Pain Clinical Trial
Official title:
Can Art Therapy Improve Breast Cancer Patients' Perception of Persistent Post Treatment Pain and Functioning? A Mixed Methods Pilot Study
Art therapy offers benefits and support for a range of psychological symptoms caused by cancer and its treatments, for example anxiety, stress, depression, sleeplessness, identity or end of life concerns. Persistent post treatment pain that adversely affects quality of life may be experienced by up to 50% of breast cancer patients. Factors such as depression, fear, anxiety or lack of sleep are shown to increase pain and suffering in people with cancer. A multitreatment approach treatment of cancer pain is therefore recommended. Art therapy offers an opportunity to communicate the experience of suffering in a non verbal mode and can be offered in addition to other treatment for pain. This pilot study proposes to explore the effect of art therapy on breast cancer patients' perception of pain, and its impact on daily functioning by offering four sessions of individual art therapy, spaced between one to three weeks apart.
Art therapy is a type of psychotherapy that uses making art and creative processes to allow
patients to express feelings that may be difficult to put into words. It has been available
at The Royal Marsden NHS Foundation Trust since 1988. Patients are referred for a range of
issues that include isolation, anxiety, depression, identity or end of life issues. Research
has shown art therapy to offer significant improvements in these areas. There is much
anecdotal evidence within art therapy of it's effectiveness for physical pain, but little
research in this area. Pain itself is acknowledged as a complex phenomena that demands a
multifocused approach to treatment. The British Pain Society's guidelines recommend a
combined approach to treatment that includes psychological and complementary therapies, but
although music therapy is cited, art therapy is not. This study proposes to broaden the
research base into art therapy's effectiveness as an additional intervention to support
patients managing physical pain, and thus be able to be offered as additional support to the
interventions currently on offer.
Art therapy would, in practice be able to be offered concurrently to all other treatments for
pain, and at at any point in the treatment journey. However for the purpose of this study, in
order to understand art therapy's potential effectiveness, it is useful to narrow the focus
of the research. It is reported that up to 50% of breast cancer patients suffer from chronic
post treatment pain, that is, for an extended period of time after all treatment for cancer
and despite being optimally treated already for their pain. In consultation with the Pain
Team at the RM it was decided that breast cancer patients were a suitable cohort for this
study.
As this is the first study at the RM looking into art therapy and physical pain, it was
decided that a mixed method study would produce the most valuable data. Narrative data from
interviews will allow a greater understanding of participants experience of art therapy, and
how it might be effective for pain. Numerical data will give information on the extent of how
effective for pain art therapy might be. The sample size is small (20 participants) in order
to allow for in depth analysis of the narrative data. Previous research studies looking at
art therapy in oncology have offered between a single, to eight, one hour individual art
therapy sessions. Art therapy research in oncology that included pain as a criteria for
study, has offered a single, hour long session and examined data on its impact on pain
collected immediately after the art therapy session. As this study proposes to explore art
therapy as an intervention that may offer benefits for pain that develop over time, four,
hour long individual art therapy sessions have been decided on. This allows for an
understanding of whether art therapy may have any effect on pain beyond an immediate
lessening during an art therapy session.
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