So happy together

The power of music and song to improve wellbeing is well known. But how can this power be harnessed to cater for individualised taste in care homes? The Musical Walkabout aims to do this

Challenges of implementing and embedding a programme to improve care for people with dementia on hospital wards

We recently took part in a national research project which evaluated an intervention to enhance person-centred care for people with dementia in hospital. The PIE (Person, Interactions, Environment) programme involves staff observing care on a ward, focusing on these three areas. Findings from observations form the basis for introducing changes to ward practices. Implementing PIE led to improvements in practice, but proved challenging in the current context of the NHS. Sustaining the programme following the research required key features to be in place, in particular the presence of a ‘driver’ to maintain momentum, the support of the ward manager to encourage ward staff to take part, and a degree of flexibility and persistence in the implementation of the programme. Staff expressed satisfaction from taking part in PIE, which continues to be a tool which is used to improve care in this area of practice

Effects of singing groups on staff well-being: a feasibility study

Aim The high levels of stress among NHS staff plus the evidence base for the value of singing for wellbeing, led to the current research aims: • To determine the feasibility of recruiting and retaining staff singing for wellbeing groups over three months and the acceptability of the proposed data collection methods. • To explore the potential impact of singing on staff wellbeing. Methods A feasibility study using a two-group, wait-list design with pretest, posttest measures plus participant feedback. Findings Recruitment failed to meet the target set and only 50% participants returned both pre and post singing questionnaires. Acceptability of the programme was high and, despite limited data, positive findings emerged in mental and work-related wellbeing, while participant comments were universally favourable. Conclusion This feasibility study suggests that proceeding to a full trial will require changes to maximise recruitment and retention. The impact of singing on the wellbeing of staff is potentially positive

Singing and COPD: exploring the experiences of people attending a group activity

Aim/objective To understand the lived experiences of participants with COPD attending a singing group. Rationale The research into singing groups for people living with COPD suggests that participants find the groups enjoyable and report it to be beneficial with regards to improving symptoms. However, the quantitative data from a companion paper (Clift, Skingley, Meadows and Dickinson, 2022) are not consistent with these findings and further research is needed to understand the underpinning explanations from the participant perspective. Approach Semi-structured interviews were conducted with five participants who have been diagnosed with COPD, recruited from a singing group designed to support them with breathlessness. Participants were asked about their experiences of living with COPD as well as of the singing programme. An Interpretative Phenomenological Analysis (IPA) approach was applied to the data gathered from these interviews. The Common Sense Model of illness representation was used to inform the analysis. Findings The study identified five explanatory themes: blame and the restrictive impact of COPD, changes in self-efficacy and a sense of control over COPD, positive social connections within the group, positive emotional and cognitive changes during and after the group, and the value of breathing techniques. Discussion and conclusion The participants reported stigma over their condition before the group and that COPD has a restrictive impact on their lives. Following attending the singing group, the participants experienced a change in their attitudes towards their condition, feeling a greater sense of confidence and control over their condition. The participants felt the factors involved in this change were the social connections both with their peers and the group leader, the positive emotional changes during and following the group and the impact of the breathing techniques they were taught. Future work should therefore aim to promote self-efficacy and self-management for participants

Singing and COPD: development, implementation and evaluation of a resource to support home practice and disease self-management

Aim To explore the use of a singing for health self-management resource for home practice within a programme of regular group singing for people with COPD. Rationale Research suggests that perceived symptoms of COPD can be improved through promoting self-efficacy and self-management of the condition. Previous literature on singing for breathing includes little detailed reference to any resources used to contribute to such improvement. This paper describes and evaluates a resource designed to address this. Approach The Singing for Better Breathing (SfBB) resource comprises a DVD of 13 films and accompanying handbook. It was developed as a practical tool for participants to use at home, as an adjunct to health education provided in an existing singing for COPD research project. The films progress through physical and vocal warm-ups plus songs which gradually demand greater vocal production and breath control. Participants were encouraged to keep diaries to record their experiences of using the resource. These were analysed using thematic analysis, supplemented by individual telephone interviews following the final session. With the onset of the Covid-19 pandemic, the resource was made available online. Findings Ten participants completed diary entries and were interviewed. All spoke positively regarding the format of the resource, and the majority found the songs to be engaging and uplifting. The use of singing as an exercise to promote breath control was reflected in a desire to demonstrate their achievements as well as the songs they had been able to sing at home. Discussion and conclusion The resource has continued to be popular, evidenced by its online uptake globally. Future related research should include a more detailed exploration of how those living with long-term health conditions might engage with and benefit from a singing for health resource to promote self-management

Evaluation of edna: arts and dance for older people

Purpose To evaluate the impact on health and wellbeing of participation in dance and arts activities by older people living in the community. Design A small-scale, mixed methods research design comprising pretest-posttest evaluation of a three month dance and arts programme. Two groups of older people underwent physical measures and completed a self-report quality of life questionnaire. Written comments and interview data were also gathered. Findings Physical tests (n=14) demonstrated improvements in posture, shoulder mobility and balance in both groups following the intervention, with some measures reaching statistical significance. Quality of life evaluations (n=21) also showed improvement, with the mental health subscale reaching statistical significance. Qualitative data showed that participants enjoyed the programme and felt physical, psychological and social benefits. Research limitations The research involved only a small sample of volunteers and a limited programme length which limits its generalizability. The absence of a control group means that causality cannot be inferred. Future research should extend recruitment to a wider geographical area and a longer intervention which includes a control group. Practical and social implications Future arts interventions for older people should include consultation prior to, and throughout the project. Commissioners should consider supporting arts for health projects, building in additional funding for evaluative work. Originality This study has added to the evidence base through combining art forms within a mixed methods framework, illustrating the interplay between the art forms, the outcomes and the potential role of social context. Keywords: Dance, arts, older people, health, wellbeing. Paper type: Research paper

Edna: energise dance nourish art

The vital need to maximise the health and wellbeing potential of the growing numbers within the older population is acknowledged at government level and among health professionals. A certain amount of research evidence exists to suggest that both visual arts and creative dance confer benefits to older people. In April 2013, North Kent Local Authorities Arts Partnership (NKLAAP) funded and produced edna – energise dance nourish art; a dance, arts, health and wellbeing project. The aim of the pilot project was to evaluate the benefits to health and wellbeing of dance and arts activities that were stimulating and developed for and with older people in Medway and Gravesend. Medway Older People’s Partnership (MOPP) and two professional artists were commissioned to support and deliver edna. Two groups of people over 50 years were formed in outreach community settings in the NKLAAP region (Local and Unitary Authority areas of Gravesham and Medway). NKLAAP also jointly commissioned The Sidney De Haan Research Centre for Arts and Health (SDH) and the Dance Science department of Trinity Laban Conservatoire of Music and Dance (TL) to undertake an empirical evaluation of edna. The research team included a Senior Researcher from SDH and a Graduate Intern from TL’s Dance Science Department. Specific physiological and psychosocial areas of health and wellbeing were chosen for assessment. The overall design involved a pretest-posttest descriptive study, incorporating validated research measures plus semi-structured interviews. Physiological assessments included postural assessment, range of shoulder mobility and balance. Psychosocial measures were collected using the World Health Organisation’s WHOQOL BREF, a quality of life (QoL) questionnaire1. A specially designed questionnaire was also used to capture general attitudes towards the project as a whole. Physiological research findings demonstrated statistically significant improvement of the left shoulder mobility within both groups and a trend towards improvement in the right shoulder mobility. Both groups saw a significant improvement in posture with the Medway group significantly improving in upper body and the Gravesend group in the lower body. For both groups there was a significant improvement in balance scores. Overall mean post-intervention QoL measures showed higher scores than at baseline, with a significant post-intervention difference in the psychological domain when compared to baseline. For participants in Medway the greatest change was in psychological and social domains. For Gravesend participants the greatest change was in the physical and psychological domains. Findings from this small scale pilot project suggest that dance and arts programmes have the potential to improve both physiological and psychosocial wellbeing of older people. It is recommended that commissioning agencies should consider including funding for such interventions in future plans and also support continuing evaluation to increase generalizability and to look at other variables in the physiological and psychological domains

Using music interventions in the care of people with dementia

The therapeutic properties of music have been recognised since antiquity. There is now a growing evidence-base to support claims to its benefit for individuals with certain health conditions, including dementia. It has been reported that music interventions can lead to improvements in cognition, behaviour and psychosocial well-being in people with the condition, as well as offering support for carers. There are a variety of types of music interventions that can be used, and it is suggested that nurses consider harnessing music’s potential as part of the care they provide. This article explores the evidence-based use of music in dementia care and outlines its potential benefits

Singing and COPD: a pilot randomized controlled trial of wellbeing and respiratory outcomes

Aims/objectives To test whether a ten-week regular weekly group singing programme, with guided home practice, leads to improvement in COPD-specific health status, as assessed by the COPD Assessment Test (CAT, primary outcome). To test whether the programme results in changes to health-related quality of life, mental health, breathlessness, lung function, functional exercise performance and breathing patterns (secondary outcomes). Rationale A number of randomized controlled trials (RCTs) exist which suggest that there are potential benefits to health and wellbeing of regular singing for people with COPD (Chronic Obstructive Pulmonary Disease). However, most rely on small samples, and findings across the different outcome measures are inconsistent, while interview studies tend to report consistent positive physical and psychological outcomes. Further research is therefore needed. Approach A single-blind, randomized controlled trial compared a structured, weekly group singing programme plus home practice between sessions over ten weeks, with a usual COPD treatment control. The sample was drawn from a local NHS population of people with COPD. Following baseline assessments, participants were allocated to a 10 week singing programme or a control. Findings Twenty-four individuals completed to follow-up. Measures at 12 weeks showed no significant differences between singing and control groups except for one item on the health status questionnaire (SF-36) which suggested the singers were less limited in their activities of daily living post-singing. Final follow-up, planned for 6 months post intervention, was aborted due to the COVID-19 pandemic. Discussion and conclusion The study failed to recruit to target. There remains a recruitment problem in RCTs of singing for COPD, resulting in inconclusive findings, which conflict with the positive qualitative evidence. A wide variety of reseach methods, as well as RCTs, are suggested to enable a better understanding of the impact of singing on COPD. Trial registration number: ISRCTN42943709

Research examples from the Sidney De Haan Research Centre for Arts and Health

The poster represents four major areas of the Centre's work: Singing for wellbeing; Dance and health; Cultural value; and Disseminatio