Systematic Review: Expressive arts interventions to address psychosocial stress in healthcare workers

Aims: To synthesize evidence about the effectiveness of expressive arts interventions used to reduce psychosocial stress among healthcare workers.

Design: Quantitative systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources: SocINDEX, PsycINFO, Pubmed, CINAHL.

Review methods: Databases were searched from 1997-2017. Fourteen studies met the criteria for final selection.

Results: Most studies occurred in the US (N = 11). Of the 897 participants, 59% were nurses. Two studies were randomized controlled trials and the others were a variation of a 1-group or 2-group pre- or quasi-experimental study. The intervention characteristics included 50% art-based, 29% music-based, and 21% used storytelling or narrative. The length of intervention varied from 1 hr to 13 weeks; 5 lasted 6 weeks. Improved outcomes were found in 13 of 14 studies reviewed and the greatest improvements were seen in burnout, stress, and emotional outcomes. Overall, music and art-based interventions had greater impact on well-being than storytelling or narrative.

Conclusions: This systematic review provides preliminary evidence for the effectiveness of expressive arts interventions.

Impact: Care for others is a preeminent value in health care; however, this can come at the expense of caring for oneself. Psychosocial stress poses a significant threat to the well-being of the healthcare workforce. Expressive arts interventions provide a creative means for reducing caregiver stress to remain well and able to provide high quality care to patients. The use of arts for healing has global application because expressive arts intervention can be culturally tailored and relevant.