What is the evidence base for Evidence-based Art? The Spring 2008 issue of journal HERD answers the question. It reminded me of the old Where’s the Beef? ads. It turns out the there isn’t much “beef” or “evidence” yet. But more is being learned all the time. What is known is summarized concisely in two paragraphs from the article in HERD called: A Review of the Research Literature on Evidence-Based Healthcare Design:
Rigorous studies on hospital art are sparse, and most have measured patient art preferences rather than effects on outcomes such as pain. The limited findings nonetheless show similarities to results from nature studies. Results suggest a consistent pattern wherein the great majority of patients prefer and respond positively to representational nature art, but many react negatively to abstract art (Carpman & Grant, 1993; Ulrich, 1991; Ulrich & Gilpin, 2003). Nanda, Hathorn, and Neumann (2007) displayed a diverse collection of 17 paintings to patients in their hospital rooms, and asked them to rate each painting for the following questions: (1) How does the picture make you feel, and (2) Would you like to hang this picture in your hospital room? Findings indicated that patients were significantly more positive about nature paintings (landscapes with verdant foliage, flowers, and water) than they were about best-selling pictures or even works by masters such as Chagall and Van Gogh (Nanda et al., 2007). The most positively rated painting depicted a gentle waterfall with vegetation. In the same research, representational nature paintings containing human figures and harmless animals such as deer were preferred over counterparts that were somewhat abstract. Eisen (2006) studied the art preferences of schoolchildren and hospitalized pediatric patients across four age groups: 5–7, 8–10, 11–13, and 14–17 years of age. Findings suggested that, irrespective of age or gender, the great majority of hospitalized pediatric patients and schoolchildren were similar in preferring nature art (such as a forest setting with lake and deer) over abstract or cartoon-like images.
Although nature pictures elicit positive reactions, there is limited evidence that emotionally inappropriate art subject matter or styles can increase stress and worsen other outcomes (Ulrich, 1991, 1999; Ulrich & Gilpin, 2003). It may be unreasonable to expect all art to be suitable for high-stress healthcare spaces, because art varies enormously in subject matter and style, and much art is emotionally challenging or provocative. The pitfalls of displaying emotionally challenging art are revealed by a study of psychiatric patients housed in a unit extensively furnished with a diverse collection of wall-mounted paintings and prints (Ulrich, 1991). Interviews with patients suggested strongly negative reactions to artworks that were ambiguous, surreal, or could be interpreted in multiple ways. The same patients, however, reported having positive feelings and associations with respect to nature artwork. Additional evidence on the stressful impact of abstract art comes from a study of a sculpture installation created for cancer patients in a large university hospital (Ulrich, 1999). Prominent in the installation were several tall metal sculptures dominated by straight-edged and abstract forms, many having pointed or piercing features. A questionnaire study found that 22% of the patients reported having an overall negative emotional response to the sculpture garden (Hefferman, Morstatt, Saltzman & Strunc, 1995). Many found the sculpture ambiguous (“doesn’t make any sense”), and some patients interpreted the sculptures as frightening and asked for a room change so they would not overlook the artworks (Ulrich, 1999).
Here are the references from these two paragraphs:
Carpman J. R. ,& Grant M. A. ( 1993 ). Design that cares: Planning health facilities for patients and visitors ( 2nd ed. ). Chicago:American Hospital Publishing, Inc.
Ulrich R. S. ( 1991 ). Effects of interior design on wellness: Theory and recent scientific research. Journal of Health Care Interior Design, 3 ( 1 ), 97–109.
Ulrich R. S. ,& Gilpin L. ( 2003 ). Healing arts.In S. B. Frampton, L. Gilpin, and P. Charmel (Eds.), Putting patients first: Designing and practicing patient-centered care. San Francisco:Jossey-Bass, 117–146.
Nanda U., Hathorn K. ,& Neumann T. ( 2007 ). The art-cart program at St. Luke’s Episcopal Hospital, Houston. Healthcare Design, 7 ( 7 ), 10–12.
Eisen S. ( 2006 ). Effects of art in pediatric healthcare. Unpublished doctoral dissertation. Texas A&M University, College Station, TX: Department of Architecture.
Ulrich R. S. ( 1999 ). Effects of gardens on health outcomes: Theory and research.In C. Cooper Marcus & M. Barnes (Eds.), Healing Gardens (pp. 27–86 ). New York:Wiley.
Hefferman M. L., Morstatt M., Saltzman K. ,& Strunc L. ( 1995 ).A room with a view art survey: The Bird Garden at Duke University Hospital. Unpublished research report, Cultural Services Program and Management Fellows Program, Duke University Medical Center, Durham, N.C.
To learn more about the Health Environments Research and Design Journal (HERD), the website is: www.herdjournal.com