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Introduction

Over the past few decades, the use of the arts in health has blossomed. What, for many centuries, was seen as a fringe activity is now being recognized as a field that has enormous potential for having a positive impact on both individuals and societies. However, despite this surge in interest and activity, there is still limited support available for people working in the field. Although the number of practical training courses for artists is growing and more universities are establishing research groups, most training activity occurs in either practice or research; there are relatively few opportunities to gain parallel experience in both. Yet arts in health is an inherently inter-disciplinary field. Researchers are often involved in the conceptualization and implementation of the interventions they are researching, and practitioners are increasingly becoming involved in research. Consequently, the aim of this book is to provide a complete overview of how to go about designing and researching arts in health interventions.

Part I explores the context for arts in health interventions. In Chapter 1, we trace the origins of the use of arts in health, considering the place of the arts in medicine and medical philosophy across the last 40,000 years and the evolution of theory and practice in the field. Chapter 2 looks back at developments over the past 200 years in the concepts of health and medicine, exploring the emergence of models of health such as the biomedical model and biopsychosocial model, and identifying myriad ways in which the arts have been shown to impact on health and wellbeing in relation to these models. Chapter 3 identifies recent health policies and national arts agendas that have made space for arts in health and considers the opportunities these have presented for research and practice. In Chapter 4, we consider what arts in health today actually is: which activities are included within the field, how they have developed, and how the field as a whole relates to other fields such as medical humanities. Each area of activity is illustrated with case studies of projects and sources of further information.

Part II looks more closely at how to go about designing and delivering arts in health interventions. In Chapter 5, we look at how to conceptualize and plan an intervention, moving through a step-by-step process assisted by reputable business models and other healthcare frameworks that are being implemented in healthcare systems around the world to help develop targeted and effective health innovations. In Chapter 6, we move onto the practicalities of implementing an intervention, evaluating its success and planning for its long-term sustainability. Chapter 7 discusses how to identify suitable partners for a project, develop a project brief, draw up contracts, and deliver induction and training programmes. It also covers a topic at the heart of arts in health: how to fund projects. Chapter 8 then outlines some of the essential information for working in healthcare settings, including issues around patient safeguarding, occupational health, and suggestions for how to engage patients and staff in projects.

In Part III, we explore how to research arts in health interventions. Chapter 9 examines the differences between evaluation and research and considers when each is more appropriate. It explores some of the myths that surround arts in health research as well as providing recommendations for new researchers and sources of research findings. Chapter 10 then outlines a step-by-step approach to the research process, introducing different study designs and research methods and advising on how to select outcome measures. Chapter 11 provides a template research protocol, demonstrating how research ideas can be mapped into a research plan and raising some of the key practical points of consideration when designing a research project. Chapter 12 focuses on research ethics, discussing ethical practice and providing template information sheets and consent forms for participants involved in studies.

Finally, Part IV contains a fact file of arts in health research and practice. An overview of 13 of the most common areas of medicine is provided along with five key research findings for each area, some project ideas, and a wealth of further reading and resources designed to inspire future projects.

Naturally, different sections of the book will appeal to different people depending on their backgrounds. For example, for researchers or research students, discussions of research in Part III may already be well known, whereas the steps involved in establishing an intervention outlined in Part II may be new territory. Similarly, for project managers or healthcare professionals, issues such as how to identify arts partners discussed in Chapter 7 may be of particular interest, but details of working in healthcare settings in Chapter 8 may be part of day-to-day practice already. Whereas for artists and arts organizations, this may be the reverse. For those who are simply seeking to find out more about the field, the context described in Part I and the key research findings in Part IV may provide the most engaging information. Overall, the book as a whole aims to provide a full picture of arts in health research and practice and is structured to map onto the lifecycle of an arts in health project. Reading it from cover to cover will hopefully provide a framework for all readers on which previous knowledge can be hung and new information can be contextualized. In keeping with this, each chapter also contains suggestions for further reading for those who want to explore particular topics in more detail. Further reading is highlighted using the symbol Q. . However, the book can also be approached as a reference text, with specific chapters used to guide aspects of research and practice. In particular, the fact file in Part IV is intended as a resource that can be revisited as new projects are planned.

Overall, as the title suggests, this book focuses on arts in health interventions: practical projects involving participants. As outlined in Chapter 4, this can include a wide range of activities including participatory arts programmes for specific patient groups, general arts activities in everyday life, arts in psychotherapy programmes, arts in healthcare technology, and arts-based training programmes for staff. But that is not to say the book will be of relevance only to those working on such practical projects. The historical, theoretical, and political background covered in Part I, for example, is relevant to the entire field of arts in health, including, for example, the use of the arts in the design of healthcare environments. Furthermore, increasingly, other types of areas of arts in health activity that might not have historically always been participatory, such as the arts in healthcare environments and the arts to translate health education messages, are now being conceptualized and designed with participatory strands. As such, it is anticipated that the more practical guidance given in Parts II, III, and IV may also be of interest to research and practice across the entire field of arts in health.

In compiling a book such as this, there are far more examples of research, policy and practice around the world than can be captured in a single volume. A difficult decision was what there was not space to include. Consequently, this book takes a particular focus on activity in English-speaking countries, including the UK, Ireland, USA, Australia, Canada, and New Zealand. Nevertheless, particularly special case studies and examples from other parts of the world are drawn in across the book in reference to arts in health being very much a global phenomenon.

As the field continues to progress, it is hoped that research and practice will continue to have the close relationship that they currently have. Through their interaction, clear healthcare needs can be identified, effective interventions designed, tested and honed, impact measured, and successful programmes rolled out to benefit more people. It is through this close relationship that the worlds of arts and health will bring the most to one another and provide the greatest value to individuals and societies globally.

 
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