Clinical Study

Oncology Received: October 2, 2019

Accepted: October 14, 2019
DOI: 10.1159/000504448 Published online: February 11, 2020

Art Therapy Sessions for Cancer Patients:

A Single-Centre Experience
Mathilde Gras a, b Elisabeth Daguenet b, c Christelle Brosse a Aurélie Beneton a
Stéphanie Morisson a
aDepartment
of Supportive Care in Oncology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez, France;
bUniversity
Department of Research and Education, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez, France;
cDepartment of Haematology, Lucien Neuwirth Cancer Institute, Saint-Priest-en-Jarez, France

Keywords
Art therapy · Cancer · Anxiety · Quality of life · Well-being
Abstract
Introduction: Cancer and anti-cancer therapies are often as-
sociated with pain, loss of self-worth, anxiety, and depres-
sion. Alternative therapies such as art therapy are available
to improve patients’ quality of life, by reducing asthenia, de-
pression, anxiety and pain. Objective: The aim of this study
was to assess the effectiveness of art therapy, namely theatre
and plastic art workshops, on well-being and quality of life
of participants in the Lucien Neuwirth Cancer Institute.
Methods: A prospective study was conducted at the Lucien
Neuwirth Cancer Institute (France), between April 2018 and
July 2018. Cancer patients followed at the Institute have
been asked to participate in 10 2-h sessions, once a week,
based on theatre and plastic art workshops. Self-report ques-
tionnaires were used to evaluate both psychological and
quality of life domains, but also satisfaction and well-being,
before (pre-test) and after the last session (early post-test),
as well as 1-month post-experimentation (late post-test). Re-
sults: Among the 14 patients who were enroled, the QLQ-
C30 questionnaire revealed a pre-test median score of 50.0,
an early post-test score of 51.5, and the late post-test re-
vealed a score of 48.0. The anxiety test revealed median
scores of 8.0 (pre-test), 6.0 (early post-test) and 6.0 (late post-
test), respectively. The depression test reported median
scores of 4.0 (pre-test), 5.0 (early post-test) and 6.0 (late post-
test), respectively. The median well-being score difference
observed between the beginning and the end of sessions is
+2.13. The minimum satisfaction score observed is 3.50 out
of 10, and the maximum is 10 out of 10. The median is be-
tween 7.00 and 10.00. Conclusions: Art therapy sessions had
an impact on patients’ welfare. We also reported a trend to-
wards amelioration of quality of life that could probably be
confirmed in a larger population, and potentially with a dif-
ferent methodology. © 2020 S. Karger AG, Basel
Introduction
Cancer and anti-cancer therapies are often associated
with life-changing impacts for patients: pain and other
discomfort symptoms, body image modification, loss of
self-worth, familial and social isolation, anxiety, and de-
pression [1–7]. To help manage these issues, different
treatments or options can be proposed, including drug
therapies, psychological support, diet measures and/or
social follow-up. Patients can also have access to comple-
mentary therapies, such as relaxation, sophrology, hyp-
notherapy, osteopathy, or acupuncture [8–10].
193.51.85.197 - 2/12/2020 4:40:55 PM

© 2020 S. Karger AG, Basel Dr. Stéphanie Morisson

Department of Supportive Care, Lucien Neuwirth Cancer Institute
108 bis, Avenue Albert Raimond
karger@karger.com
BP 60008 FR–42271 Saint-Priest-en-Jarez (France)
Université de Paris

www.karger.com/ocl
Downloaded by:

stephanie.morisson @ icloire.fr
 Art therapy has been used in the care of cancer patients Table 1. Baseline characteristics of the study population
for many decades and it is increasingly used in oncology
departments or palliative care units. It is based on the idea Variables Number Percentage
that creativity has a therapeutic effect, and that expression Age, years
of fear, anxiety, and pent-up emotions could enhance Median (range) 49.5 (25–71) –
well-being and quality of patients’ life. Art therapy is a Sex
real way of expression and communication for patients Female 12 85.7
Male 2 14.3
but also for their loved ones, utilizing creative modalities,
Primary cancer
including sculpture, drawing, and painting, theatre, and Breast 6 42.9
music ways. Through these methods, patients can share Lung 2 14.3
their lived experience and sensations to stand by their Ovary 2 14.3
feelings. Art therapy sessions offer a time to communi- Upper aero-digestive tract 1 7.1
Pancreas 1 7.1
cate, to be listened to, to de-stress, and to enjoy, where the Intestine 1 7.1
suffering subject feels recognized as a person and not as a Myeloma 1 7.1
patient anymore [11–13]. Professional activity
The use of art therapy in cancer care settings is increas- Sick leave 8 57.1
ingly noticeable over recent years. Interestingly, studies Retirement 3 21.4
Part-time job 2 14.3
showed an improvement of quality of life (QoL), and a No job 1 7.1
reduction of discomfort symptoms, such as asthenia, de- Patient transportation
pression, anxiety and pain [14–23]. Personal vehicle 12 85.7
From a perspective of QoL amelioration, the Lucien Taxi 1 7.1
Neuwirth Cancer Institute, in relationship with the Ligue Public transport 1 7.1
Contre le Cancer, organized art therapy sessions for can-
cer patients, who are followed at the Institute. Our aim
was to assess the effectiveness of art therapy, namely the- (early post-test), as well as at 1-month post-experimentation (late
atre and plastic art workshops, on well-being and QoL of post-test). Psychological distress was assessed using the Hospital
participants. Anxiety and Depression Scale, a 14-item inventory comprising 7
anxiety-related symptoms and 7 depression-related symptoms.
The QoL was rated with the EORTC-QLQ-C30 that encompasses
6 domains (i.e., physical function, role function, emotional func-
Methods tion, pain, fatigue, global health/QoL). All patients were also asked
to express their expectations regarding these art therapy sessions
Study Design and Study Population and to indicate their concomitant treatments, in particular antalgic
We conducted a prospective study at the Lucien Neuwirth Can- and anxiolytic treatments. Patient and study details were obtained
cer Institute between April 2018 and July 2018. Cancer patients from the medical records and interviews with the subjects. After
receiving or having received chemotherapy and/or radiotherapy the study period (14 weeks), no further follow-up was planned.
were eligible to participate: diagnosed with cancer, independently Finally, we surveyed patients’ satisfaction before and after each ses-
of the stage, aged ≥18 years, good performance status, could com- sion with a visual well-being scale, graduated from 0 (not satisfied
municate and understand the questionnaires, could attend the at all) to 10 (fully satisfied), as a proxy to evaluate art therapy im-
planned workshop sessions. plementation at the Lucien Neuwirth Cancer Institute.

Art Therapy Workshops Statistical Analysis

The patients were trained, guided and monitored by two pro- The descriptive statistics used were frequency or mean stan-
fessional art therapists. The study planned 10 2-h sessions, once a dard deviation. No statistical test was performed. Only a descrip-
week, based on theatre and plastic art workshops. Each session tive analysis of the results was carried out. Median values were
comprised two parts: body and voice warm-up (i.e., respiratory given with their ranges.
exercises, movements, and voice games), individual or collective
theatre and plastic art games (i.e., living painting improvisation,
painting, corporal awakening). The end of each session was char-
acterized by a sharing time on creations/works as well as a com- Results
mon discussion on emotions felt before and after the activities.

Questionnaires and Data Collection Baseline Characteristics of the Population

Self-report questionnaires were used to evaluate both psycho- Among the 14 patients screened for this study, 14 pa-
logical and QoL domains before (pre-test) and after the last session tients were included, and most patients were women
193.51.85.197 - 2/12/2020 4:40:55 PM

2 Oncology Gras/Daguenet/Brosse/Beneton/Morisson
DOI: 10.1159/000504448
Université de Paris
Downloaded by:
(86%). Their median age was 49.5 years (range, 25–71 Table 2. Concomitant treatments at the 3 assessment points
years). The main primary tumour location was the breast
(n = 6, 42.9%), followed by the lung (n = 2, 14.3%) and Pre-test, Early post-test, Late post-test,
n (%) n (%) n (%)
ovary (n = 2, 14.3%). Most patients were on sick leave
during art therapy session (n = 8, 57.14%), other ones Anti-cancer 11 (73.4) 12 (66.6) 14 (82.3)
were on retirement (n = 3, 21.4%), 2 participants were in Analgesic 2 (13.3) 4 (22.2) 2 (11.8)
part-time job (14.3%), and 1 participant had no job dur- Antidepressant 2 (13.3) 1 (5.6) 1 (5.9)
Anxiolytic 0 (0.0) 1 (5.6) 0 (0.0)
ing the sessions (7.1%). Three different means of trans-
portation were used by patients: personal vehicle (n = 12, Total 15 (100.0) 18 (100.0) 17 (100.0)
85.7%), taxi (n = 1, 7.1%) and public transport (n = 1,
7.1%). The detailed baseline characteristics are shown in
Table 1.
Table 3. Median questionnaires scores and standard ratios at the 3
Before, during, and 1 month after sessions, patients’ assessment points
concomitant treatments were reported. They were main-
ly anti-cancerous treatments whatever the observed pe- Pre-test Early Late
riod (n = 11, 73.4% in pre-test; n = 12, 66.6% in early post- post-test post-test
test; n = 14, 82.3% in late post-test). The second mostly
QLQ-C30
used treatment was analgesics (n = 2, 13.3% in pre-test; Total scores 50.0±9.2 51.5±11.5 48.0±8.9
n = 4, 22.2% in early post-test; n = 2, 11.8% in late post- HADS
test). Finally, antidepressants and anxiolytics were less Anxiety scores 8.0±4.9 6.0±4.2 6.0±4.4
used (between 5.6 and 13.3% for antidepressants, and 0.0 Depression scores 4.0±3.7 5.0±3.0 6.0±3.6
and 5.6% for anxiolytics). Concomitant analgesic, anxio- Total scores 11.5±7.6 12.0±5.7 14.0±5.1
lytic, antidepressant, and anti-cancerous treatments are HADS, Hospital Anxiety and Depression Scale.
reported in Table 2.

Art Therapy Sessions, Experiences and Expectations

Most of the patients did not experience art therapy
(n = 9, 64.3%) before sessions. Motivations for participa-
tion were numerous, such as changing one’s mind, meet-
ing people, discovering art therapy, and expressing one’s
feelings. Regarding the attendance to the sessions, only 2
patients attended all sessions (14.3%), while 5 patients
were absent one time (35.7%). The other participants at-
tended between 3 and 8 times. Reasons of non-attendance
were diverse: medical appointments (n = 9, 34.6%), asthe-
nia (n = 5, 19.2%), death of a relative (n = 2, 7.7%), pain
(n = 1, 3.9%), or personal reason (n = 1, 3.9%). Of note, 1
patient was absent in 6 sessions because he did not feel
comfortable with the group, probably due to his young
age as compared to the other participants.
Effect of Art Therapy on QoL, Anxiety and Depression
All patients taking part in art therapy completed the
questionnaires before the beginning of the sessions (pre-
test), after the 10 sessions (early post-test), and 1 month
after the end of art therapy sessions (late post-test). The
results are presented in Table 3.
The QLQ-C30 questionnaire is an auto-evaluation,
evaluating 5 functions, 9 symptoms, and global health
state [24].
The median score obtained on pre-test is 50.0 with a
standard deviation at 9.2. The early post-test median
score is 51.5 with a standard deviation at 11.5, and the late
post-test reveals a score of 48.0 with a standard deviation
at 8.9.
The Hospital Anxiety and Depression Scale question-
naires were also completed on pre-test, early post-test,
and late post-test. A high “A score” reveals anxiety trou-
bles, and a high “D score” reveals depression troubles.
Each score is between 0 and 21.
The anxiety pre-test median score is 8.0 with a stan-
dard deviation at 4.9. The median score in the early post-
test period is 6.0 with a standard deviation at 4.2, and the
late post-test median score is 6.0 with a standard devia-
tion at 4.4.
The depression score is 4.0 with a standard deviation
at 3.7 in the pre-test and 5.0 with a standard deviation at
3.0 in the early post-test period. To finish, the median
score is 6.0 with a standard deviation at 3.6 in the late
post-test period.
Total Hospital Anxiety and Depression Scale scores
are 11.5 ± 7.6 in the pre-test, 12.0 ± 5.7 in the early post-
test, and 14.0 ± 5.1 in the late post-test period.
193.51.85.197 - 2/12/2020 4:40:55 PM

Art Therapy Sessions for Cancer Patients Oncology 3

DOI: 10.1159/000504448
Université de Paris
Downloaded by:
 Color version available online
12 Q1
min
median
10 max
Q3
8.50 8.75
8 8.00 7.88 7.88
7.75 7.75 7.50
6.88 6.75 6.75 7.00 7.00
6 6.00 6.00 6.25
5.63

4.50
4
3.00 3.00
2

0
Before After Before After Before After Before After Before After Before After Before After Before After Before After Before After
Session 1 Session 2 Session 3 Session 4 Session 5 Session 6 Session 7 Session 8 Session 9 Session 10

Fig. 1. Well-being before and after each session.

Color version available online

12

10 10.00
9.75
9.00 9.00 9.00 9.13
8.50
8 7.88
7.05 7.00
6

4
Q1
min
2 median
max
Q3
0
Session 1 Session 2 Session 3 Session 4 Session 5 Session 6 Session 7 Session 8 Session 9 Session 10

Fig. 2. Global satisfaction for participants at each session.

Well-Being
Well-being before and after each session is reported in
Figure 1. Differences were calculated: the minimal differ-
ence observed is −8.5, meaning that the patient was in a
worse mood than before the session. Maximum differ-
ence observed is +8.0, and the median is +2.1.
Satisfaction
Figure 2 represents global satisfaction for participants
at each session. The minimum observed is 3.5 out of 10,
and the maximum is 10 out of 10. The median is between
7.0 and 10.0.
Discussion
This study revealed a trend towards QoL amelioration
and a real satisfaction for participants, despite a small and
heterogeneous population, and recruitment difficulties.
Indeed, group constitution was time-consuming and has
taken approximately 3 months.
The first difficulty was the homogeneity of the popula-
tion. Different pathologies were represented (breast or
lung), in accordance with data that we can find in the lit-
erature [15, 16]. There were 12 women and only 2 men in
art therapy sessions. Many studies showed that mostly
women participate in art therapy sessions [16], explain-
193.51.85.197 - 2/12/2020 4:40:55 PM

4 Oncology Gras/Daguenet/Brosse/Beneton/Morisson
DOI: 10.1159/000504448
Université de Paris
Downloaded by:
ing the few prostate or lung cancers, frequently treated at
our Institute [10]. However, the initial idea was to recruit
only patients with cerebral tumours, because they often
present communication difficulties, and art therapy could
be a solution to enhance this point. Sharing the same pa-
thology could also facilitate communication within the
group. But the health state of this kind of patients worsens
quickly and we were unable to form a group. Therefore,
sessions were opened to all pathologies.
The second difficulty was the way of transport, because
patients had to be able to come to sessions with their own
transportation. Almost all patients took their personal ve-
hicles to come. Patients should be in good health to drive
and this could be a bias for recruitment: too weak people are
not able to come to sessions, even if they would want to.
Three months were necessary to recruit enough partici-
pants. During this time, many patients’ health state wors-
ened, and they either cancelled their participation or came
to sessions all the same, but impaired. Health state could
explain important absenteeism. Indeed, it was difficult to
obtain a full group for each session: this is the disadvantage
of having a fixed day, because Thursday is probably not the
day where most people are available. Furthermore, partici-
pants were patients, so they had a lot of medical appoint-
ments. One patient was regularly absent, because he felt
younger than the other ones in the group: maybe the popu-
lation was not enough heterogeneous concerning partici-
pants’ ages. Interestingly, Koom et al. [17] and Bar-Sela et
al. [18] also reported high absenteeism. Furthermore, pa-
tients were mostly on sick leave during art therapy session
(n = 8, 57.1%), and other ones were on retirement (n = 3,
21.4%), or in part-time jobs (n = 2, 14.3%).
Anxiety and depression scores were globally quite sta-
ble, whereas in the literature, a depression score ameliora-
tion [18, 22], or an amelioration on both scores is often
observed [14, 16, 19, 21, 23]. More sessions might be nec-
essary to observe this amelioration.
Concerning well-being, we can also report a good im-
pact. Indeed, median and maximum scores were globally
improved after each session. Last but not least, maximum
scores of well-being increased after each session, and min-
imum scores enhanced for all sessions, excepted for ses-
sions 4, 5, 6, and 7. It was neither the same patient at each
session who chose the minimum score, nor the same pa-
tient at one session who put the minimum before and after
the session. This could mean that some sessions were
more liked than other ones, and patients did not prefer the
same sessions. It could come from different expectations,
as previously mentioned: “change one’s mind, meet peo-
ple, discover art therapy, and express one’s feelings.”
Art Therapy Sessions for Cancer Patients
Well-being score amelioration was associated with an
important global satisfaction, with medians between 7
and 10, and results always equal to or higher than 5, sug-
gesting that patients were quite satisfied. Forzoni et al.
[11] reported in their article that 94% of participants de-
scribed their art therapy experience as “helpful.” Indeed,
these data have clinical implications, as they showed that
art therapy may be useful to support patients during the
stressful time of chemotherapy treatment. Different pa-
tients used it to fulfil their own different needs, either be-
cause there is a need to relax (improved mood) or to talk
(self-narrative) or to visually express and elaborate emo-
tions (discovering new meanings).
Regarding pain, Lefèvre et al. [21] reported a signifi-
cant pain reduction. This reduction was not reported in
our study, because among the selected population, no
participant presented pain: only 3 patients out of 14 used
analgesics at baseline. One month after the sessions, only
1 patient still took analgesics. So, few patients were in
pain, or with uncontrolled pain. Only one absence was
due to pain.
Sessions proposed by the professionals included paint-
ing and theatre. Other art therapy session types might be
more suitable to enhance QoL, and to decrease stress and
anxiety, such as music therapy [25]. By diversifying the
offer, workshops could also become more attractive for
patients.
Despite the beneficial impact on QoL (QLQ-C30 score
amelioration) in the present study, further investigations
on a larger population might be necessary to confirm that,
as observed in other studies such as those by Koom et al.
[17] on 50 patients, Svensk et al. [20] on 41 patients, or
Bozcuk et al. [22] on 48 patients. Our population of 14
patients might have been too small to observe a signifi-
cant difference.
Conclusion
Art therapy sessions have been appreciated by pa-
tients, who reported high satisfaction and high well-being
scores. We can conclude that art therapy sessions have a
positive impact on patients’ welfare. We also reported a
trend towards QoL amelioration. Yet, this has to be con-
firmed in a study with a larger population, and poten-
tially with different workshops, such as music therapy.
Pain investigation is another endpoint to follow. Collec-
tive efforts have to be put to permit access to these work-
shops for all patients, in order to promote art therapy as
a novel and efficient supportive care in routine praxis.
193.51.85.197 - 2/12/2020 4:40:55 PM
Oncology 5
DOI: 10.1159/000504448
Université de Paris
Downloaded by:
 Acknowledgements Disclosure Statement

We would like to thank the Ligue Contre le Cancer Loire that The authors have no conflicts of interest to declare.
allows us to set up art therapy sessions. Many thanks to the Marche
Bleue association that recruited two art therapists, Anne Jalard and
Camille Chaslot, who performed art therapy sessions. These pro-
fessionals took time to constitute groups, and to answer partici- Funding Sources
pants’ questions. They were really appreciated by the patients.
The “Ligue Contre le Cancer Loire” offered to “Marche Bleue”
the financial support to hire art therapists for leading art therapy
sessions in the Lucien Neuwirth Cancer Institute.
Statement of Ethics

The patients’ oral consent was systematically obtained. All per-

formed procedures were in accordance with the ethical standards
of the institutional research committee and with the 1964 Helsinki
Declaration and its later amendments. The institutional ethics
committee approved the survey.
Author Contributions
Mathilde Gras, Elisabeth Daguenet and Stéphanie Morisson
wrote the present article. Christelle Brosse, Aurélie Beneton and
Stéphanie Morisson organized the financial demand and the orga-
nization of art therapy sessions.

References
1 Mitchell AJ, Chan M, Bhatti H, Halton M,
Grassi L, Johansen C, et al. Prevalence of de-
pression, anxiety, and adjustment disorder in
oncological, haematological, and palliative-
care settings: a meta-analysis of 94 interview-
based studies. Lancet Oncol. 2011;12:160–74.
2 Carlson LE, Waller A, Mitchell AJ. Screening
for distress and unmet needs in patients with
cancer: review and recommendations. J Clin
Oncol Off J Am Soc Clin Oncol. 2012; 30:
1160–77.
3 Carlson LE, Angen M, Cullum J, Goodey E,
Koopmans J, Lamont L, et al. High levels of
untreated distress and fatigue in cancer pa-
tients. Br J Cancer. 2004;90:2297–304.
4 Cleeland CS, Mendoza TR, Wang XS, Chou
C, Harle MT, Morrissey M, et al. Assessing
symptom distress in cancer patients: the M.D.
Anderson Symptom Inventory. Cancer. 2000;
89:1634–46.
5 Hwang SS, Chang VT, Fairclough DL, Cog-
swell J, Kasimis B. Longitudinal quality of life
in advanced cancer patients: pilot study re-
sults from a VA medical cancer center. J Pain
Symptom Manage. 2003 Mar;25(3):225–35.
6 Potter J, Hami F, Bryan T, Quigley C. Symp-
toms in 400 patients referred to palliative care
services: prevalence and patterns. Palliat Med.
2003;17:310–4.
7 Chang VT, Hwang SS, Feuerman M, Kasimis
BS. Symptom and quality of life survey of
medical oncology patients at a veterans affairs
medical center: a role for symptom assess-
ment. Cancer. 2000;88:1175–83.
8 Richardson MA, Sanders T, Palmer JL, Greis-
inger A, Singletary SE, et al. Complementary/
alternative medicine use in a comprehensive
cancer center and the implications for oncol-
ogy. J Clin Oncol Off J Am Soc Clin Oncol.
2000;18:2505–14.
9 Horneber M, Bueschel G, Dennert G, Less D,
Ritter E, Zwahlen M, et al. How many cancer
patients use complementary and alternative
medicine: a systematic review and metaanaly-
sis. Integr Cancer Ther. 2012;11:187–203.
10 Gras M, Vallard A, Brosse C, Beneton A, Sot-
ton S, Guyotat D, et al. Use of complementary
and alternative medicines among cancer pa-
tients: a single-center study. Oncology. 2019;
97:18–25.
11 Forzoni S, Perez M, Martignetti A, Crispino S.
Art therapy with cancer patients during che-
motherapy sessions: an analysis of the pa-
tients’ perception of helpfulness. Palliat Sup-
port Care. 2010;8:41–8.
12 Bosi L. Intervention au Séminaire Art & Care.
Université Paris I. 2014.
13 Chardon F. Les spécificités de l’Art-théra-
pie en oncologie médicale lors de
l’accompagnement en fin de vie. 2010.
14 Nainis N, Paice JA, Ratner J, Wirth JH, Lai J,
Shott S, et al. Relieving symptoms in cancer:
innovative use of art therapy. J Pain Symptom
Manage. 2006;31:162–9.
15 Wood MJM, Molassiotis A, Payne S. What re-
search evidence is there for the use of art ther-
apy in the management of symptoms in adults
with cancer? A systematic review. Psy-
chooncology. 2011;20:135–45.
16 Geue K, Goetze H, Buttstaedt M, Kleinert E,
Richter D, Singer S, et al. An overview of art
therapy interventions for cancer patients and
the results of research. Complement Ther
Med. 2010;18:160–70.
17 Koom WS, Choi MY, Lee J, Park EJ, Kim JH,
Kim SH, et al. Art therapy using famous
painting appreciation maintains fatigue levels
during radiotherapy in cancer patients. Ra-
diat Oncol J. 2016;34:135–44.
18 Bar-Sela G, Atid L, Danos S, Gabay N, Epel-
baum R, et al. Art therapy improved depres-
sion and influenced fatigue levels in cancer
patients on chemotherapy. Psychooncology.
2007;16:980–4.
19 Thyme KE, Sundin EC, Wiberg B, Oster I, As-
tröm S, Lindh J, et al. Individual brief art ther-
apy can be helpful for women with breast can-
cer: a randomized controlled clinical study.
Palliat Support Care. 2009;7:87–95.
20 Svensk A-C, Oster I, Thyme KE, Magnusson
E, Sjödin M, Eisemann M, et al. Art therapy
improves experienced quality of life among
women undergoing treatment for breast can-
cer: a randomized controlled study. Eur J
Cancer Care (Engl). 2009;18:69–77.
21 Lefèvre C, Ledoux M, Filbet M. Art therapy
among palliative cancer patients: aesthetic di-
mensions and impacts on symptoms. Palliat
Support Care. 2016;14:376–80.
22 Bozcuk H, Ozcan K, Erdogan C, Mutlu H,
Demir M, Coskun S, et al. A comparative
study of art therapy in cancer patients receiv-
ing chemotherapy and improvement in qual-
ity of life by watercolor painting. Comple-
ment Ther Med. 2017;30:67–72.
23 Lee J, Choi MY, Kim YB, Sun J, Park EJ, Kim
JH, et al. Art therapy based on appreciation of
famous paintings and its effect on distress
among cancer patients. Qual Life Res. 2017;
26:707–15.
24 Jarlier M, Castan F, Barbieri A, Anota A, Sav-
inac M, Azria D, et al. Analyse statistique du
questionnaire EORTC-QLQ-C30 à l’aide de
programmes Stata. Available from: https: //
www.em-consulte.com/en/article/971117/data/
revues/03987620/v63sS2/S0398762015
002084/.2015.
25 Krishnaswamy P, Nair S. Effect of music ther-
apy on pain and anxiety levels of cancer pa-
tients: a pilot study. Indian J Palliat Care.
2016;22:307–11.
193.51.85.197 - 2/12/2020 4:40:55 PM

6 Oncology Gras/Daguenet/Brosse/Beneton/Morisson
DOI: 10.1159/000504448
Université de Paris
Downloaded by: