Measurements of Results for Viewing Arts in Relieving Stress
Evidence for the effects of viewing visual artworks on stress outcomes: a scoping review
Abstruse
Objective To review the existing bear witness on the effects of viewing visual artworks on stress outcomes and outline any gaps in the enquiry.
Design A scoping review was conducted based on the Joanna Briggs Institute methodology for scoping reviews and using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Two independent reviewers performed the screening and information extraction.
Data sources Medline, Embase, APA PsycINFO, Cochrane Central, Scopus, Google Scholar, Google, ProQuest Theses and Dissertations Database, APA PsycExtra and Opengrey.eu were searched in May 2020.
Eligibility criteria Studies were included if they investigated the effects of viewing at least one visual artwork on at least one stress outcome measure. Studies involving active engagement with fine art, review papers or qualitative studies were excluded. There were no limits in terms of twelvemonth of publication, contexts or population types; however, only studies published in the English language were considered.
Data extraction and synthesis Information extracted from manuscripts included: written report methodologies, population and setting characteristics, details of the artwork interventions and cardinal findings.
Results xiv primary studies were identified, with heterogeneous study designs, methodologies and artwork interventions. Many studies lacked important methodological details and only four studies were randomised controlled trials. 13 of the fourteen studies on self-reported stress reported reductions after viewing artworks, and all of the iv studies that examined systolic claret pressure reported reductions. Fewer studies examined eye rate, heart rate variability, cortisol, respiration or other physiological outcomes.
Conclusions In that location is promising evidence for effects of viewing artwork on reducing stress. Moderating factors may include setting, individual characteristics, artwork content and viewing instructions. More than robust research, using more standardised methods and randomised controlled trial designs, is needed.
Registration details A protocol for this review is registered with the Open Science Framework (osf.io/gq5d8).
- complementary medicine
- mental wellness
- psychiatry
- social medicine
Data availability statement
Information sharing not applicative as no datasets generated and/or analysed for this study. No data are available.
http://creativecommons.org/licenses/past-nc/4.0/
This is an open access article distributed in accordance with the Creative Eatables Attribution Non Commercial (CC Past-NC 4.0) license, which permits others to distribute, remix, suit, build upon this work non-commercially, and license their derivative works on different terms, provided the original piece of work is properly cited, appropriate credit is given, whatever changes made indicated, and the use is non-commercial. Encounter: http://creativecommons.org/licenses/by-nc/4.0/.
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- complementary medicine
- mental health
- psychiatry
- social medicine
Strengths and limitations of this study
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A comprehensive scoping review was conducted using a broad and inclusive search strategy and a big multifariousness of databases were searched.
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The reviewers independently followed a structured and prepublished protocol for searching, screening and extracting data which followed the Joanna Briggs Constitute methodology for scoping reviews and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.
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But studies published in the English language were included, peradventure resulting in articles of other languages being missed.
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Slight deviations in the original protocol were performed in society to make the information screening more feasible.
Introduction
A number of studies and reviews have suggested that participation in the arts is beneficial for health.1–4 Because of this, many healthcare and workplace settings offer art programmes, including fine art therapy, music and visual art displays, to reduce stress and meliorate well-existence for staff, patients and customers.five However, there is little evidence that these programmes accept the desired effects and in that location is a need for a high-quality prove base of operations for art-based interventions.one iv
Engagement with arts tin be divided into active and passive participation. Agile participation involves making, creating or teaching arts.2 6 This includes art therapy (where an fine art therapist directs the creation of artworks to achieve a detail goal and foster improved mental health and well-beingness), as well as other arts-based interventions that are non goal driven and practise not require a trained professional.7 In contrast passive participation involves behaviours such as observing, viewing, listening and watching art.2 6 Passive viewing of artworks has the advantages of being an like shooting fish in a barrel, low-price and non-invasive intervention. This scoping review focused on the furnishings of passively viewing visual artworks and therefore excluded research pertaining to the active participation in arts.
There is some evidence that viewing artworks as an intervention is benign; however, this bear witness is not of uniformly high quality, is rarely critical, and is sparse, with many of import theoretical and evidential gaps. As well equally this, most of the show comes from anecdotes, descriptions and personal experiences, rather than empirical research.eight 9 Although many settings accept been used inside this research, including healthcare, art museums and laboratories, there is a paucity of evidence to demonstrate whether these settings affect outcomes differently. Demographics may be of import moderators as ethnicity, gender and age may influence preferences for certain types of artworks. Yet, rigorous research has yet to be conducted examining the influence of settings and populations.
Due to these limitations, it is important to review the existing evidence and identify any research gaps that demand to exist addressed. As the show base of operations is small and heterogeneous, a systematic review could non be accurately completed and would exist too restrictive, so instead a scoping review was conducted. The results tin can be used to directly future enquiry to make full these gaps before a full systematic review tin be completed.
At that place is no universally accepted definition of artworks as this construct has been inconsistent and debated. For the purpose of this review, artwork was defined equally 2-dimensional artistic works made primarily for their aesthetics, rather than whatsoever functional purpose. This definition was created from working definitions of visual and fine arts used in previous research.10 eleven Based on this definition, this review included studies on paintings, drawings and prints and excluded studies on sculpture, films, interior design or architecture. Photographs were just included if they depicted artworks, as it was deemed too difficult to decide the divergence between 'artistic' photography and 'not-artistic' photography based on the definition of artworks provided for this review. Digital artworks were included.
Viewing artworks is a form of visual environmental enrichment and is theorised to be stress-reducing through positive distraction.8 12 To explore this theory, the review focused on the effects of viewing visual artworks on stress outcomes. Both psychological and physiological stress outcomes were included.
Objective and research questions
The aim of this scoping review was to systematically identify the current testify available on the furnishings of viewing visual artworks on stress issue measures and identify research and knowledge gaps to help future research. The following research question was formulated: what research has been conducted on the effects of viewing visual artworks on stress outcomes in any populations and settings?
Several secondary questions were developed to map the available evidence:
What populations and settings were studied?
What study methodologies were used?
What stress outcomes were measured?
What type and content of artworks were viewed?
What was the duration of the artwork viewing and how many artworks were viewed?
Did the studies show changes in the stress outcomes?
Methods
A preliminary search for previous reviews on this topic was conducted on Google Scholar, Joanna Briggs Institute (JBI) Bear witness Synthesis and the Cochrane Database of Systematic Reviews prior to creating the protocol.
Protocol
A scoping review protocol was developed based on the JBI methodology for scoping reviews13 and using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.
Eligibility criteria
Studies had to meet the post-obit inclusion criteria; be a primary study where participants passively viewed at to the lowest degree one visual artwork every bit an intervention, including viewing paintings, drawings, prints, digital artwork or photographs of artworks, and measured at least i stress consequence measure (physiological or psychological indices). Measures of anxiety or mood were not considered as straight measures of stress and therefore brutal out of the scope of this review. Unpublished enquiry, including working papers, theses/dissertations and conference proceedings were included if they were identified by the search.
Studies were excluded if participants had active appointment in the arts (eg, studies on art therapy or the production/creation of art), the written report investigated the effects of interior pattern, compages, sculpture, films or photography not depicting artworks, and review papers, including systematic reviews, scoping reviews and meta-analyses.
Equally per the scoping review objectives, at that place were no restrictions in terms of populations, contexts, dates of publication or study designs. Still, during the screening phase, it was decided to exclude qualitative studies as these studies did not have clear stress outcomes, which was a key inclusion criterion. Merely studies published in the English language were considered.
Search strategy
To identify potentially relevant studies, the following electronic databases were systematically searched; Medline, Embase, APA PsycINFO, Cochrane CENTRAL, Scopus and Google Scholar (showtime thirty pages), with the help of a subject librarian. The search string combined a set of artwork and stress terms within each set with 'OR' and between the 2 sets with 'AND.' The search was start conducted using an extended list of search terms from the registered protocol; however, this search strategy resulted in a large number of irrelevant articles. Therefore, in the final search, some of the more ambiguous search terms were removed to refine the search further. For example, the term 'drawing' was removed as this could refer both to artistic drawings and 'drawing' claret. The last search strategies for 2 example databases are presented in table 1.
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Table one
Example search strategy syntax for databases
The gray literature was searched using the same search terms to place any unpublished studies. Grey literature databases searched included; Google (limited to the first xx pages), ProQuest theses and dissertations database, APA PsycExtra and Opengrey.european union.
A search was then conducted past mitt of the reference lists of relevant identified articles. Lastly, the 'cited by' feature of Google Scholar was used to come across if any of the relevant studies had been cited by undetected manufactures. All extracted references from these searches were imported to RefWorks and all duplicates removed. The final search was executed on 27 May 2020. The number of studies identified past the search strategy is shown in figure i.
Screening and study choice
Screening of the studies identified by the search strategy was conducted by 2 independent reviewers using a two-staged approach using the programme Covidence (www.covidence.org). Due to the high book and big number of unrelated studies identified, i writer initially screened the titles and removed any irrelevant studies, before the start stage. In the starting time stage of screening, two reviewers independently screened the abstracts for the eligibility criteria. If a written report'southward eligibility was judged to be uncertain, the commodity was included in the second stage. In the second stage, two reviewers screened the total texts of the studies to decide final inclusion or exclusion based on the eligibility criteria. The 2 stages were conducted past the reviewers independently, with the results of each stage discussed. Any disagreements related to eligibility of an article were discussed and agreement was reached. The two reviewers had overall 86% agreement. The number of included and excluded studies at each stage of the screening process is shown in figure 1, with reasons for exclusion.
Information extraction and analysis
Data were extracted from each included study into a charting form by the ii reviewers independently. This charting class was developed in accordance with the review questions. It included; publication details (ie, title, twelvemonth, authors), methodology (ie, aims, design, population characteristics, setting, outcomes, study registration, power analyses, comparator groups, randomisation and blinding), artwork details (ie, type and content of artwork, duration of artwork viewing, number of artworks) and key findings related to scoping review questions.
The charting form was iteratively refined during the extraction process to ensure all useful information was extracted. The charting course was first independently pilot tested by the ii reviewers on a random sample of iv studies. The reviewers discussed this process and amended the charting form by calculation a cavalcade about the artwork viewing directives given to the participants. Information extraction was then completed for the remaining studies independently by the two reviewers and any inconsistencies were discussed. This extracted data are reported in tabular and descriptive text format to answer the review questions.
Patient and public involvement
Patients and the public were non involved in whatsoever stage of this review.
Results
As shown in figure 1, the search strategy resulted in 3882 texts, which were screened for eligibility. Afterward the initial title and abstract screening, the full text was retrieved for 53 articles and examined confronting the eligibility criteria. During this process, three theses were found to take matching published journal manufactures and therefore were excluded every bit duplicates. The remaining excluded manufactures did not meet the eligibility criteria. This screening narrowed the studies downwards to xiv articles for inclusion.
The design and key findings related to the stress outcomes of each study are briefly detailed in table 2, with specific details regarding the secondary review questions provided in table 3. All 14 articles were primary studies published every bit journal articles. Apart from the duplicate theses mentioned above, no grey literature met the eligibility criteria for inclusion. The studies' publication dates ranged from 1972 to 2020. Viii studies came from Europe,9 14–20 4 from the USA10 21–23 and one each from Australia24 and New Zealand.25
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Table two
Summaries of the studies' designs and cardinal stress consequence findings
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Table 3
Overview of studies included in the review
Summary of study methodologies
Designs
The 14 studies had very different designs and methodologies (encounter table three). Only nine studies used a between groups design.ix 10 14 16 17 20 22 23 25 Another four used a within groups pattern, where measures were compared previewing to postviewing the artworks, with no comparator groups.15 18 19 24 The last study used a cantankerous-sectional design, measuring stress-reduction at one time point.21
Of the nine betwixt groups designs, half dozen used a no artwork control group as a comparator,9 10 17 twenty 22 23 and one used scrambled versions of the artworks.25 Krauss et al16 gave unlike viewing directives to each group and de Jong14 had groups with different fine art experience levels. Four of these betwixt groups studies were considered randomised controlled trials (RCTs).ix 10 16 xx
Settings
Six studies were conducted in an art gallery or museum,fifteen–19 24 iii in a laboratory,14 22 25 four in hospital rooms or hospital public spaces9 10 21 23 and one in senior citizens' apartments.20 These settings represent a mix of both naturalistic settings with high ecological validity and laboratory settings with loftier experimental command.
Populations
The majority of studies investigated healthy participants in the form of students,14 17 22 office workers15 or the general public.16 18 19 25 Other research used patient populations known to have loftier stress levels. Four studies investigated hospitalised patients,9 21 with two beingness paediatric samples.10 23 Lastly, D'Cunha et al24 investigated people living with dementia and Wikström et al,20 elderly women.
At that place is lilliputian research on whether population type affects stress reactions. Very few studies compared demographic factors, with the following exceptions. de Jong14 found that having different fine art feel affected outcomes. Iii studies found significant differences between the stress-reducing furnishings of viewing artwork between males and females.10 15 22 Lastly, one report compared results across different health weather condition, but found similar results between groups.21
Outcomes
Nine studies explored only physiological stress measures,14 16 19 20 23–25 three explored but psychological stress measures9 21 22 and the remaining two explored both.10 15 The psychological stress measures included; the Cox Mackay Stress Arousal checklist,26 a stress describing word checklist,27 Likert scales, and a distress thermometer.28 The physiological measures were mainly cardiovascular, including blood pressure, heart charge per unit and skin conductance, which were measured in eight studies. Salivary biomarkers were measured in three studies15 24 25 including cortisol, alpha-amylase and interlukin-half dozen. Respiration was measured in ii studies.ten 14
Registration details
None of the studies were preregistered.
Power
Sample sizes ranged from 27 to 826 participants; yet, only 2 studies conducted a ability analysis to determine their sample size. Krauss et al's16 power analysis gave a required sample size of at least 68, and a final sample of 75 was recruited. The power analysis in McCabe et al9 gave 200 participants and a sample of 199 were recruited; nonetheless, only 164 were included in the analyses. The other 12 studies did non provide a power assay. Law et al25 was a pilot study, and was not expected to conduct a power analysis to determine sample size. Therefore, information technology is difficult to determine if all studies were fairly powered.
Randomisation
All ix between-groups studies reported randomisation of participants to groups. However, the method of randomisation was not stated in many studies. Only four studies9 10 sixteen xx were RCTs.
Blinding
For most studies, it was difficult to bullheaded the participants, because in most cases participants were explicitly asked to view particular artworks, and therefore both the researcher and participants were aware of which artworks they were viewing. Nevertheless, ii studies did successfully bullheaded the written report equally both the researchers/nurses collecting the stress measures and the participants themselves were not explicitly made aware of the presence (or absence) of the artworks.23 25
Summary of the artwork interventions
Types of artworks
Ten studies used physical artworks. Most were original paintings, withal, one report used posters depicting artworks22 and another used a window mural.23 Another three studies used digital reproductions of artworks. Two used slideshows of digital images,xiv 25 whereas the third used the Open Window, which digitally projected artworks.9 The last study directly compared concrete artworks with their digital reproductions.xviii This report did not find whatever differences between the types of artwork, indicating that digital reproductions may be just every bit stress-reducing every bit physical artworks.
Content of artworks
The content ranged from representational nature images, to complex abstract artworks. Five studies provided an assortment of artwork content in 1 exhibition15 17 21 24 and therefore it could not be determined whether content was influential. Two studies investigated the effects of abstract artwork but did not compare these to another artwork type.sixteen 18 Another study14 compared the physiological effects of artworks rated to exist 'ugly' or 'beautiful.' Although the exact content of the artwork was non described, this study did find that participants had higher skin conductance and respiration rates while viewing the 'beautiful' paintings, compared with the 'ugly' paintings, demonstrating that the aesthetic content of the artwork may influence their effects.
Another four studies investigated the effects of viewing nature artworks. Two studies found that self-reported stress was lower when viewing nature artworks compared with abstract artworks.10 22 One study found that different aspects of nature might have stronger furnishings; a forest mural resulted in larger blood pressure decreases than an aquatic mural.23 Nature content may as well bear upon biological indicators of stress responses; cortisol levels decreased faster after a stressor in people viewing scrambled versions of nature artworks, compared with the original nature artworks.25
The remaining two studies9 20 did not report on the content of the artwork, and therefore, cannot be categorised.
Duration of artwork viewing
Nine studies reported the duration participants spent looking at the artwork (see table 3). This ranged from 2 min to over 48 hours. No study investigated whether changing the duration of exposure to artworks affected stress outcomes.
Quantity of artworks
About of the studies did not specify the exact number of artworks viewed. Of those studies that did specify a number, it ranged from one artwork to over 5300 in 1 exhibition. One-half of the studies had participants view a collection of artworks every bit an exhibition or fine art programme. Only two studies showed each participant one artwork and both were in paediatric hospital rooms.10 23 The other experimental studies ranged from viewing 4 to 26 artworks in 1 sitting, with the exact numbers provided in table 3.
Viewing directives
5 studies explicitly mentioned the viewing directives given to participants. The researchers from ii experimental studies told participants to attentively look at and explore each artwork,14 18 whereas the researcher in another study asked visitors to explore the art gallery in any manner they pleased.15 The remaining two studies asked participants to talk over and describe each artwork to the group during art programmes.twenty 24 1 of these studies24 had a trained art educator facilitating the discussions, whereas the other20 had a lead researcher, with no specified training.
Summary of key findings
All but i of the studies that measured self-reported stress institute a significant decrease later viewing artwork,10 15 21 22 with the final study showing no significant changes.ix A consequent decrease in systolic blood force per unit area was also constitute beyond the 4 studies measuring claret pressure.x 17 xx 23 Pare conductance and skin conductance variability both increased while viewing artworks.14 sixteen 19 The results for centre rate were mostly consistent. Two of the iii studies that measured heart rate found that viewing artworks decreased heart rate.19 23 The other study found that viewing cute paintings increased centre rate for students trained in fine arts and decreased heart rate for other participants.14
The cortisol and respiration results were less consequent. An art gallery visit decreased salivary cortisol levels15; however, a 6-calendar week fine art intervention for people living with dementia increased waking cortisol levels.24 Lastly, later on a stressor, salivary cortisol decreased faster in those viewing scrambled images, compared with those viewing landscapes.25 Viewing beautiful paintings lead to an increment in respiration rates in a salubrious sample.14 Whereas nature artworks in a hospital room decreased respiration rates in children.10 These studies all had different samples, settings and artworks which may take deemed for these mixed findings. Lastly both alpha-amylase25 and interleukin- 624 were each merely measured in 1 report and showed no meaning changes.
Discussion
This scoping review aimed to identify the bachelor bear witness on the effects of viewing visual artworks on stress outcomes and identify gaps in the inquiry. The 14 included studies demonstrate that research in this area is growing, with 10 studies beingness published in the final x years. There are a number of limitations to research in this area, including a paucity of RCTs, and heterogeneous methodologies and interventions. This scoping review was able to comprehensively identify the relevant research and descriptively present some evidence to address the research questions outlined in the introduction and identify gaps for futurity research, equally detailed below.
Overall, the preliminary findings from the included studies back up the claim that viewing artworks can reduce stress, in particular self-reported stress and systolic blood pressure. These preliminary quantitative results support qualitative enquiry showing that viewing artworks provides positive distraction from a hospital environs and lowers cocky-reported stress.9 12 29 The findings indicated that digital artworks tin have like stress-reducing effects to concrete artworks, thus increasing the avenues available for viewers. Artwork interventions tin can therefore be transposed onto computers, televisions, phones and tablets, as a portable, inexpensive and like shooting fish in a barrel intervention for stress-reduction.
Together the preliminary evidence suggest that the provision of artworks could reduce stress. Nevertheless, mixed findings combined with a lack of homologous methodologies mean that more than rigorous research is needed. Futurity research needs to utilize stronger methods including: acceptable comparator groups, power analyses to ensure sufficient sample sizes, clearly defined randomisation procedures and preregistration. If we examine the results from just the 4 RCTs, the show is fifty-fifty less conclusive. More detail on these studies and their findings are provided in table two; nonetheless, but one of the four RCTs showed significant effects for their principal hypotheses. Wikström et alxx found a significant subtract in systolic blood pressure after an fine art intervention. In contrast, McCabe et alix found no pregnant effects on distress measures, and Eisen et alx only establish significant effects when subgroup analyses of historic period were conducted. Lastly, Krauss et al16 did observe significant decreases in physiological stress when viewing artworks compared with baseline; however, they found no significant differences between the viewing directives provided, which was their principal hypothesis. Therefore, more RCTs however need to be conducted on this topic for clearer conclusions to be made.
The differences between the studies suggest important moderating factors, one of which is setting. The museum context may add to the effects of viewing artwork, as museum related factors may lead to greater appreciation of artwork.30 In addition, viewing artwork in a museum usually involves walking, which has its own stress-reducing effects.31 Laboratory studies remove some of these contextual factors and may provide more specific evidence for the effects of viewing artworks, just they have lower ecological validity. The hospital room is an important setting every bit patients are often confined to their room for long time periods and rooms are often deprived of ecology enrichment. Artwork could act every bit visual stimulation to positively distract patients from their stress, pain and medical conditions, and therefore it is suggested that artwork is placed in hospital rooms and waiting rooms. Artwork could also take stress-reducing benefits in other settings such equally waiting rooms and workplaces, which are often related to high stress. More research in these settings should be conducted.
Other possible moderating factors include individual characteristics, although picayune enquiry has investigated these. Gender differences were found in two of the included studies, with a trend towards females experiencing greater stress-reduction in response to nature artworks.10 22 I small survey found that African Americans and Caucasians have similar preferences for nature artworks32; however, no study has investigated whether culture affects the stress-reducing furnishings of artworks. Given the diverseness in cultures, demographics and individual preferences for artwork, it may be over simplistic to suggest that all individuals experience artwork the aforementioned mode.33
The findings indicate that the content and aesthetic qualities of artwork are also important considerations. Although mixed, the studies generally indicated that nature, especially greenery, may exist the almost stress-reducing. This is consistent with inquiry demonstrating that nature artwork is nearly preferred past adults34 and children.10 There are two main theories equally to why viewing nature is beneficial for humans. The evolutionary theory proposes that because humans evolved in a natural environment, nature is processed more efficiently and nosotros are predisposed to experience restoration.35 On the other hand, the attention restoration theory posits that nature can annul the mental fatigue caused by stress and therefore reduce cognitive strain.36 Thus, these two theories point to nature artwork equally having the greatest stress reducing effects, as demonstrated in this review. In contrast, abstract artworks can be seen as challenging, ambiguous and unclear for viewers, leading to increased stress.thirty 37 This is supported by the emotional congruence theory which posits that stressed people are probable to project their negative experiences and emotions onto ambiguous environmental surround, including artworks.5 Other artwork content could exist provocative and emotionally inappropriate for certain situations, eliciting anger and dislike. For example, a study past Ho et al33 found that sure provocative artworks elicited feelings of loneliness and hopelessness in viewers, suggesting artwork must be chosen carefully, with particular emphasis on the provision of nature artworks.
The mixed findings suggest that under some weather, viewing artwork may be physiologically relaxing, whereas under other conditions viewing artwork may exist physiologically stimulating. The direction of these effects may not only depend on the content of the artwork, but too the context and viewers' stress levels. Regardless of the direction of effects on physiology, lower self-reported stress may upshot.
Although this review focused on the stress-reducing furnishings of viewing artwork, it may also be of import to investigate the stimulating aspects of artwork. For certain populations, such every bit people living with dementia, visual stimulation and enrichment through artworks could improve other aspects of health, such as cognitive function.24 As discussed above, visual stimulation and enrichment may also be important to provide positive distraction from negative experiences. Three studies showed an increment in physiological stress.14 24 25 This increased stimulation may exist related to the content of the artworks ('beautiful' vs 'ugly' paintings,14 or landscapes vs scrambled images25) or the types of populations involved (people living with dementia24 and fine art students14). Therefore, the provision of stimulating artworks may be appropriate for certain situations, including for people living with dementia.
Pick may exist another important variable. This is particularly pertinent in settings where people have little control. Art Carts have been used in hospitals to let patients to cull which artworks to view during their stay to give them a sense of command over their surroundings.29 Two studies in this review9 20 gave participants a choice of artwork, however research is yet to investigate whether the element of choice affects stress outcomes.
Directives given to viewers may influence the way participants view artworks and therefore moderate the artworks' stress-reducing effects. Wikström38 previously discussed the importance of creating an art-dialogue when viewing and discussing artworks in social club to ameliorate appointment, understanding and empowerment. Other research33 demonstrated that the descriptions given to viewers about artwork could exist influential, and therefore this may be an important chemical element for studies to include. Even so, few studies reported the directives given. It is important for time to come research to report what directives were provided and investigate whether this is influential.
Finally, it is difficult to determine the dose-response relationship of artwork viewing. At that place was picayune consistency in the number of artworks shown to each participant, and no study investigated whether the quantity of artworks or viewing durations mattered. Therefore, future research could investigate the best artwork viewing duration and number of works.
Limitations
This review is limited by but including articles published in the English language. Manufactures in other languages could accept been missed. The review deviated slightly from the original protocol. Due to the big number of irrelevant articles identified using the original search strategy, the search terms were narrowed and the original title screening was only conducted by one reviewer. These deviations were required to make the search and screening more than feasible. This review did not include feet or mood measures or studies using qualitative methodology, as these outcomes were considered exterior the scope of the review.
Conclusions
This scoping review summarised the relevant research that investigated viewing visual artworks on stress outcomes. Fourteen studies met the eligibility criteria, with extracted results showing consistent reductions in self-reported stress and systolic claret force per unit area, but mixed effects on other physiological outcomes. All the same, there were only four RCTs, and there was high heterogeneity in research methodologies. Setting, individual characteristics, artwork content and viewing instructions may be of import moderating factors. More than robust research is recommended that uses standardised interventions, validated cess methods and RCT designs, to investigate the effects of viewing visual art on stress outcomes.
Data availability statement
Information sharing not applicative as no datasets generated and/or analysed for this written report. No data are available.
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