title: The effect of a creative art program on self-esteem, hope, perceived social support, and self-efficacy in individuals with multiple sclerosis: a pilot study.
abstract: BACKGROUND
  Creative art has been found to be beneficial to some patients with chronic illness. Little is understood about how creative art can benefit individuals living with multiple sclerosis (MS).
  
  
  OBJECTIVE
  The purpose of the pilot study was to determine if there was a difference in self-esteem, hope, perceived social support, and self-efficacy in individuals with MS after a 4-week creative art program.
  
  
  METHODS
  A one-group, pretest/posttest design was used. The convenience sample of 14 individuals was recruited from MS Centers and the National MS Society. They ranged in age from 29 to 70 years (M = 51.3 years, SD = 12.5 years). Participants included 14 women. The creative art program included week 1-watercolor, week 2-collage making, week 3-beading, and week 4-knitting. Each of the four weekly sessions was facilitated by a registered nurse with expertise in MS and lasted 2 hours. Creative artists instructed participants and provided a hands-on experience for each of the creative projects. Participants were free to share thoughts, experiences, and words of support and encouragement during each session. The variables were measured before starting the creative art program and after the final session. The instruments included the Rosenberg Self-Esteem Scale, the Herth Hope Index, the Modified Social Support Survey, the MS Self-Efficacy Scale, and a sociodemographic questionnaire. The Statistical Package for the Social Sciences Version 16.0 was used to analyze the data.
  
  
  RESULTS
  There was a significant increase in all variables after the creative art program as follows: self-esteem (t = -3.05, p = 009), hope (t = -3.96, p = .002), social support (t = -2.21, p = .046), self-efficacy to function with MS (t = -2.68, p = .019), and self-efficacy to control MS (t = 3.22, p = .007). The power analysis revealed a large effect size for hope (d = 1.06), self-esteem (d = 0.82), and self-efficacy (control; d = 0.86). A medium effect size was found for self-efficacy (function; d = 0.72) and social support (d = 0.59).
  
  
  CONCLUSIONS
  The creative art program was found to be effective and had a positive influence on self-esteem, hope, social support, and self-efficacy to function and control MS. Creative art has the potential to enhance the lives of those living with MS and should be investigated with a larger sample of participants.
authors.affiliation: Michelle Keating, RN OCN MSCN, is Cancer Nurse Educator, David C. Pratt Cancer Center, St. Louis, MO.
authors.forename: Cira
authors.initials: C
authors.lastname: Fraser
authors.forename: Michelle
authors.initials: M
authors.lastname: Keating
mesh_terms: D000328:Adult; D001155:Art Therapy / Q000379:methods*; D005260:Female; D065026:Hope; D006801:Humans; D008875:Middle Aged; D008923:Missouri; D009103:Multiple Sclerosis / Q000451:nursing* / Q000523:psychology*; D010865:Pilot Projects; D020377:Self Efficacy; D012938:Social Perception; D012944:Social Support; D011795:Surveys and Questionnaires