title: Art therapy based on appreciation of famous paintings and its effect on distress among cancer patients.
abstract: We aimed to evaluate the effectiveness of art therapy based on appreciation of famous paintings on the distress of cancer patients receiving radiotherapy. In particular, we focused on anxiety, depression, and cancer-related symptoms.
  
  
  
  Between October 2015 and February 2016, cancer patients receiving radiotherapy were recruited prospectively to participate in the art therapy based on famous painting appreciation. The art therapy took place in two parts comprising 4 sessions of famous painting appreciation and 4 sessions of creative artwork generation; these sessions were performed twice weekly over four weeks. Cancer-related distress was measured using the Hospital Anxiety and Depression Scale (HADS), Hamilton Depression Rating Scale (HDRS), and Edmonton Symptom Assessment Scale (ESAS) at three points: before the art therapy began, after the fourth session of art therapy, and after the eighth session.
  
  
  
  Of the 24 enrolled patients, 20 (83%) completed all eight sessions. We observed significant improvements in HADS anxiety and total scores over time according to linear mixed models with Bonferroni corrections (all p < 0.05). Furthermore, HDRS scores demonstrated significant decreases according to linear mixed models (p = 0.001). Fewer patients met the HADS or HDRS criteria for severe anxiety or depression after the intervention. We observed no changes in ESAS mean scores.
  
  
  
  Art therapy based on famous painting appreciation significantly improved cancer-related anxiety and depression and reduced the prevalence of severe anxiety and depression during cancer treatment.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeongshim
authors.initials: J
authors.lastname: Lee
authors.affiliation: Graduate School of Clinical Art Therapy, CHA University, Pocheon, Gyeonggi-do, Republic of Korea.
authors.forename: Mi Yeon
authors.initials: MY
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jiyu
authors.initials: J
authors.lastname: Sun
authors.affiliation: Graduate School of Clinical Art Therapy, CHA University, Pocheon, Gyeonggi-do, Republic of Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Park
authors.affiliation: Graduate School of Clinical Art Therapy, CHA University, Pocheon, Gyeonggi-do, Republic of Korea.
authors.forename: Ju Hye
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Graduate School of Clinical Art Therapy, CHA University, Pocheon, Gyeonggi-do, Republic of Korea.
authors.forename: Minchul
authors.initials: M
authors.lastname: Kang
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea. mdgold@yuhs.ac.|Cancer Information Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of Korea. mdgold@yuhs.ac.
authors.forename: Woong Sub
authors.identifier: 0000-0002-9435-7750
authors.initials: WS
authors.lastname: Koom
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy*; D001155:Art Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000532:radiotherapy; D010151:Paintings; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Art therapy; Cancer; Distress; Painting appreciation