Completed Research Projects

Completed Research Projects

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.