Using Art Participation to Promote Psychosocial Health Among People With Physical Disabilities: A Feasibility Study

Overview

This study aims to explore the feasibility of a newly developed theory-based inclusive art participation program for promoting psychosocial health of people with physical disabilities living in residential care homes. Specifically, the feasibility is assessed following the framework proposed by Bowen et al. (2009), which encompassed five aspects, including demand, implementation, practicality, preliminary effects, and acceptability. As for the preliminary effects, this project will evaluate self-esteem, sense of control, self-efficacy, mood, and social connectedness after the completion of program. This study will adopt a one group pretest-posttest approach with quasi-experimental design to collect both quantitative and qualitative data, employing a mixed-methods study design.

The World Health Organization (WHO) estimates that approximately 1.3 billion people, around 16% of the global population, are currently living with disabilities, encompassing mental, intellectual, and physical disabilities. Among those, over 30% of them experience physical disabilities. These numbers reflect that a large proportion of people in global experience mobility, dexterity, coordination, or stamina impairments, which may result from traumatic injuries, nervous system disorders, autoimmune diseases, or age related degenerative diseases. As a result, some people with physical disabilities are unable to take care of themselves and thus require assistance from family members or caregivers, while some further consequently reside in residential care homes to receive ongoing support. Although residential care homes offer essential medical and daily living support to people with physical disabilities who cannot be taken care of at home, these facilities have mainly prioritized physical care. While psychosocial needs are often addressed as a secondary concern or sometimes overlooked. On the other hand, current evidence reports that some residents with physical disabilities spend much of time physically and socially inactive. Due to limitation in mobility, many of them may not independently perform basic activities of daily living or engage in social interactions, which may bring a great loss of autonomy, competence, and relatedness to them, leading to psychosocial health issues. In recent decades, there has been an increasing interest in the use of art participation in healthcare settings to serve as a multidisciplinary approach to facilitate health of individuals. Growing evidence also supports the positive impact of art participation on psychosocial health of individuals in residential settings. Nevertheless, such evidence focuses on the population of older adults, people with dementia, and children with intellectual disabilities, while the benefits of people with physical disabilities in residential settings remain unclear. Furthermore, the scope of such evidence primarily underscores art participation as a tool for addressing health issues by non-verbal expression and non-judgmental environments. However, it overlooks the potential of art participation as a valued and inclusive social activity that affirms the rights of people with physical disabilities, meanwhile, contributes meaningfully to their psychosocial health. Moreover, there is a lack of understanding of the processes by which art participation supports communication, expression, choice, and autonomy of people with physical disabilities. Clearly, pediatric inclusive art participation program within residential settings requires both evidence and theory to move forward as a recognized program format. Based on such evidence, there is a need to conduct a more specific study that focuses on using inclusive art participation programs for residents with physical disabilities who experience physical and social barriers. Due to the lack of research on the continued examination of how the process of inclusive art participation benefit people with physical disabilities in residential care homes, developing a new inclusive art participation program for them is warranted to investigate its impacts. More importantly, the Medical Research Council (MRC) framework suggests that the stage of feasibility should be conducted to assess the procedure for developing and evaluating a complex program and to determine whether the definitive study can be undertaken in the future. Therefore, it is worthwhile designing a study to explore the feasibility of this newly developed program prior to conducting a large-scale study to examine its effectiveness.