A qualitative exploration of stroke survivors’ and artists’ perceptions of the benefits and mechanisms of action of a visual arts creative intervention after stroke:a qualitative exploration

Background: Evidence suggests psychosocial benefits of art participation after stroke. This study explored stroke survivors’ experiences of a visual arts-based creative engagement intervention (CEI) within inpatient rehabilitation to examine how benefits occurred.Method: Participants: 11 previous CEI participants selected by age, gender and disability; three CEI artists.Data collection: semi-structured interviews conducted by a qualitative researcher. Topics included experiences, beliefs and benefits of CEI.Data analysis: Framework Approach facilitated by NVivo. A coding framework was developed and themes identified. Explanatory associations and thematic relationships were explored to develop higher order concepts. Disconfirming evidence was sought and respondent checking occurred to ensure interpretative validity.Results/Findings: Tailoring art activities to match preference, interests and abilities facilitated creative and physical goal-setting. Creative skill development and subsequent goal review enhanced confidence and perceived control over physical recovery, providing hope for life after rehabilitation. Expressive processes were absorbing, providing emotional reflection on stroke and recovery and enjoyment that enhanced mood. The art environment contrasted with wards and provided opportunities for social interaction that facilitated communication and enhanced mood. Celebration of the artwork provided appraisal by others that enhanced self-esteem and identity as artists rather than disabled survivors.Discussion: Understanding how the CEI structure, processes and environment influence outcomes is vital if we are to develop and test effective art interventions. Findings illustrate how discrete components influence psychosocial outcomes.Conclusion: Art participation provides a valuable adjunct to rehabilitation. This study shows how benefits may occur and indicates important outcomes for examination in an effectiveness trial