Social context, art making processes and creative output: A qualitative study exploring how psychosocial benefits of art participation during stroke rehabilitation occur

Purpose: To explore stroke survivors' and artists' beliefs about participatory visual arts programme participation during in-patient rehabilitation to identify benefits and potential mechanisms of action. Method: Qualitative design using semi-structured in-depth interviews with stroke survivors (n=11) and artists (n=3). Analysis: Data were audio-recorded and transcribed. Framework approach was used to identify themes and develop conceptual schemes. Results: The non-medical, social context of art facilitated social interaction, provided enjoyment and distraction from stroke and re-established social identity thereby improving mood. The processes of art making generated confidence and self-efficacy, setting and achievement of creative, communication and physical recovery goals that provided control over survivors situation and hope for recovery. Creative output involved completion of artwork and display for viewing. This enhanced self-esteem and improved mood, providing survivors with new identities through positive appraisal of the work by others. Self-efficacy, hope and control appeared to mediate benefits. Conclusion: This study provides a model of intervention components, mechanisms of action and outcome mediators to explain how art participation may work. Findings suggest that art may influence important psychosocial outcomes that other rehabilitation approaches do not typically address. The study paves the way for a future effectiveness trial. ▸ Implications for Rehabilitation • Participation in an art programme during rehabilitation appears to improve stroke survivors mood, confidence and self-esteem and enhances perceptions of hope and control over recovery. • Social interactions, the processes of art making and review and appraisal by others may be key intervention components from which benefits are derived. • Benefits from art participation may enhance survivors experiences of rehabilitation and appear to provide benefits that other rehabilitation interventions do not. • Art participation should be considered as an important adjunct to traditional rehabilitation.