The effect of creative arts therapy and arts medicine on psychological outcomes in women with breast or gynecological cancer: A systematic review of arts-based interventions

Breast cancer and gynaecological cancer are two major diagnoses affecting women worldwide. Clinical research on arts-based approaches for these populations has gained a growing interest in the last decade with promising results. The purpose of this study was (a) to review evidence of arts-based approaches involving creative arts therapy (CAT) and arts medicine (AM) on psychological outcomes in women of both populations and (b) to evaluate the reporting of arts-based interventions. This systematic review examined randomized controlled trials and quasirandomized controlled studies with repeated measures. Researchers assessed each study for risk of bias using GRADE. A checklist called Reporting on Arts-Based Interventions was developed and applied to all studies included in this review. Researchers computed effect sizes for relevant outcomes. Searches identified 294 items producing 104 nonduplicate titles. Twenty-one items met inclusion criteria. These included a total of 1,703 participants (83.1% breast cancer, 16.9% gynecological cancer). CAT was applied in 10 papers (n = 646); AM in 11 (n = 1,057). For gynecological cancer, only two AM studies were found and no CAT studies were identified. Anxiety and depression were the most prevalent outcomes for both approaches across all studies. Overall, small to large effect sizes were found for AM studies and null to large effect sizes for CAT studies. Body image and sexuality were scarcely addressed. Intervention reporting was inadequate. The results suggest that arts-based interventions may be effective for improving psychological outcomes for targeted populations. Research for gynecological cancer patients is recommended, as are trials aimed at improving body image and addressing sexual function and related concerns. Enhanced quality of methodology and intervention reporting are critical.