpretative phenomenological approaches to analysis

(Brief Summary) This article is based on my experience of carrying out two studies that explored the meanings of artistic occupations (in particular, textile arts) for women who were living with long-term health problems (Reynolds 1997, Reynolds and Prior 2003). Inquiry into the meanings of occupation for people in the community who are coping with illness and life transitions is a growing area of occupational therapy research (for example, Christiansen et al 1999, Jonsson et al 2001, Lyons et al 2002). A better understanding of the phenomenology of occupation may help to inform professional practice

Long-term experience of vasomotor instability: A five-year follow-up study of perceived control, coping and distress

Objectives: Vasomotor instability can be a long-term feature of the post-menopause yet little is known about how women cope. This study followed up a group of women over five years, to examine whether current levels of flush-related distress/discomfort were associated with past and present control beliefs, catastrophic thoughts and coping strategies. A further aim was to validate two measures developed in previous research against conceptually relevant standardised scales