Completed Research Projects

Slow Art Plus: Developing and Piloting a Single Session Art Gallery-based Intervention for Mental Health Promotion via a Mixed Method Waitlist Randomized Control Trial (RCT)

Project Duration: 2022-2023
Principal Investigators: Dr. Andy Hau Yan Ho
Grant Awarding Agency: Johnson & Johnson Foundation
Amount Awarded: S$ 45,000
Abstract of Research: In recognition of the mental health concerns that accompany COVID-19, the National Gallery Singapore (NGS) had developed her own Slow Art programme in 2020 with the aim to provide interested individuals with a meaningful platform for social connection, conversation, and art appreciation through an online visual art experience. While feedback surveys have shown an average satisfaction score of 86.5%, no formal evaluation has been conducted to examine the effectiveness of NGS Slow Art programme. The current study builds on the industrial expertise of the NGS and harnesses the clinical and empirical expertise of the Principal Investigator, in developing and piloting an enhanced version of the NGS Slow Art programme, namely “Slow Art Plus” for mental health promotion. Utilizing a Participatory Action Research (PAR) paradigm, this 12-month study will adopt a mixed method Waitlist Randomized Control Trial (RCT) with a built-in acceptability and feasibility study to test the efficacy of Slow Art Plus in reducing stress and empowering self-care among 200 participants. Slow Art Plus will be a first-of-its kind standardized intervention that integrates slow-looking, mindfulness and self-compassion practices, as well as reflective and creative expressions for addressing the mental health promotion needs of the general population, with the goal of relieving stress as well as building resilience and self-care capacity. Slow Art Plus has great potential to create a completely new paradigm of mental health self-care across the arts industry, fuelling hope and vitality into the lives of all people in Singapore and around the world.

Understanding and Strengthening University Students’ Psycho-Socio-Emotional Wellness and Preparedness for COVID-19 and Future Pandemics: A Cross-Sectional Mixed-Methods Study

Project Duration: 2021-2023
Principle Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Singapore Ministry of Education (MOE) Tier 1 Grant
Amount Awarded: S$ 82,618
Abstract of Research: Under the shadow of COVID-19, life as we know it is rapidly changing. One of the strongest measures put in place, globally, to protect people and curb the spread of COVID-19 is social distancing. While this has shown to be effective in slowing the rate of infections, social distancing also implies displacement of social and work life routines, prohibiting physical closeness and intimacy with loved ones, peers and colleagues. The progressive disintegration of our social relationships and connections is a threat to our sense of normalcy, safety, belonging and personhood – which can result in deleterious mental and emotional outcomes such as fear, anxiety, depression, and loneliness.

Youths, especially undergraduate university students, coping with the challenges identity formation, emerging adulthood and workforce entry are at a higher risk for mental health problems such as loneliness, depression and suicide ideation under normal circumstances. COVID-19 brings an additional layer of developmental difficulties to this population cohort, it is thus imperative to strengthen their psycho-socio-emotional wellness and preparedness for future infection waves of the new coronavirus and other pandemics. As such, there is an urgent need to examine the psychological impacts of COVID-19 on undergraduate students – to identify those who cope well (resilient group) and those who need more support (vulnerable group), to pinpoint the individual, relational and contextual factors that affect their mental health, and to develop a holistic understanding of their needs, struggles, and coping strategies.

The proposed research fills a critical knowledge gap by examining the challenges and coping strategies of university students in facing COVID-19 and related social distancing measures. This understanding will inform the development of a public health crisis preparedness and response framework on both public policy and higher education levels, one that provides evidence-based supportive initiatives and resilience-based psychoeducation programs that protect the psycho-socio-emotional well-being of youths in the midst of and in anticipation of current and future pandemics.

Effects of Participatory ‘A’rt-Based Activity On ‘Health’ of Older Community-Dwellers: The Singapore A-Health Randomized Controlled Trial Study

Project Duration: 2020-2022
Principle Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: NTU Lee Kong Chian School of Medicine and Sir Mortimer B. Davis Jewish General Hospital
Amount Awarded: S$79,600
Abstract of Research: Aging is often associated with worsening health and withdrawal from social activities, both increasing the risk of poor quality of life. While it has been reported that participatory art activities can promote and elevate health and wellbeing among older adults, relevant research are mostly weak in intervention design with unclear methodology. In 2015, Dr Olivier Beauchet (Co-Investigator) and his colleagues at the McGill Centre of Excellence on Longevity and the Montreal Museum of Fine Arts successfully initiated a standardized museum-based participatory art programme known as “A-Health: Participatory Art-based Activity on Health of Older Community Dwellers”. Through a pilot single-arm study, A-Health was found to be effective in improving health condition, quality of life and wellbeing of Montreal older adults. Building on the success of the pilot A-Health Study, an international consortium comprising academic institutions, national museums and galleries has been established to systematically test the efficacy of the A-Health Intervention Framework in health and wellness promotion. Using the gold standard of Multi-site Randomized Control Trial, 6 major cities around the world including Canada (Montreal), France (Nice), England (London), Taiwan (Kaohsiung), Switzerland (Basel), and Singapore is part of this extraordinary effort to develop and test a series of empirically-driven and culturally-unique museum-based participatory art programmes that follow a unifying A-Health framework. The ultimate goal is to firmly authenticate the causal link between art, health and wellness, with the breakthrough of creating an efficient museum art programme for seniors of all ethnicities and cultural backgrounds. The Singapore A-Health RCT study (current study), is led by an interdisciplinary team including Dr Andy Ho (SSS Psychology), Dr Olivier Beauchet (LKCMedicine) and Dr Michael Tan (ADM), implemented in partnership with National Gallery Singapore. This significant collaboration will ensure programme sustainability in the local context.

ARTISAN 2.0: Deconstructing the Integrative Efficacy of a Multimodal Art-based Intervention to Strengthen Understanding and Demystify Misconceptions on Arts, Heritage, and Health

Project Duration: 2019-2022
Principle Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: National Arts Council (NAC) Research Grant
Amount Awarded: 123,000
Abstract of Research: To address the urgent problem of loneliness via citizen empowerment, ARTISAN (Aspiration and Resilience Through Intergenerational Storytelling and Art-based Narratives), a multimodal, intergenerational arts and heritage-based intervention was developed in partnership with the National Arts Council and the National Museum Singapore. Results from a 2018 pilot study revealed ARTISAN’s robust effectiveness in promoting resilience, social connectedness, personhood and nationhood among Singaporean youths and seniors. Despite these promising findings, questions and doubts remain to surface among biomedical researchers and medical clinicians about the multimodal nature of ARTISAN and its precision treatment impact. Objectives: To critically investigate and assess the independent and combined efficacy of each key intervention component of ARTISAN’s framework for promoting positive life changes, including participatory arts, art space, and storytelling within an intergenerational context. A five-arm, multicenter randomized controlled trial (RCT) with four treatment groups and one control group will be conducted. 70 youths and 70 seniors will be recruited from the 10 community collaborators and equally randomized into: (1) full ARTISAN condition, (2) intergenerational participatory arts condition, (3) intergenerational art space condition, (4) intergenerational storytelling condition, and (5) control condition of physical activity. Participants will be assessed at baseline, immediate post-intervention and 10-week follow-up with psychometric measures to assess intervention outcomes, while qualitative focus groups will be conducted to inform and enhance future intervention design. The findings from this study will add to the existing empirical foundation of ARTISAN for large-scale societal dissemination, while serving to demystify any doubts, misunderstanding and misconceptions about the efficacy of arts and heritage for health promotion and social empowerment.

Preventing Limb Losses in Singapore through Health Literacy and Healthcare Improvement

Project Duration: 2019-2022
Co-Principle Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Ministry of Health Singapore – Health Service Research Grant (HSRG)
Amount Awarded: 1,528,312
Abstract of Research: Diabetic foot ulcers (DFU) are the leading cause of amputations and mortality among patients with diabetes. Worryingly, Singaporean statistics indicate a faster rate of ulcer deterioration and higher rates of amputations compared to most other countries. The current applied care model in Singapore is acute-centric and does not sufficiently consider strategies for prevention and self-care. The aim is to support more efficient prevention and management of DFUs and thereby reduce the number of DFUs and its progression to limb loss. The hypothesis is that this can be achieved through (a) evidence-based prevention, (b) better care co-ordination, (c) improved understanding about the gaps in the provision and deviations from care guidelines, and (d) enhanced self-care of people with DFUs or at risk of developing a DFU through an app-based educational program targeting patients, informal caregivers and foreign domestic workers. The work by the national Diabetes Prevention and Care Taskforce to fight diabetes will be complemented by focusing on the prevention and management of DFUs. Current everyday care related to DFUs will be investigated to outline treatment pathways and identify possible gaps in the provision of care. Additionally, patients, informal caregivers and foreign domestic workers will be surveyed on their knowledge on preventing and caring for DFU and current care provision and monitoring. An app will be developed and evaluated supporting evidence-based practice through eLearning for the prevention and caring of DFUs directed towards patients, informal caregivers and foreign domestic workers. Health economic modelling will demonstrate potential gains through better healthcare coordination, evidence based prevention and more advanced self-care. Taken together, the proposed research activities will help to maximize the potential of available resources for preventing and caring of DFUs in Singapore, enable earlier identification of patients prone to develop microvascular complications, decrease the number of complications, and demonstrate savings in costs and improvements in quality-of-life.

The Cost of Care in Advanced Dementia: Blessing or Burden?

Project Duration: 2019-2023
Principal Investigators: Dr. Allyn Hum and Dr. Andy Hau Yan Ho
Grant Awarding Agency: Funded by the NTU Ageing Research Institute for Society and Education & Geriatric Education Research Institute (ARISE-GERI), Singapore
Amount Awarded: S$100,000
Abstract of Research: In Singapore, the cost of dementia care is estimated to be as great as for heart disease and cancer. Singapore will spend $1.4 billion annually for healthcare “direct (or ‘formal’) costs”, which will encompasses both medical and non-medical expenses. “Indirect (or ‘informal’) costs” relate to the financial burdens affecting the individual, which includes loss of income for family caregivers who care for them without any financial returns. In Singapore, non-reimbursable and unpaid labor costs range annually from S$15,750 for mild dementia to S$33,408 for moderate dementia. With increased debility and complications in the last stage of dementia, these costs will increase. Beyond the financial burdens, the intangible costs of caregiving for the advanced dementia (AD) sufferer are the psychosocial, emotional and spiritual burdens which are difficult to quantify. Caregivers suffer loss in quality of life and are more likely to suffer poor physical health and emotional distress than non-caregivers. Caregiver burden leading to burnout is a known factor for institutionalization. The main aim of this study is to measure the intangible costs of caregiving for AD patients and compare these costs between those living in the community (home based) and in institutions (i.e., nursing home or hospice). 180 principal family caregivers of advanced dementia patients will be identified and recruited from different healthcare sites (community and institutions) to participate in a longitudinal survey to identify their needs and mental health outcomes. Lived experiences of 30 AD family caregivers of community living (with and without palliative care support) and institution-based (i.e., nursing home) advanced dementia patients will be examined via a longitudinal qualitative approach with a concurrent nested design.

Mindful-Compassion Art Therapy for Dementia Care (MCAT-DC) – Empowering Resilience and Holistic Wellbeing for Sustainable Family Caregiving: A Waitlist Randomized Controlled Trial

Project Duration: 2019-2022
Principal Investigator: Dr. Andy Hau Yan Ho
Grant Awarding Agency: Funded by the NTU Ageing Research Institute for Society and Education (ARISE) Strategic Initiatives, Singapore
Amount Awarded: S$198,989
Abstract of Research: Dementia is a neurodegenerative disease that leads to irreversible decline in one’s cognitive and functional capacity, identity, and personhood. In Singapore, the number of persons with dementia is expected to soar to 187,000 by 2050. Hence, it is imperative to render comprehensive support to dementia sufferers, and especially their family caregivers. While local initiatives have raised public awareness and developed services for dementia care, they do not adequately address the psycho-socio-spiritual needs of family caregivers, as caregiving stress can greatly impede one’s mental and emotional health. International research for dementia family caregivers has thus focused on developing multicomponent interventions that accentuate holistic support to promote healthy and sustainable caregiving. This proposed 3-year study builds on the empirical foundation of Mindful-Compassion Art Therapy (MCAT) to test its efficacy as a multicomponent, holistic, psycho-socio-spiritual intervention for supporting dementia family caregivers. MCAT is a group-based intervention that integrates mindfulness meditation and art therapy, with reflective awareness complementing emotional expression, to foster self-compassion and inner-resilience among professional caregivers. Results from a randomized controlled trial (RCT) with end-of-life care workers revealed MCAT’s effectiveness for reducing burnout and promoting wellbeing to enrich caregiving.

The Healthcare Worker’s Journey of Care and Recovery: A Qualitative Study on the Lived Experience of Supporting Stroke Patients in Singapore’s Rehabilitation Unit

Project Duration: 2019-2022
Overall Technical Principle Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Rehabilitation Research Institute Singapore (RRIS) Rehabilitation Research Grant 3 – Complementary Grant
Amount Awarded: 299,800
Abstract of Research: Stroke is often a life-changing event as it is a sudden-onset condition with long-term consequences. Healthcare workers (HCWs) including nurses, physicians, social workers, physiotherapists and occupational therapists work closely with stroke survivors to improve independence in daily activities and quality of life. However, despite playing an important role in their care and recovery, there is limited number of studies that focus on the underlying psycho-socio-practical issues that arise from caring for this group of patients. For example, one study in 2015 observes that nurses’ involvement in rehabilitation in stroke units have not been previously reported although they ‘represent the largest professional group working with stroke-survivors’.1 Employing a phenomenological qualitative research design with an interpretive-systemic framework, the main aim of this project is to identify these issues from the perspectives of HCWs and pave the way for guidelines, protocols and programs that can enhance the wellness and professional competency of HCWs. Specifically, our expected findings will serve to inform and advance policies and practices of stroke care in hospital, rehabilitation and community settings, which can potentially lead to the development of better training and supportive programmes to empower HCWs whose care experiences are often complex, insightful, yet rarely explored in research. With a holistic understanding of service provision and care experiences, we can develop better support for HCWs which will in turn translate to better care for stroke patients.

Development and Evaluation of a novel Narrative E-Writing Intervention (NeW-I) for Parents of Children with Life-Limiting Illness: A Pilot Randomized Controlled Trial for Advancing Holistic Paediatric Palliative Care and Parental Bereavement Support

Project Duration: 2018-2020
Principal Investigator: Dr. Andy Hau Yan Ho
Grant Awarding Agency: Funded by the Temasek Foundation Innovatives, Singapore Millenium Foundation Grant Programme
Amount awarded: S$253,390
Abstract of Research: Conventional grief support interventions for parents whose children are terminally ill often begin only after the child’s death. Despite robust evidence which shows that pre-loss interventions that enhance death preparedness can alleviate psychological distress and prevent adverse grief outcomes among family caregivers of dying patients, there is no known program designed specifically to address the psycho-emotional-spiritual needs of parents facing child loss. And while the National Strategy for Palliative Care in Singapore aims to promote holistic end-of-life care services to patients and their caregivers, vast inadequacy continues to exist in the support provided to parents caring for a dying child in the local context. A novel therapist-facilitated, online intervention is conceived to fill thiscritical service gap. Adopting an evidence-based approach, the research team has developed a strength-focused and meaning-oriented Narrative e-Writing Intervention (NeW-I) for parents anticipating the death of their child due to a chronic life-limiting condition. The design of NeW-I is informed by an existing body of research (i.e. international systemic review and local qualitative inquires) that critically examines the lived experience of bereaved parents of children with life-limiting illnesses. NeW-I will be implemented in Singapore in collaboration with KK Women and Child’s Hospital and Club Rainbow Singapore. A pilot Randomized Control Trial (RCT) with a built-in accessibility and feasibility study will examine the efficacy of the NeW-I therapeutic protocol for enhancing quality of life, spiritual wellbeing, hope and perceived social support, as well as reducing depressive symptoms, caregiver burden and anticipatory grief among a purposive sample of 66 participants. NeW-I aspires to enhance quality of life, spiritual well-being, hope and sense of social support, as well as alleviating depressive symptoms, caregiving burden, and adverse grief outcomes among Singaporean parents facing the terminal illness and eventual death of their sick child. The findings generated will form the foundation of a full-scale RCT for advancing holistic paediatric palliative care and parental bereavement support locally and around the world.

A Multicentre Randomized Controlled Trial of a Novel Family Dignity Intervention (FDI) for Asian Palliative Care.

Project Duration: 2017-2020
Principal Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Funded the Singapore Ministry of Education (MOE) Academic Research Fund (AcRF) Tier 2 Grant.
Amount awarded: S$541,421
Abstract of Research: In Singapore, demand for palliative care has surged over the past decade and will continue to rise in the future under the context of population ageing. The Government and the Ministry of Health have honorably aspired to enhance the provision of holistic palliative care to patients and families facing chronic and terminal illnesses. However, most palliative interventions still focus predominately on pain and symptom management without addressing psycho-socio-spiritual concerns. To date, there is no available palliative care intervention for dignity enhancement in the Singapore, and little has been done with the Asian population. Building on our empirical foundations and expertise in dignity and dignity therapy, this randomized controlled trial will develop and test a novel “Family Dignity Intervention” for older Asian terminally-ill patients and their family caregivers. The FDI will emphasize dyad work to facilitate open dialogue, strengthen family connectedness, and cultivate familial Compassion so as to create a supportive and constructive platform that foster the expressions of appreciation, achieving reconciliation, fortifying family bonds, solidifying and passing on transcendental wisdom and values across generations. The expected outcomes of this pioneering study will generate new knowledge contributing to advancement in both clinical theories and practices in palliative end-of life care for Singapore and for all Asian communities around the world.

Non-Palliative Care Professionals Caring for End-of-Life Patients: A Lived Experience Study on Needs, Challenges and Actions for Strengthening Clinical Competency and Psycho-Socio-Emotional Capacity in Singapore

Project Duration: 2019-2020
Principal Investigator: Dr. Andy Hau Yan Ho
Grant Awarding Agency: Funded by the Lien Foundation, Singapore
Amount awarded: S$120,000
Abstract of Research: A 2014 study by the Lien Foundation in Singapore found that medical professionals outside of palliative care perceived themselves as inadequate in communicating with and caring for critically and terminally ill patients, despite the high prevalence of death occurring in non-palliative care units such as geriatric, oncology and intensive care. Being constantly exposed to the trauma, pain and sufferings of their patients and families, while lacking clinical skills, emotional competency and institutional support for end-of-life care work, non-palliative care professionals (NPCPs) are faced with insurmountable stress that would inevitably result in burnout. Burnout is a reaction to chronic job-related stress, and occurs when individuals become overwhelmed with the emotional, mental and physical duress associated with their professional work. Beyond the individual level, burnout has also been found to negatively impact quality of care and expression of empathy among professional care providers, while causing increased medical errors among physicians, and heightened turnover rates of workers in various healthcare institutions. With population ageing, the demand on NPCPs to care for end-of-life patients will surge, alongside with increased but unsupported job expectations, adding to the potential of burnout which can prove detrimental to the safety and quality of patient care. Yet, there is scarce investigations on the experiences, needs and challenges that NPCPs face in caring for end-of-life patients in local and international contexts. The current study aims to address this critical knowledge gap through an in-depth qualitative study that explores and investigates the lived experience of NPCPs from 7 major medical disciplines outside of palliative medicine that responsible for the care of critically and terminally ill patients and their families. The expected findings from will contribute to advancement in both theories and practices in end-of-life care to better support NPCPs in their roles. The knowledge generated can also serve as the foundation for developing an evidence-based and cultural-specific education programme to support and augment end-of-life care by NPCPs in Singapore and Asia.

A Qualitative Study on the Lived Experience of Bereaved Parents of Children with Life-Limiting Illness: Advancing Parental Bereavement Support in Singapore and Greater Asia.

Project Duration: 2017-2019
Principal Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Funded the Singapore Ministry of Education (MOE) Academic Research Fund (AcRF) Tier 1 Grant.
Amount awarded: S$74,985
Abstract of Research: Contrary to the common belief that most deaths occur in later life, world statistics show that over 11.4 million children and youth die annually due mainly to life-limiting illnesses and congenital conditions. In Singapore, approximately 400-500 children and youth between the ages of 0 to 24 die every year, leaving thousands of parents, grandparents and extended families heartbroken and devastated. Despite these significant figures, there is a dearth knowledge on how bereaved parents cope with their child’s end of life and eventual death, leading to consequential inadequacy on parental bereavement support services locally and internationally. This first-of-its kind study is conceived to fill this important knowledge gap via a qualitative research design to explore the lived experience of 30 Singaporean single-or-couple parents whose child suffered from a life-limiting illness before the age of 19, and as a result passed away in subsequent years [N=30]. These explorations conducted either in English/Mandarin/Malay through Meaning-Oriented Interviews will identify the shared commonalities in the experience of child loss, the struggles and strength of living with grief, as well as the factors that support or impede bereavement outcomes. Participant recruitment via purposive sampling from 3 most respect pediatric palliative care providers, including Children’s Cancer Foundation, HCA Hospice Care Star PALS, and Club Rainbow, will facilitate the examination of parental bereavement among a wide spectrum of critical illnesses and cultural backgrounds. Through the process of theory building with Grounded Theory Approach, this study will develop a cultural-specific Parental Bereavement Care Model for Advancing theories and practices in pediatric palliative care and bereavement support services for Singapore and for all Asian communities around the world. The generated findings will be disseminated widely locally and internationally via academic publications, conference presentations, self-help booklets and information pamphlets.

Project ARTISAN: Fostering Aspiration and Resilience through Intergenerational Storytelling and Art-based Narratives.

Project Duration: 2018-2019
Principal Investigator: Dr. Andy Hau Yan Ho
Grant Awarding Agency: Funded by the National Art Council Singapore, Research and Development Grant
Amount awarded: S$40,700
Abstract of Research: While many community arts-based programme were found to enhance social inclusion amongst older adults and lead to improvements in holistic wellbeing, physical and mental health, there is currently no available data to illuminate the benefits of an intergenerational arts programme involving elderly-youth dyads in Singapore. Also, there is a dearth of research that examines the interplay between art space and art content in cultivating positive psycho-socio-emotional changes on art participants in the local context. This pilot study adopts a Participatory Action Research (PAR) approach to develop a novel ARTISAN intergenerational arts programme that aims to promote life meaning, resilience and wellbeing, as well as to enhance social support and national identity among the older and younger generations Singapore. Utilizing a wait-list randomized controlled trial design (RCT), 34 elderlies and 34 youths (N=68) were invited to participate in a 5-week, 10-hour intervention programme. Through the integrative processes of curated museum visits (art space), facilitated storying (art facilitation), creative art-making and reflective writing (art content), the intervention focused on the exploration of five unique themes to engage senior-youth dyads. Quantitative data obtained before and after the intervention will be triangulated with qualitative data generated from feasibility focus groups and reflective writings to explore its potential benefits and benefiting processes in achieving the aforementioned outcomes. To encourage social change and empowerment, public art exhibitions showcasing the artworks from this programme were also held within the community. Hence, by developing, implementing and systematically evaluating a novel ARTISAN art-based programme that connects the youths and older adults with curated art space, art content and art facilitation, this study value adds and fills an existing gap within the arts and culture literature in Singapore. Furthermore, it allows the study of the benefits of arts as a viable and cost-effective platform in increasing community engagement and enhancing wellbeing and social cohesion; mediating the detrimental effects of critical social issues brought about by an aging population and increasing social distance. The expected outcomes of this pioneering study will generate new knowledge, contributing to the advancement of art and health research in Singapore, as well as the advancements in both theories and practices for creative aging and intergenerational bonding. Being first of its kind, it forms the foundation for the development of other theoretically-driven and effective intergenerational art-based programmes that can be useful for different cohorts of older adults and youths; allowing appropriate social policies, supportive schemes and relevant courses of actions to be established in response to the government’s call for more intergenerational programmes. The findings from this study will also form the foundation for a larger Population Health Project on Arts and Wellness.

The Arts for Ageing Well: A landscape study on art participation and holistic wellbeing among current and future older generations of Singapore.

Project Duration: 2016-2018
Principal Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Funded by the National Art Council of Singapore, Research and Development Fund.
Amount awarded: S$200,000
Abstract of Research: Fashionable terms such as active aging, graceful aging and creative aging are all intricately woven through the principal health promotion goals of personal autonomy, social participation and community involvement. One has to look no further than to the Arts to realize its vital significance in cultivating these goals, as art participation has long been known to have tangible effects on health and mental health. However, there is no available data to illuminate the intricate relationships between art participation and holistic health among the older generations of Singapore. Hence, there is an imminent need to critically examine the landscape of art participation among Singapore’s young-old and older adults, to investigate the relationships between art participation and holistic well-being, as well as to identify the various facilitating and debilitating factors of art participation and active ageing. The current study is the first-ever attempt to critically address this important knowledge gap by utilizing a holistic investigative approach with both quantitative and qualitative methodologies for exploring and understanding the notion of “Art for Ageing Well”. The expected findings will generate new knowledge contributing to the advancement of practices and policies for promoting sustainable art participation among Singapore’s current and future older generations.

An Evaluation of the National Advance Care Planning Programme – A Qualitative Study

Project Duration: 2016-2017
Co-Principal Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Funded by the Singapore Ministry of Health, in collaboration with The Agency of Integrated Care.
Amount Awarded: $1,040,200
Abstract of Research: Advance Care Planning(ACP) is a voluntary process of discussion on future care preferences between an individual, his or her family and healthcare providers. ACP describes the type of care the person would prefer, if he or she is to become very sick and unable to make health care decisions in the future. Carried out successfully, the ACP process will lead to appropriate documentation and adherence of individual care preferences across different healthcare settings, whereby individuals wishes will be respected and honored. Studies have reported that ACP is associated with improved quality of care at the end of life, fewer in-hospital deaths and an increased use of hospice. In 2011, a national ACP programme was launched in Singapore, of which focuses on achieving the three objectives of: (i) increasing awareness about ACP among healthcare professionals, community and religious leaders, and the public; (ii) recruiting and training ACP facilitators to conduct ACP conversations in health and social care organisations; and (iii) establishing and strengthening systems to support ACP implementation, including a national ACP IT system. Five years onwards, an evaluation of the effectiveness of the National ACP programme is required. The qualitative component of this evaluation examines how ACP has been implemented and embedded within the existing clinical practice, by exploring the experiences of facilitators and referring clinicians who conducted ACP session, and patient-family dyads who received ACP within acute care settings.

Development and evaluation of a novel Mindful-Compassion Art Therapy (MCAT) Supervision for self-care and collegial support among end-of-life care professionals in Singapore.

Project Duration: 2016-2018
Principal Investigator: Dr Andy Hau Yan Ho
Grant Awarding Agency: Funded by the Nanyang Technological University Start Up Grant.
Amount awarded: S$34,994
Abstract of Research: The need for empathy and the difficulties of coping with morality when caring for the dying and the bereaved pose great psychological and spiritual strains. Palliative care professionals are particularly prone to burnout given the intense emotional and existential nature of their work. Supervision is one important way to provide adequate support that focuses on both professional and personal competencies in working with death and loss. Previous research has provided robust evidence that support the inclusion of art therapy within supervision for it had effectively reduced burnout and enhanced emotional regulation. Combining the practice of mindfulness in art-therapy based supervision, with reflective awareness complementing emotional expression, has immense potential to create a dynamic platform for self-care and collegial support, of which could ultimately cultivate resilience and compassion resilience among those immersed the field of end-of-life care. This pioneering study develops and tests a novel Mindful-Compassion Art Therapy (MCAT) for its effectiveness in reducing work-related stress among EOL care workers in Singapore, as well as its capacity in elevating participants’ sense of resilience, self-awareness, acceptance and compassion. The expected outcomes of this study will advance theories and practices in caring for end of life caregivers both locally and internationally.