Observational study of an Arts-in-Medicine Program in an outpatient hemodialysis unit.
BACKGROUND
Long-term hemodialysis is associated with impaired quality of life (QOL) and depression, which are thought to worsen compliance with the treatment regimen. With the success of our hospital's Arts-in-Medicine Program, we launched a similar set of activities in the long-term dialysis unit and sought to measure their effects.


METHODS
At baseline and 6 months, we administered the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and Beck depression scales to 46 patients (44% men; mean age, 52 years) and assessed their percentage of achieved dialysis time, interdialytic weight gain, and predialysis laboratory results. We tested for a relationship between these variables and Arts-in-Medicine Program participation (low and high; 51% and 49%). Arts in Medicine was offered each shift, led by artists, and included artwork, crocheting, crafts, seasonal displays, poetry, and playing musical instruments.


RESULTS
At 6 months, the patients, nurses, technicians, and physicians subjectively believed that Arts in Medicine had a positive impact on the unit. In paired comparisons to baseline, there was significant improvement in SF-36 scores for Role-Physical (mean values, 34.4 to 38.7; P = 0.04), less weight gain (3.6 to 3.2 kg; P = 0.02), greater serum carbon dioxide content (20.4 to 22.5 mEq/L [mmol/L]; P < 0.01), greater phosphate levels (5.3 to 5.7 mg/dL [1.71 to 1.84 mmol/L]; P = 0.04), and a trend to less depression (Beck score, 15.3 to 12.1; P = 0.07). Regression analyses showed that high participation correlated with improved SF-36 scores for Social Function (11.1-unit increase; P = 0.01), Bodily Pain (7.6-unit increase; P = 0.04), and Role-Physical (6.6-unit increase; P = 0.06), as well as a trend to greater albumin levels (0.11 g/dL [1.1 g/L]; P = 0.08), but with greater phosphate (0.8 mg/dL [0.26 mmol/L]; P = 0.01) and lower calcium levels (0.3 mg/dL [0.07 mmol/L]; P = 0.07).


CONCLUSIONS
Participation in a new Arts-in-Medicine Program correlated with improved QOL measures, and there were encouraging trends for depression, as well as certain laboratory and hemodialysis parameters.
Division of Nephrology, Hypertension, and Transplantation, University of Florida, Gainesville, FL 32610-0224, USA. rossea@medicine.ufl.edu
Edward A
EA
Ross
Tracy L
TL
Hollen
Bridget M
BM
Fitzgerald
D003863:Depression / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects*; D026421:Sensory Art Therapies