Promoting healthy ageing in care homes
: mixed methods feasibility exploration of engaging older residents in arts-based activities using digital health technology

  • Saima Nafis

    Student thesis: Doctoral ThesisDoctor of Philosophy


    Despite numerous health benefits of arts, cognitive, creative, cultural and digital health activities for older people, the care home population is often ignored and neglected from benefiting activities available outside of care homes. Age-friendly arts-based well-being software applications (apps) were found to provide digital health solutions by bringing museum arts and cognitive activities within care homes. Literature showed limited information about Arts-based digital (ABD) interventions for older people in care homes (OPLICH) in the UK. To fulfil the knowledge quest, this thesis aimed to explore the feasibility and impacts of ABD intervention on OPLICH. Formal ethical approvals were sought for three interconnected studies to answer exploratory research questions. The first study, evidence-based realistic review used an extensive literature search including mixed qualitative and quantitative methods. It revealed heterogeneousness and poor-quality studies for ABD interventions. A knowledge gap was found for a single theory and method to encompass ABD interventions. Two ABD apps, Armchair Gallery and ArtOnTheBrian were identified that were tailored for older people and incorporated culture (museum arts) and cognitive activities (games). Adapting the ‘Hierarchy of Needs’ and ‘Healthy ageing’ model, an empirical, ‘Needs-based Healthy Ageing Model’ (NBHAM) was created and tested as a theoretical framework of this research. The second focus group and consultation study aimed to assess residents, staff and research partners’ needs and readiness for ABD interventions. 17 people (9 staff & 8 residents) participated in the 3 focus groups study across two care homes. The results revealed the suitability of the Armchair Gallery app for the ABD intervention. The third mixed-method feasibility study was aimed to explore the health and social impacts of ABD activities in care homes using the Armchair Gallery app. The collaborative approach and involving care staff helped in refining the protocol for the ABD intervention. An experimental design (before and after) was used for the 6 weeks trial. 25 people (2 facilitators, 11 residents and 12 staff) were recruited. Using the idea of ‘Living Lab’, the researcher lived in the care home to deliver the ABD intervention. Two groups of 4-6 residents used the Armchair Gallery app for the weekly 45-60 minutes group ABD activities using iPads for six weeks. The activities blended traditional arts, crafts, cultural and cognitive activities. Multiple subjective and objective evidence-based data collection tools were used. Statistical (quantitative) and thematic (qualitative) analysis helped in triangulation and data validation. Most recruitment and retention targets were achieved. ABD intervention revealed positive changes in the quality of life, mental well-being, cognition, computer use, mood and emotions of the participating residents. Improvement in residents and staff’s confidence and social interaction was reported. The intervention was found enjoyable, empowering and engaging. The app was easy to learn and use. Overall, the ABD intervention was feasible and acceptable. This thesis has laid the foundation for future larger ABD intervention trials with its empirical theoretical model ‘NBHAM’ and presenting exploratory findings of the feasibility of ABD intervention in a replicable and transparent manner.
    Date of Award3 Dec 2021
    Original languageEnglish
    SupervisorHazel Barrett (Supervisor) & Andy Turner (Supervisor)

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