Mapping of Initiatives on Culture, Health and Well-being

During the years 2016-2018, the Rehabilitation with Culture project was ongoing at Danderyd Hospital for patients with long-term condition. People with long-term condition were offered rehabilitation with culture twice a week for eight weeks. The participants received cultural experiences such as a concert, dance performance and art show, and themselves participated in activities in dance, music, crafts, art and film. The cultural programs were put together by Region Stockholm's county cultural facilities, and led by cultural educators. The activities were adapted for people with low level of function and prolonged pain.
The project is unique because it has been researched from both a humanistic and medical perspective. Qualitative research has been conducted with a focus on the participants' experiences and benefits of cultural activities in the rehabilitation and quantitative research through extensive questionnaire surveys before and after the rehabilitation. In addition to this, medical examinations have been carried out through blood tests, blood pressure and pulse taking before and after the rehabilitation.
The research team has consisted of Monika Löfgren, lay physiotherapist, docent and university lecturer at Karolinska Institutet, Georg Drakos, docent in ethnology and Helena Bani-Shoraka, Senior Lecturer in Interpreting Studies, Stockholm University.

Clown Rounds want to create moments of joy and relieve anxiety in children in the hospitals, their parents, siblings and staff, but also the elderly with dementia and the staff at the nursing homes they visit. All hospital clowns are basically professional artists, specially trained to work with sick and disabled children and young people. The Clown Rounds programme is oriented towards: 1) People from hospitals - where they meet the children and their families, patients and hospital staff and 2) People from nursing homes - where they meet old people with dementia and care staff. The work in nursing homes requires different forms of preparation compared to when the clowns meet children and relatives in the hospitals.
Clown Rounds is based in Malmö, but has the whole of Skåne as its field of work. Every week the clowns visit children's clinics in Malmö, Lund, Helsingborg, Kristianstad and Ystad. In 2019, they met 7,691 children and young people in the hospitals around Scania.
The initiative is run in collaboration with Folkuniversitetet and is financed by an annual operating grant from Kultur Skåne and the Swedish Health and Welfare Board. Donations from foundations and funds and gifts from companies, organizations and individuals also form an important part of the financing.

With the Arms Full of Adventure project is a reading and literature project that lifts and explores how the fairytale and adventure can give children in hospitals, their siblings and friends closeness to joy, excitement and conversation. The project's intention was to strengthen the collaboration of different professions around the reading and literature promotion activity that can live on long after the end of the project period. The project had regional partners and a target group that was cross-county. The project was based on the collaboration between different professionals as librarians, hospital teachers, therapists, sibling supporters, health care personnel.
Author visits and workshops, theater, hospital clowns and adventure walks create conversations about books and their images. A permanent fairytale walk is designed at Norrland University Hospital. It is good to move around when you are ill and replacing a normal hospital environment with a more humanized hospital environment can provide a positive experience of hospital time.

The Clown Clinic is an organization with hospital clowns that has existed since 2001, but had its beginnings as early as 1994 when they started in the children's cancer department at Östra Sjukhuset in Gothenburg. They work to improve the quality of life for children, adults, the elderly and everyone else they meet.
Several initiatives of Clown Clinic include:
1) Clown visit to hospitals: Queen Silvia's Children's Hospital in Gothenburg, Södra Älvsborg Hospital in Borås, Norra Älvsborg County Hospital in Trollhättan, Skaraborg Hospital in Skövde, Ryhov County Hospital in Jönköping, Central Hospital in Karlstad and Halland Hospital in Halmstad.
2) Clown visits to nursing homes: since 2013 they have been visiting people with dementia at Tre Stiftelser's nursing homes in Gothenburg. Continuity combined with the clowns' ability to find ways to communicate creates moments of heartfelt togetherness.
3) Other clown activities: they also offer lectures and video greetings.

Over the past decade interest has grown in the Netherlands for sustainable arts in health programming. Successful projects have encouraged administrators, funders, governments, researchers, and artists to explore the role that the arts can play in care and illness prevention. However, the Netherlands has no structures in place to systematically support arts in health programming, to train practitioners, or to encourage research and policy formulation.
The mission of Arts in Health Netherland is to give creative art-making a permanent place in the care system of the Netherlands. They work together with care institutions and communities in the North of the Netherlands to develop sustainable arts in health programs in support of wellbeing. Furthermore they develop arts in health education and training programs for university students and mid-career professionals and facilitate arts in health research.

The Art and Culture in Long-term Care and Support program was initiated in collaboration with the RCOAK Foundation, the Sluyterman van Loo Fund and the Ministries of Education, Culture and Science and the Ministry of Health, Welfare and Sport. The aim of this program is to link culture to long-term care and support, in a structural and sustainable way.
The Art and Culture in Long-term Care and Support program will set out actions on three development lines:
1) Targeted development and dissemination of knowledge from ongoing initiatives: Many cultural initiatives are already underway in long-term care and support. These initiatives are ideally suited to gain experience and knowledge. Priorities are the further inventory of art initiatives and the investigation of active elements and bottlenecks. Practice-oriented research is used to improve the quality of existing initiatives. Within the project is will be explored the way in which effects are described so that they are meaningful for pacients, their environment and healthcare professionals.
2) Research and method development: Within this line, efforts will be made to develop appropriate research methods, preferably mixed-methods instruments. These must be in line with the aspects of positive health, art and culture. When conducting research, the needs of various stakeholders, such as insurers, municipalities and healthcare institutions, will be take into account. Attention is needed for both practical learning from research and the process of embedding in institutions and scaling up initiatives.
3) Anchoring and sustainability: A lot is already happening in the field of art and culture within the long-term care and support sector. However, it is often incidental and the supply is fragmented. Because funding of art initiatives is seen as a major problem, one of the priorities is to develop business cases for various initiatives. The knowledge acquired in the first two lines can be used as evidence for the further development of policy for these crossovers between art and care. Frontrunners in this field and ambassadors can be helpful in further developing, disseminating and embedding the offer. A cross-domain knowledge network ensures a good exchange of knowledge about policy, practice and research.

Art to Work initiative increases the chance of reintegration and work in all kinds of professions for those involved in the programme. The participants are guided by an art teacher and a permanent counselor to find a suitable working environment. They follow creative workshops in various art disciplines such as theatre, visual arts and music, in combination, if possible, with their work experience. By being creative the participants are discovering where their passion and talents lie. They work on a positive self-image and this increases their self-confidence.
The following aspects are covered in each workshop:
- Self-insight: Discover qualities that can help them find and keep interesting work. In addition, they learn to deal with limits and pitfalls.
- Insight into the other: They learn to understand others better.
- Self-regulation: They learn to take on responsibilities. They learn to focus. They learn to give their opinion, learn to listen and adapt.
- Dealing with others: They learn to present yourself, learn to work together, to deal with conflict.
- Justification: They learn to take initiative and show perseverance.
The group is never larger than 10 participants. By working together in a group they get to know each other's values. During the creative process there is space and safety to share these stories with each other. In addition, the imagination is challenged and it is nice to work together every week to ultimately arrive at a joint end product.

This art center wants to make the healing effect of art & nature accessible to everyone. The site, formerly a repurposed farm, with its rich history, nature, studios, exhibition space and sculpture garden, forms a community where people can 'be', in the broadest sense of the word. In a world where the pace is high, everyone is busy and under pressure, there is a growing need for space and tranquility. By immersing yourself in nature you experience space and you can relax. Your head may stand still for a moment, just like time. Art also has this effect on body and mind. This can be done both in experiencing art and in artistic creation. It provides a diverse range with which the participants can experience the inspiring terrain and the artistic environment for themselves.

This is a project for all health professionals. From November 2021 until March 2022, 5 artists from the 289 Association in Faro, Algarve exhibited their work in the cafeteria of the Algarve University Hospital Centre. Art for Health project aims to improve the physical, mental and social well-being of the health professionals of Faro's city's hospital. The pandemic has been very hard for all, but especially for professionals in a medical environment. Art relieves emotional tension and it is used to inspire a moment of contemplation, of existential questioning that might relieve them from the stressful situation they face. The artistic interventions took place in the cafeteria, considering it is a space frequently used by the hospital's health professionals: doctors, executives, administrative staff, technicians, nurses and auxiliary staff.

The dance activities implemented by the Gävleborg authorities from Sweden work in different ways to make dance accessible to everyone, regardless their dance abilities or age. Through networking, continuing education, workshops and performances for children, young people and adults, the people of the region are invited to participate in the cultural life, experiencing the dance art. Several programs implemented in the region are:
- Dance for health: in the spring of 2020, a network group was initiated with trained instructors in dance for health.
- Dance and Parkinson's: in 2020, work on a national study regarding dance and Parkinson's has begun, in which representatives from various parts of Region Gävleborg's organization and Gävleborg's county participate.
- Dance for the elderly and people with various functional abilities: Kultur Gävleborg has produced material for lessons for leading dance classes