Description
Book SynopsisThis book, written by academics across a range of disciplines, including healthcare and social sciences discusses the increasing use of the arts in healthcare research, which often stems from the recognition that for some topics of investigation, or when dealing with sensitive issues, the usual qualitative or quantitative paradigms are not appropriate. While there is undoubtedly a place for such approaches, arts-based research paradigms (ABR) offers, not only additional study and data-collection tools, but also provides a new and enjoyable experience for those involved.
The use of the arts as a medium to improve health and wellbeing was well documented by the World Health Organisation (WHO) in 2019, with over 3,000 studies conducted around the globe on the value of the arts in the prevention of ill health and promotion of health across the life span. This book examines how the arts, in a variety of forms, can be used by those working directly in healthcare settings as well as those involved in research across all health or patient settings. Covering a range of ABR genres, including literature (such as narrative and poetic inquiry); performance (music, dance, play building); visual arts (drawing and painting, collage, installation art, comics); and audio-visual and multimethod approaches, this user- friendly book will appeal to nurses, researchers in nursing and allied healthcare professions, as well professionals in the social sciences, psychosociology, psychology, literature and arts.
Table of ContentsPreface Chapter 1. Introduction to the book, its purpose and the context to which it is writtenHinsliff-Smith, McGarry, AliThis chapter will lay the foundation for the flow of the book including how it is intended to be used and read as a resource for practitioners and those interested in incorporating ABR or as a standalone research method within a healthcare context.
Chapter 2. Arts use within healthcare and what is the evidence across health care disciplines and professionsDr. Jamie Bird Sage Stephanou This chapter will outline the role of the arts within healthcare research from the perspective of the creative and expressive arts having a radical agenda to challenge the status quo. The arts give shape and voice to those experiences and lives that have been silenced and hidden by structural practices of prejudice and discrimination. The arts challenge the colonial and capitalist practices of domination and the mastery of human and non-human others through rationality, as they appear within academic research and healthcare practices. The arts bring imaginative, intuitive and embodied experiences into the same space as reason and logic in order to create a radical ethics of care, so that the marginalised becomes centred, and participants become the beneficiaries and co-producers of knowledge. Drawing upon the authors knowledge and practice of the use of the arts within therapeutic and research contexts, the chapter will expand upon these themes, putting forwards a structure for framing arts-based research within healthcare, that will make it appropriate for adapting to, and responding to, a changed society that we desperately need to imagine.
Chapter 3. “It is…, it stands for…, it shows…”: arts-based representations in data generation and analysis Nicole BrownArts-based approaches are employed because they allow researchers get closer to the participants’ experiences and emotions, because they help participants express experiences differently, and because they support participants’ processes of reflection and meaning-making. The benefits of arts-based approaches are therefore undisputed and often summarised as enabling richer, deeper data. In my contribution, I draw on my research into the lived experience of chronic illnesses and disabilities to highlight how two kinds of arts-based work leads to different forms and results in data and furthermore, how arts-based data generation lends itself to an arts-based analytical process. I argue, that the data is not necessarily richer or deeper, but different, which makes it insightful and exciting. I commence my chapter with an outline of the theory underpinning the work with metaphorical representations and object-work, before presenting two examples from my research: LEGO models and identity boxes that research participants produced. I then demonstrate how these representations in combination with conversations with participants lead to embodied, visceral responses, which, in turn and quite automatically, call for an arts-based approach to analysis. I show the benefits for researchers as well as participants and the wider society, when it comes to understanding and sharing experiences. I conclude with practical strategies and wider consideration of applicability of arts-based stance in data generation and analysis in healthcare research. Key words: metaphors, Lego, identity box, chronic illness, disability, fibromyalgia, arts-based analysis
Chapter 4. Proximity, accessibility, sensitivity, voice: the possibilities for arts based approaches in healthcareDr Julie McGarry Traditionally, two main research paradigms, broadly described as positivism (quantitative methodologies) and interpretivism (qualitative methodologies) have been used to describe the epistemological and ontological positioning of a researcher. The former derived from the natural sciences and the latter developing from the recognition of the differing meaning and nature of ‘knowledge’. Latterly however, even traditional qualitative approaches have elicited a degree of criticism in terms of their limitations to fully appreciate the ‘constant movement’ of social life. For example, Foster (2007) describes her rationale for using an arts based research approach as taking ‘into account a host of standpoints as well as capturing the complexities and not least, the beauty of life….the research process is every bit as key as the resultant findings’ (p363). Leavy (2015) further supports this approach in describing the ‘synergies between artistic and qualitative practices’ (p18). For example, highlighting that both seek to provide sensitive accounts of people, their situations and their lives in order to challenge dominant discourses and expose bias. Importantly, arts based approaches offer a medium thorough which participants may feel empowered to share their experiences through their own accounts rather than that of the researcher. This is arguably of central importance within the sphere of research that may be deemed ‘sensitive’, for example in hard to reach group or where the voices of participants have been largely unheard. The use of arts based research approaches as a way of exploring the lived experience of individuals therefore is also now recognised both within post-modern qualitative research methods (Foster, 2007) and within the context of informing professions in everyday practice. It has been argued that the value of personal narrative for example, lies in the reframing of the discourse of health and illness from one which is professionally dominated to one which holds the most meaning for the individuals concerned (Frank, 2013). A deeper exploration of these facets alongside examples from the authors own work form the basis for this chapter.
Chapter 5. Use of Personas and participative methods when researching with hard to reach groupsDr Parveen Ali The term hard-to-reach is frequently used within the fields of health and social care refers to those groups in society who experience distinct barriers to inclusion, participation and access to services and research especially when researching sensitive issues such as domestic abuse, experiences of inequalities etc. People often find it hard to share their views on this topic and researchers and professionals have to think of new ways to overcome this barrier and facilitate discussion. In such situation use or art can be helpful. Anything that makes one use their creative thinking, imagination and creative skills is classed as art. The purpose is to express emotions, feelings, concerns and issues about any phenomena. Use of personas or pen portraits thus can be classed as arts as it allows participants to explore and share their views, concerns and experiences by creating a new person. Personas are used to identify, understand and address the needs, motivations, attitudes and behaviours of a specific individuals or groups in a community. As people can explore issues in relation to the person described in pen portrait, it makes it easier for them to talk about sensitive healthcare issues. This chapter will explore how personas or pen portraits can be useful as a method to encourage the use of creative thinking, imagination and storytelling to facilitate discussions around sensitive issues such as domestic abuse. Examples from projects will be used to help explain how the method was used in practice. Keywords: Personas, pen portrait, creative thinking, imagination, arts
Chapter 6. Photo-elicitation: unleashing imagery in healthcare research Lucian Milasan“A picture is worth one thousand words” the old adage goes. For qualitative researchers in particular, who traditionally rely on language to convey meanings, this appears to be an advantageous transaction in the context of staggering levels of visual information encountered daily. It is estimated, for example, that approximately half a billion photos are added every day to social media platforms, without taking into account videos that are currently on a rising trend. Unsurprisingly, this represents only a small fraction of the avalanche of visual stimuli to which we are subjected, not to mention the “mental” images that we generate in a lifetime i.e. quasi-perceptual imagery resembling the actual experience, but occurring in the absence of external stimulatio It becomes clear from the theoretical stage that photo-elicitation, as with photography in general, is an innovative technique that has the potential to develop, and be developed alongside with, methodologies for which verbal and written language is essential. This advantage is due to the relative simplicity of the photo-elicitation method that consists in handing out photo cameras to research participants to capture aspects of the researched phenomena and discuss these with the researcher in interviews or focus groups (Harper, 2002). In most of the instances, photographs are produced by the research participants, also called “native image-making” (Wagner, 1979), but occasionally clippings from magazines (Larivière et al., 2015), images or video-clips downloaded from the Internet (Greco, Lambert, & Park, 2017), and visual images produced by the researcher (Glaw, Inder, Kable, & Hazelton, 2017), or a combination of those, are also utilised in photo-elicitation. Keywords: photography, photo-elicitation, interviews, (mental) health / healthcare, qualitative research
Chapter 7. At the Interface of Life Writing and Life Sciences: Eating Disorders Narratives of Lived Experience in English, German and French Literature Dr Heike Bartel & Dr Richard VytniorguLiterary narratives dealing with lived experience of eating disorders – from fiction and autobiographical writing to poetry and graphic novels – can deliver for those researching and working in healthcare important insights into these often misunderstood and stereotyped mental illnesses. However, such narratives are much more than useful delivery tools for content to benefit medical practice and science. Our chapter will outline how these texts at the interface of life writing and life sciences can raise pressing ethical and aesthetic questions about the articulation of the ‘voices’ of sufferers and survivors, the challenges to the authority of rigid medical systems as well as established literary traditions, the cultural formulation of illness and the potential of literary expression for recovery and change. Our comparative literary approach will focus on select text by female and male authors in English, German and French.Key words: eating disorders, mental health, autobiographical writing, Health / Medical humanities, patient voice
Chapter 8. How can Arts be used within the context of dementia care?Dr Emily CousinsHealthcare research is increasingly inter-disciplinary, accounting for multiple perspectives and paradigms. Taking the field of the arts and dementia as an example, this chapter will explore how its evidence base has been strengthened by blending methodological approaches from the humanities and sciences to demonstrate ‘what works’. Clinical research often assumes a quantifiable treatment, with a prescribed dosage to achieve particular outcomes. Conversely, the benefits and effects of arts interventions can be subjectively analysed using interpretive methods. Furthermore, the philosophy of person-centred care rightly gives voice to the expertise of people with dementia. How can researchers reconcile scientific rigour with creative understandings and personal insights of care and wellbeing? By combining mutually enhancing methodologies, it is possible to generate inter-disciplinary findings that are as robust as they are rich. Keywords: methodology; arts; dementia; taxonomy; paradigm
Chapter 9. Hand-drawn infographics: a tool for reflection and creativity in healthcare research and beyondJulia Reeve This chapter will draw on my experiences in creative researcher and academic development. It will provide the wider context of my work using arts-based approaches to research, plus supporting theory. It will then focus on the affordances of hand-drawn infographics in a healthcare setting, supported by visual examples. Visualising a research topic using analogue techniques such as drawing and collage provides researchers with:• A powerful tool for reflection, both on the self and the topic• A catalyst for creative thinking and the gaining of new insights• A vehicle for communication with diverse audiencesThe chapter will conclude with reflective, hands-on activities that can be applied to a variety of healthcare research settings.Key words: Infographics/Reflection/Communication/Visualisation/Drawing
Chapter 10. Use of writing letters and other literature forms to capture experiences of research participantsDr Heike Bartle, Julie McGarry, Kathryn Hinsliff-Smith and Gill LangWithin any form of qualitative research the researchers role is to help the participant share their experiences and for the researchers to translate and convey the messages often as interview themes and findings. However, often these traditional qualitative approaches to research are not appropriate and may cause undue distress and anxiety to the participant and also to the researcher. For example, with any tramatic or life affecting experience as often seen within healthcare, such as receiving a terminal diagnosis or other survivor stories. Use of letters and other written forms are a really useful medium to engage with patients who may find this aproach less intrusive, less intimidating and more acceptable to participate in. In this chapter the authors will share the expericnes of letter writing used when working with surviors of sexual violence, a topic that is not easily spoken about by surviors often women and girls.
Chapter 11. Collage, an often neglected Art form for use in research, using Canadian examplesDr Kimberley Fraser This chapter will address the use of collage as an arts based intervention to elicit, reflect on, and express stories. Collage is an effective strategy to attract a wide range of individuals because it does not require any prior knowledge of art making. Most of us learned to cut and paste in kindergarten making this arts-based activity a little more accessible to those participants who might not otherwise engage, perhaps feeling uncomfortable or unfamiliar with a specific medium such as drawing or painting. This chapter will describe the process used in a specific arts-based research study using collage and follow up interviews with family caregivers, the majority of whom were older adults. The approach to data analysis for collage and other arts-based products will be described. This chapter will conclude with an overview of three different innovative knowledge translation activities and events with clinicians (world-café), decision-makers (conference art-show), and the general public (display in a public art gallery with a public talk).Last chapter x3 Editors (Hinsliff-Smith, McGarry, Ali) Summary Chapter for the book drawing upon the many examples where ABR is described within this resource in order to ellicit an understanding of often very complex healtcare interactions. The book will draw upon work conducted across various healthcare settings by a range of different academic disciplines from a wide spectrum of social sciences including philsophy and education to healthcare professionals and clinicians working in research and healthccare settings. This resource will be applicabel for anyone intersted in ABR in any geographic setting.
Chapter 12. Conclusion Hinsliff-Smith, McGarry, AliChapter for the book drawing upon the many examples where ABR is described within this resource in order to ellicit an understanding of often very complex healtcare interactions. The book will draw upon work conducted across various healthcare settings by a range of different academic disciplines from a wide spectrum of social sciences including philsophy and education to healthcare professionals and clinicians working in research and healthccare settings. This resource will be applicabel for anyone intersted in ABR in any geographic setting.
