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Pitkala KH, Rautiainen L, Aalto UL, Kautiainen H, Kolster A, Laakkonen ML, Partonen T, Roitto HM, Strandberg TE, Opacin N, Puntscher S, Siebert U, Coll-Planas L, Sachs AL, Litt JS, Jansson AH. Participants' baseline characteristics and feedback of the nature-based social intervention "friends in nature" among lonely older adults in assisted living facilities in finland: a randomised controlled trial of the RECETAS EU-project. BMC Geriatr 2024; 24:812. [PMID: 39375627 PMCID: PMC11457361 DOI: 10.1186/s12877-024-05408-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 09/25/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND Loneliness is common among older adults in institutional settings. It leads to adverse effects on health and wellbeing, for which nature contact with peers in turn may have positive impact. However, the effects of nature engagement among older adults have not been studied in randomised controlled trials (RCT). The "Friends in Nature" (FIN) group intervention RCT for lonely older adults in Helsinki assisted living facilities (ALFs) aims to explore the effects of peer-related nature experiences on loneliness and health-related quality of life (HRQoL). In this study we aim describe the participants' baseline characteristics of the RCT, feasibility of FIN intervention and intervention participants' feedback on the FIN. METHODS Lonely participants were recruited from 22 ALFs in Helsinki area, Finland, and randomised into two groups: 1) nature-based social intervention once a week for nine weeks (n = 162) and 2) usual care (n = 157). Demographics, diagnoses and medication use were retrieved from medical records, and baseline cognition, functioning, HRQoL, loneliness and psychological wellbeing were assessed. Primary trial outcomes will be participants' loneliness (De Jong Giervald Loneliness Scale) and HRQoL (15D). RESULTS The mean age of participants was 83 years, 73% were female and mean Minimental State Examination of 21 points. The participants were living with multiple co-morbidities and/or disabilities. The intervention and control groups were comparable at baseline. The adherence with intervention was moderate, with a mean attendance of 6.8 out of the nine sessions. Of the participants, 14% refused, fell ill or were deceased, and therefore, participated three sessions or less. General subjective alleviation of loneliness was achieved in 57% of the intervention participants. Of the respondents, 96% would have recommended a respective group intervention to other older adults. Intervention participants appreciated their nature excursions and experiences. CONCLUSIONS We have successfully randomised 319 lonely residents in assisted living facilities into a trial about the effects of nature experiences in a group-format. The feedback from participants was favourable. The trial will provide important information about possibilities of alleviating loneliness with peer-related nature-based experiences in frail residents. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT05507684. Registration 19/08/2022.
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Affiliation(s)
- Kaisu H Pitkala
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland.
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.
| | - Laura Rautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
- The Finnish Association for the Welfare of Older Adults, Helsinki, Finland
| | - Ulla L Aalto
- University of Helsinki, Helsinki, Finland
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Annika Kolster
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
- Health Services, Western Uusimaa Wellbeing Services, Espoo, Finland
| | - Marja-Liisa Laakkonen
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
- Department of Social Services and Health Care, Geriatric Clinic, Helsinki Hospital, City of Helsinki, Finland
| | - Timo Partonen
- Department of Healthcare and Social Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hanna-Maria Roitto
- University of Helsinki, Helsinki, Finland
- Department of Social Services and Health Care, Geriatric Clinic, Helsinki Hospital, City of Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki, and, Helsinki University Hospital , Helsinki, Finland
- University of Oulu, Center for Life Course Health Research, Oulu, Finland
| | | | - Sibylle Puntscher
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria
| | - Uwe Siebert
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Health Decision Science, Departments of Epidemiology and Health Policy & Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura Coll-Planas
- Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), Vic, Spain
- University of Vic-Central University of Catalonia (UVic-UCC). Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Ashby L Sachs
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jill S Litt
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Anu H Jansson
- Department of General Practice and Primary Health Care, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
- The Finnish Association for the Welfare of Older Adults, Helsinki, Finland
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Sterckx A, Delbaere B, De Blust G, Spacova I, Samson R, Van den Broeck K, Remmen R, Keune H. Fine-tuning the practical relevance of a quality framework for integrated nature-based interventions in healthcare facilities. A qualitative interview study. Front Public Health 2024; 12:1379230. [PMID: 38898895 PMCID: PMC11186510 DOI: 10.3389/fpubh.2024.1379230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction Integrated nature-based interventions in healthcare facilities are gaining importance as promising health and biodiversity promotion strategies. This type of interventions combines the restoration of biodiversity in the vicinity of the healthcare facility with guiding patients in that natural environment for health outcomes. However, quality appraisal of these interventions is still poorly developed. Based on a recent scoping review, the authors developed a preliminary quality framework in support of healthcare facilities designing, implementing and evaluating integrated nature-based interventions. This present study aims to fine-tune the practical relevance of the quality framework within the emerging practice. Methods A qualitative interview study was conducted in seven healthcare facilities in Belgium. Using a combination of snowball and purposive sampling, 22 professionals, involved in the integrated nature-based intervention in their facility, participated in the study. The semi-structured interviews were transcribed and imported into NVivo. A deductive and inductive thematic analysis was used to explore the practical relevance of the quality framework. A stakeholders' assembly review and a member checking of the findings were also part of the study. Findings Twenty-two interviews with nature management coordinators, healthcare professionals, and healthcare managers were conducted by three principal investigators in seven healthcare facilities implementing integrated nature-based interventions. The contextualization and complexity of integrated nature-based interventions in the participating healthcare facilities demonstrated the need for an evidence-based quality framework describing nature-based interventions. The study led to nine quality criteria, confirming the eight quality criteria derived from a previous scoping review, and the identification of a new quality criterion 'Capacity building, leverage and continuity'. These quality criteria have been refined. Finally, a proposal for a quality framework was developed and operationalized in a checklist. Deployment of the quality framework should be embedded in a continuous cyclical, adaptive process of monitoring and adjusting based on evaluations at each phase of an integrated nature-based intervention. Discussion Bridging the domains of healthcare and nature management in the context of an integrated nature-based intervention in a healthcare facility requires a transdisciplinary approach. Scientific frameworks such as "complex interventions," Planetary Health and One Health can support the co-design, implementation and evaluation of integrated nature-based interventions within a cyclical, adaptive process. In addition, the importance of the quality of the interactions with nature could gain from more sophisticated attention. Finally, the implications for healthcare facilities, policymakers and education are discussed, as well as the strengths and limitations of the study.
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Affiliation(s)
- Ann Sterckx
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ben Delbaere
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Geert De Blust
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Irina Spacova
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Roeland Samson
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Kris Van den Broeck
- Chair Public Mental Health, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Roy Remmen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hans Keune
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Carroll C, Higgs J, McCray S, Utter J. Implementation and Impact of Health Care Gardens: A Systematic Scoping Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:431-449. [PMID: 38011751 DOI: 10.1089/jicm.2023.0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background: In community and school settings, gardens and garden interventions have been shown to confer several psychosocial, physiological, and nutritional benefits. However, little is known about the implementation and impact of health care gardens on patients, visitors, and staff health and well-being. The primary aim of this review is to identify and describe the types of gardens and common design elements implemented in health care settings and the impact these gardens have on the health and well-being of patients, visitors, and staff. A secondary aim is to assess the quality of available evidence. Methods: PubMed, CINAHL, EMBASE, and PsycINFO were systematically searched on October 28, 2022. Primary qualitative and quantitative studies (excluding case reports and studies) were eligible for inclusion if they described the types of gardens and common design elements implemented in health care settings (hospitals, aged care, rehabilitation facilities, and medical centers) and/or assessed the impact of garden interventions on the health and well-being of patients, visitors, and staff. Review, selection, and data extraction were conducted by two independent researchers, with findings synthesized and presented in narrative form. Articles were critically appraised using the mixed methods appraisal tool (MMAT). Results: Eighteen articles were included. Eight studies provided detailed descriptions of the types of gardens implemented in health care settings (healing [n = 3], therapeutic [n = 2], sensory [n = 2], children's fairy gardens [n = 1], and enriched [n = 1] gardens). Studies examining the psychosocial impacts of gardens were most frequently reported (n = 16), followed by physical (n = 4) and nutritional (n = 2). A wide range of positive outcomes, predominantly relating to patients (n = 12), were reported, including improvements in stress, quality of life (QOL), cognitive function, physical activity, and fruit and vegetable intake. The evidence was heterogeneous and low-medium quality. Conclusions: The findings suggest that implementing gardens and garden interventions in health care settings may positively impact the health and well-being of patients, visitors, and staff. Most studies related to the impact of gardens on patients' mental health and QOL, indicating the need for further research to explore physical and nutritional outcomes, as well as health outcomes of staff and visitors. Findings also suggest the need for high-quality study designs (e.g., cluster control trials) and standardized measurement tools.
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Affiliation(s)
- Chloe Carroll
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Jennifer Higgs
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Sally McCray
- Nutrition and Dietetics, Mater Health, South Brisbane, Australia
| | - Jennifer Utter
- Nutrition and Dietetics, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
- Nutrition and Dietetics, Mater Health, South Brisbane, Australia
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Panțiru I, Ronaldson A, Sima N, Dregan A, Sima R. The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis. Syst Rev 2024; 13:45. [PMID: 38287430 PMCID: PMC10823662 DOI: 10.1186/s13643-024-02457-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Gardening and horticultural therapy (HT) has been widely recognised as a multicomponent approach that has affected a broad range of health and well-being outcomes. The aim of this umbrella review and meta-analysis was to compare the findings of previous reviews on the impact of multiple gardening interventions and gardening attributes on different well-being constructs. METHODS Electronic databases including PubMed, Web of Science, Science Direct, the Cochrane Library, and Google Scholar were searched from inception to December 2022. Interventional and observational reviews were eligible for inclusion in this umbrella review. Outcome measures included mental well-being, health status and quality of life. The key exposure variables were gardening and horticultural therapy. Narrative synthesis was used to evaluate the overall impact of gardening and HT on study outcomes. For a subsample of studies with available quantitative data, a random effect meta-analysis was conducted. RESULTS This umbrella review included 40 studies (10 interventional studies, 2 observational studies, and 28 mixed interventional and observational studies). The reviewed studies reported an overall positive impact of gardening activities on several measures of mental well-being, quality of life, and health status. Meta-analysis showed a significant and positive effect of gardening and HT activities on well-being (effect size (ES) 0.55, 95% confidence interval (CI) 0.23, 0.87, p < 0.001). CONCLUSIONS Evidence from observational and interventional studies supports a positive role for gardening and HT activities on well-being and general health. Interventional studies with horticultural-based therapies were effective in improving well-being and quality of life both in the general population and vulnerable subgroups. The high degree of heterogeneity in the included studies cautions against any direct clinical implications of the study findings.
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Affiliation(s)
- I Panțiru
- Department of Horticulture and Landscape, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca-Napoca, Romania
| | - A Ronaldson
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - N Sima
- Department of Technological Sciences, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca-Napoca, Romania
| | - A Dregan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - R Sima
- Department of Horticulture and Landscape, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Cluj-Napoca-Napoca, Romania.
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Sterckx A, Delbaere B, De Blust G, Spacova I, Samson R, Remmen R, Keune H. Quality criteria of nature-based interventions in healthcare facilities: a scoping review. Front Public Health 2024; 11:1327108. [PMID: 38274513 PMCID: PMC10808570 DOI: 10.3389/fpubh.2023.1327108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Implementing integrated nature-based interventions that simultaneously serve human health and the restoration of biodiversity in healthcare facilities is considered a promising strategy. As an emerging field of research and practice in healthcare, identification of quality criteria is necessary to support desired outcomes related to biodiversity, human health and intervention processes. This study is part of a larger research project in collaboration with the Flemish Agency of Nature and Forest in Belgium. Methods A scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, in PubMed, Medline, Web of Science and Scopus. A step-by-step tabular screening process was conducted to identify relevant studies and reviews of nature-based interventions, published in English between January 2005 and April 2023. A qualitative content analysis was conducted and the results were then presented to the project steering group and a panel of stakeholders for refinement. Results After filtering on the eligibility criteria, and with focus on healthcare facilities, 14 articles were included in this study. A preliminary nature-based interventions quality framework with a set of quality indicators has been developed. Discussion When designing integrated nature-based interventions, a needs analysis of users and the outdoor environment should be conducted. Next, the integration of a One Health and biodiversity perspective and the application of a complex intervention framework, could support the quality of the design and implementation of nature-based interventions in healthcare facilities and facilitate their assessment. In future work, more rigorous research into the design and implementation of integrated nature-based interventions is needed to test and refine the quality criteria in practice.
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Affiliation(s)
- Ann Sterckx
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ben Delbaere
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Geert De Blust
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Irina Spacova
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Roeland Samson
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Roy Remmen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hans Keune
- Chair Care and the Natural Living Environment, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Payne L, McMurran M, Glennan C, Mercer J. The Impact of Working with Farm Animals on People with Offending Histories: A Scoping Review. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:1282-1302. [PMID: 35674200 PMCID: PMC10394960 DOI: 10.1177/0306624x221102851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Within the Criminal Justice System, using animals for therapeutic or rehabilitative purposes has garnered momentum and is extensively researched. By contrast, the evidence concerning the impact of farm animal work, either on prison farms or social farms for community sanctions, is less well understood. This review sought to explore the evidence that exists in relation to four areas: (1) farm animals and their contribution to rehabilitation from offending; (2) any indicated mechanisms of change; (3) the development of a human-food/production animal bond, and (4) the experiences of forensic service users working with dairy cattle. Fourteen articles were included in the review. Good quality research on the impact of working with farm animals and specifically dairy cattle, with adult offenders, was very limited. However, some studies suggested that the rehabilitative potential of farm animals with offenders should not be summarily dismissed but researched further to firmly establish impact.
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Shrestha T, Chi CVY, Cassarino M, Foley S, Di Blasi Z. Factors influencing the effectiveness of nature-based interventions (NBIs) aimed at improving mental health and wellbeing: Protocol of an umbrella review. PLoS One 2023; 18:e0273139. [PMID: 37478105 PMCID: PMC10361498 DOI: 10.1371/journal.pone.0273139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 07/01/2023] [Indexed: 07/23/2023] Open
Abstract
Several systematic reviews support the use of nature-based interventions (NBIs) as a mechanism of enhancing mental health and wellbeing. However, the available evidence for the effectiveness of these interventions is fragmentary and mixed. The heterogeneity of existing evidence and significant fragmentation of knowledge within the field make it difficult to draw firm conclusions regarding the effectiveness of NBIs. This mixed method umbrella review aims to synthesise evidence on the effectiveness of nature-based interventions through a summative review of existing published systematic reviews and meta-analyses. A systematic search in PsycINFO, PubMed, Greenfile, Web of Science, Embase, Scopus, Academic Search Complete (EBSCO), Environment Complete (EBSCO), Cochrane Library, CINAHL, Health Policy Reference Centre and Google Scholar will be performed from inception to present. The search strategy will aim to find published systematic reviews of nature-based interventions (NBIs) where improving health and wellbeing is an explicit goal. This is a mixed method review, and systematic reviews with both quantitative and qualitative data synthesis will be considered. Two authors will independently perform the literature search, record screening, data extraction, and quality assessment of each included systematic review and meta-analysis. The individual qualitative and quantitative syntheses will be conducted in parallel and combined in an overarching narrative synthesis. The quantitative evidence will be used to assess the strength and direction of the effect of nature-based interventions on mental health and wellbeing outcomes. Evidence drawn from qualitative studies will be analysed and synthesised to understand the various pathways to engagement, involvement process and experiential factors that may mediate experiences. The risk of bias of the systematic reviews will be assessed using a 16-item Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklist. Trail registration: This review is registered on PROSPERO (CRD42022329179).
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Affiliation(s)
- Topaz Shrestha
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Marica Cassarino
- School of Applied Psychology, University College Cork, Cork, Ireland
- Environmental Research Institute, University College Cork, Cork, Ireland
| | - Sarah Foley
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Zelda Di Blasi
- School of Applied Psychology, University College Cork, Cork, Ireland
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Overbey TA, Diekmann F, Lekies KS. Nature-based interventions for vulnerable youth: a scoping review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:15-53. [PMID: 34758663 DOI: 10.1080/09603123.2021.1998390] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
Nature-based interventions hold promise for vulnerable youth experiencing mental, emotional, developmental, behavioral, or social difficulties. This scoping review examined wilderness therapy, animal assisted therapy, care farming, and gardening and horticultural therapy programs to raise awareness and guide future development of research and treatment options. Studies included in this review were identified through a systematic search of the literature informed by a scoping review framework. Studies were examined by design, sample, intervention, and key findings. The majority of studies were quantitative using repeated measures designs and were conducted primarily in the United States. Sample sizes were generally small. Interventions were residential and community based with varying degrees of duration. Outcomes were largely positive across a wide range of psychosocial and behavioral measures and often maintained post-treatment. We emphasize the importance of robust empirical designs, comprehensive description of the interventions and surrounding therapies, and identification of target groups.
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Affiliation(s)
- Tracey A Overbey
- University Libraries, The Ohio State University, Columbus, Ohio, USA
| | - Florian Diekmann
- Food Agricultural, and Environmental Sciences Library, The Ohio State University, Columbus, Ohio, USA
| | - Kristi S Lekies
- School of Environment and Natural Resources, The Ohio State University, Columbus, Ohio, USA
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Arnell L, Källström Å, Gunnarsdottir H. Relative Wellbeing of Women Maltreated as Children. Violence Against Women 2022; 28:2947-2965. [PMID: 34894883 PMCID: PMC9452851 DOI: 10.1177/10778012211058218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study explores and analyzes how adult women in Sweden exposed to childhood maltreatment describe wellbeing, by using a thematic analysis of 22 semi-structured interviews with women maltreated as children. The results show that wellbeing was described as relative to both social norms and the childhood experiences and constituted four dimensions: Material and/or economic; Social and relational;Emotional; and Physical and/or mental. This study concludes that it is important to consider the relative and multiple ways wellbeing can be experienced and understood and to problematize norms of wellbeing, acknowledging the various ways people appraise their lives.
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Affiliation(s)
- Linda Arnell
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Åsa Källström
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Hrafnhildur Gunnarsdottir
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Health Sciences, University West, Trollhättan, Sweden
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Masterton W, Parkes T, Carver H, Park KJ. Exploring how greenspace programmes might be effective in supporting people with problem substance use: a realist interview study. BMC Public Health 2022; 22:1661. [PMID: 36050664 PMCID: PMC9436451 DOI: 10.1186/s12889-022-14063-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Greenspace programmes are health projects run outside in nature, typically with the aim of improving mental health. Research suggests that programmes may also be effective in supporting people with problem substance use (PSU), but there is limited understanding of the key components that make them successful for this client group. Previous work has claimed that a realist-informed intervention framework for greenspace programmes for mental health could be transferable to programmes that support people with PSU, and that this could provide insight into the causal processes within programmes. However, this claim is yet to be explored in depth. The aim of this study was to further test, refine, and consolidate the proposed framework to show how greenspace programmes could support people with PSU. METHODS Using a realist approach, 17 participants (8 programme staff; 9 wider stakeholders) were interviewed about contexts, mechanisms, and outcomes (CMOs) relative to greenspace programmes for mental health and PSU. Semi-structured interviews were used since they facilitated exploration of the proposed framework but were flexible enough to allow identification of new CMOs for framework refinement. Interviews were audio-recorded, fully transcribed, and analysed inductively and deductively against the proposed framework. RESULTS Findings supported the proposed framework and indicated that greenspace programmes support people with poor mental health and PSU due to: feelings of escape; space to reflect; physical activity; self-efficacy; feelings of purpose; relationships; and shared experiences. However, data showed that programmes must also consider: explicit intervention focus to ensure adequate support for clients; existing challenges with funding and stakeholder buy-in; and the impact of COVID-19. Findings allowed development of a refined framework that shows how greenspace programmes can support people with PSU. CONCLUSION The findings of this project are theoretically novel and have practical relevance for those designing greenspace programmes by providing recommendations on how to optimise, tailor, and implement future interventions. Findings could be particularly relevant for academic researchers, multidisciplinary health professionals, and for those working in the third sector, developing and delivering greenspace programmes for people to improve their mental health and to support them with PSU.
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Affiliation(s)
- Wendy Masterton
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Tessa Parkes
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - Hannah Carver
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - Kirsty J Park
- Biological and Environmental Sciences, University of Stirling, Stirling, FK9 4LA, Scotland, UK
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shoib S, Hussaini SS, Chandradasa M, Saeed F, Khan T, Swed S, Lengvenyte A. Role of pets and animal assisted therapy in suicide prevention. Ann Med Surg (Lond) 2022; 80:104153. [PMID: 36045797 PMCID: PMC9422226 DOI: 10.1016/j.amsu.2022.104153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Sheikh shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | | | | | - Fahimeh Saeed
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Tuba Khan
- Md, ziauddin university, Karachi, Pakistan
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
- Corresponding author.
| | - Aiste Lengvenyte
- IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
- Department of Urgent and Post Urgent Psychiatry, CHU Montpellier, Montpellier, France
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12
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Taylor EJ. How Can I Use Nature to Nurture the Spirit? J Christ Nurs 2022; 39:193. [PMID: 35665425 DOI: 10.1097/cnj.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Elizabeth Johnston Taylor
- Elizabeth Johnston Taylor, PhD, RN, FAAN, is a professor at the School of Nursing at Loma Linda University, Loma Linda, CA. She researches and writes frequently on spiritual care
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Moyers SI, Abildso CG, Kelley GA. Context, classification and study methodologies in research into nature-based therapies: protocol for a scoping review. BMJ Open 2022; 12:e060734. [PMID: 35393333 PMCID: PMC8991050 DOI: 10.1136/bmjopen-2021-060734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nature provides an array of health benefits, and recent decades have seen a resurgence in nature-based interventions (NBI). While NBI have shown promise in addressing health needs, the wide variety of intervention approaches create difficulty in understanding the efficacy of NBI as a whole. This scoping review will (1) identify the different nomenclature used to define NBI, (2) describe the interventions used and the contexts in which they occurred and (3) describe the methodologies and measurement tools used in NBI studies. METHODS AND ANALYSIS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews, four databases will be searched (PubMed, Web of Science, Scopus, ProQuest Dissertations and Theses Global) as well as cross-referencing for published and unpublished (masters theses and dissertations) studies on NBI in humans. Eligible studies must employ intervention or observational designs, and an English-language abstract will be required. Database searches will occur from inception up to the date of the search. Animal-based therapies and virtual-reality therapies involving simulated nature will be excluded. Independent dual screening and data abstraction will be conducted. Results will be analysed qualitatively as well as with simple descriptive statistics (frequencies and percentages). ETHICS AND DISSEMINATION Since this is a scoping review of previously published summary data, ethical approval for this study is not needed. Findings will be published in a peer-reviewed journal. This protocol has been registered with Open Science Framework (https://osf.io/mtzc8).
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Affiliation(s)
- Samantha I Moyers
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - Christiaan G Abildso
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
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Lipponen M, Hallikainen V, Kilpeläinen P. Effects of Nature-Based Intervention in Occupational Health Care on Stress – A Finnish Pilot Study Comparing Stress Evaluation Methods. J Multidiscip Healthc 2022; 15:577-593. [PMID: 35378740 PMCID: PMC8976576 DOI: 10.2147/jmdh.s353168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/28/2022] [Indexed: 12/20/2022] Open
Abstract
Purpose To assess methodology and its limitations for measuring effects of nature-based intervention (NBI). Patients and Methods Participants were 11 middle-aged female health care workers with lowered capacity to work. NBI included six group appointments in six months study period. Heart rate variability (HRV) and self-reported pain and work exhaustion were measured pre-post study period. Salivary α-amylase samples were collected immediately before and after three individual interventions. Salivary cortisol samples were collected on the same three interventions, on three consecutive days starting from the day of intervention, to assess (a) month effect (pre-post study period) and (b) day effect (intervention day vs non-intervention day). Results Individual interventions resulted in increase in α-amylase activity. However, the average fold increase decreased from the 3.05 ± 1.20 of the first intervention to 1.91 ± 1.00 and 1.46 ± 0.77 in the second and third intervention, respectively (p < 0.001). Cortisol concentrations were lower on intervention days vs non-intervention days, the difference being indicative (p = 0.050). Pain and work exhaustion decreased during the study period, as well as HRV, although any of these changes was not statistically significant. Conclusion For a large-scale study, it would be ideal to select assays for both major pathways: hypothalamic-pituitary-adrenal axis can be measured by cortisol, whereas response via autonomic nervous system can be measured by HRV, when roles of sympathetic and parasympathetic nervous systems can be pinpointed separately. Salivary α-amylase can be used when continuous monitoring is not possible. Psychological well-being of participants should be surveyed, as well as their activities and moods on sampling days recorded.
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Affiliation(s)
- Maija Lipponen
- Unit of Bioeconomy and Environment, Natural Resources Institute Finland, Paltamo, Finland
- Correspondence: Maija Lipponen, Unit of Bioeconomy and Environment, Natural Resources Institute Finland, Manamansalontie 90, Paltamo, FI-88300, Finland, Tel +35 8295322024, Email
| | - Ville Hallikainen
- Unit of Natural Resources, Natural Resources Institute Finland, Rovaniemi, Finland
| | - Pekka Kilpeläinen
- Unit of Measurement Technology, Kajaani University Consortium, University of Oulu, Kajaani, Finland
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15
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Beck AJ, Barber T, McKenzie H, Thorlakson J, Dell C, Keeping-Burke L. Perceptions and experiences of health care professionals and staff with animal-assisted interventions in health care settings: a qualitative systematic review protocol. JBI Evid Synth 2022; 20:924-930. [PMID: 35019870 DOI: 10.11124/jbies-21-00151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to examine the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. INTRODUCTION Animal-assisted interventions are applied in the areas of health, education, and human services to help improve individuals' health and wellness. The positive effects of animal-assisted interventions on individuals have been shown in multiple health disciplines from pediatrics to long-term care and include outcomes such as decreased feelings of loneliness and increased feelings of support. The increase of animal-assisted interventions in human health initiated growing research on health care professionals' perceptions and experiences of these interventions. No current qualitative systematic reviews have focused solely on health care professionals' and staff's perceptions of animal-assisted interventions. Conducting such a review will advance understanding of how these providers perceive and engage with animal-assisted interventions as well as their influence and role in coordinating these interventions. INCLUSION CRITERIA This review will consider qualitative primary studies that address the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. Studies published from database inception to present and in English will be considered. METHODS Nine bibliographic databases will be systematically searched for published and unpublished studies by employing a three-step search strategy. Two reviewers will independently appraise the studies and extract qualitative data using the standardized JBI critical appraisal and data extraction instruments. Findings from the review will be categorized according to similarity in meaning and categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42021258909).
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Affiliation(s)
- Amy J Beck
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada Department of Family Medicine, University of Alberta, Edmonton, AB, Canada Department of Sociology, University of Saskatchewan, Saskatoon, SK, Canada Cameron Science, Technology, and Business Library, University of Alberta, Edmonton, AB, Canada Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
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16
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Murroni V, Cavalli R, Basso A, Borella E, Meneghetti C, Melendugno A, Pazzaglia F. Effectiveness of Therapeutic Gardens for People with Dementia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9595. [PMID: 34574519 PMCID: PMC8469939 DOI: 10.3390/ijerph18189595] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 12/11/2022]
Abstract
This paper is a systematic review of quantitative studies conducted on the benefits of visiting gardens and gardening therapy for people with dementia (PWD) in an effort to assess the effectiveness of such treatments and obtain information on the most appropriate garden design for this population. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. Four databases were searched (PubMed, Web of Science, PsycINFO, Scopus), with no time limits. Out of a total of 480 articles considered, 16 studies were selected for review. In all but two of the studies examined, gardening therapy and the use of therapeutic gardens induced psychophysiological improvements in PWD. The areas showing the greatest effects were Engagement, Agitation, Depression/Mood, Stress, and Medication. It also emerged that interest in this sphere has been growing in the last decade, but there is still a shortage of empirical evidence of the beneficial effects of therapeutic gardens in relation to the type and severity of dementia, and of garden design guidelines. Despite the limited number of studies investigated, the review confirmed the benefits of gardening and therapeutic gardens in PWD. There is nonetheless a need to conduct more quantitative research to support currently-available evidence and generate more information, focusing on garden design criteria, in-garden activities, the type and severity of dementia examined, and effects on caregivers as well as on PWD.
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Affiliation(s)
- Veronica Murroni
- Department of General Psychology, Università degli Studi di Padova, 35121 Padova, Italy; (V.M.); (E.B.); (C.M.)
| | - Raffaele Cavalli
- Department of Land Environment Agriculture and Forestry, Università degli Studi di Padova, 35020 Padova, Italy;
| | - Andrea Basso
- “Giotto” Social Cooperative, 35127 Padova, Italy;
| | - Erika Borella
- Department of General Psychology, Università degli Studi di Padova, 35121 Padova, Italy; (V.M.); (E.B.); (C.M.)
| | - Chiara Meneghetti
- Department of General Psychology, Università degli Studi di Padova, 35121 Padova, Italy; (V.M.); (E.B.); (C.M.)
| | | | - Francesca Pazzaglia
- Department of General Psychology, Università degli Studi di Padova, 35121 Padova, Italy; (V.M.); (E.B.); (C.M.)
- Inter-University Research Center in Environmental Psychology (CIRPA), 00185 Roma, Italy
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17
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Turner M, King N, Mojtahedi D, Burr V, Gall V, Gibbs GR, Hudspith LF, Leadley CB, Walker T. Well-being programmes in prisons in England and Wales: a mixed-methods study. Int J Prison Health 2021; 18:259-274. [PMID: 34382757 DOI: 10.1108/ijph-03-2021-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE In the past decade, there has been growing awareness of well-being and its importance and an increase in the development of activities or programmes aimed at improving well-being. The purpose of this study is to investigate what well-being programmes were being offered to prisoners in England and Wales and what benefits and other outcomes were experienced. DESIGN/METHODOLOGY/APPROACH The study used a mixed-methods exploratory design in two phases. Phase 1 was a questionnaire survey of all adult prisons in England and Wales, completed by prison staff. In Phase 2, a sample of survey respondents took part in in-depth interviews. FINDINGS The programmes identified in Phase 1 included physical activities, creative arts, mindfulness, horticulture, reading and animal-assisted activities. Prison staff reported a range of universally positive outcomes shared by all programmes, including enthusiasm from prisoners, enjoyment of the activities and being able to do something different from the usual prison routine. However, in Phase 2, interviewees rarely mentioned direct health and well-being benefits. The impetus for programmes was varied and there was little reference to national policy on health and well-being; this reflected the ad hoc way in which programmes are developed, with a key role being played by the Well-being Officer, where these were funded. ORIGINALITY/VALUE The literature on well-being programmes in prisons is limited and tends to focus on specific types of initiatives, often in a single prison. This study contributes by highlighting the range of activities across prisons and elucidating the perspectives of those involved in running such programmes.
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Affiliation(s)
- Mary Turner
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Nigel King
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Dara Mojtahedi
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Viv Burr
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Victoria Gall
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Graham R Gibbs
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Lara Flynn Hudspith
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | | | - Tammi Walker
- Centre for Applied Psychological Science, Teesside University, Middlesbrough, UK
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18
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Madsen LS, Poulsen DV, Nielsen CV, Handberg C. "It Was Definitely an Eye-Opener to Me"-People with Disabilities' and Health Professionals' Perceptions on Combining Traditional Indoor Rehabilitation Practice with an Urban Green Rehabilitation Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115994. [PMID: 34204913 PMCID: PMC8199774 DOI: 10.3390/ijerph18115994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
Research points to the health benefits of rehabilitation in urban green spaces. Nevertheless, more studies indicate complexity of utilising urban green spaces in an established health system context. An understanding of challenges related to rehabilitation in urban green spaces remains unaddressed. Therefore, the aim was to describe and analyse people with disabilities' and health professionals' perceptions on combining traditional indoor rehabilitation practice with an urban green rehabilitation context. The interpretive description methodology was applied supplemented by Edgar Schein's Model of Organisational Culture. Three online focus group interviews were conducted with people with disabilities (n = 4) and health professionals (n = 10). Three interrelated themes formed an understanding of rehabilitation practice in an urban green rehabilitation context: "ambivalence due to contextual change", "negotiating rehabilitation assumptions" and "expanding the frame of rehabilitation". Expanding the frame of rehabilitation to an urban green context may provide a basis for enhancing compatibility to everyday life for people with disabilities and still accommodate structural quality standards of professional rehabilitation practice.
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Affiliation(s)
- Louise Sofia Madsen
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark; (C.V.N.); (C.H.)
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Correspondence:
| | - Dorthe Varning Poulsen
- Department of Geosciences and Natural Resource Management, University of Copenhagen, 1958 Frederiksberg, Denmark;
| | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark; (C.V.N.); (C.H.)
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Regional Hospital West Jutland, Central Denmark Region, 7400 Herning, Denmark
| | - Charlotte Handberg
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark; (C.V.N.); (C.H.)
- National Rehabilitation Centre for Neuromuscular Diseases, 8000 Aarhus, Denmark
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19
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Harper NJ, Fernee CR, Gabrielsen LE. Nature's Role in Outdoor Therapies: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5117. [PMID: 34065947 PMCID: PMC8150931 DOI: 10.3390/ijerph18105117] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 11/22/2022]
Abstract
Objective: To report on the role of nature in outdoor therapies through review and summary of existing systematic and meta-analytic reviews in an effort to articulate a theoretical framework for practice. Materials and methods: An umbrella review was conducted following systematic protocols PRISMA guidelines. Results: Fourteen studies met the inclusion criteria and represented five self-identified approaches: nature-based therapies, forest therapy, horticultural therapy, wilderness therapy, and adventure therapy. Clear and comprehensive descriptions of theory, program structure, and activity details with causal links to outcomes were mostly absent. Conclusions: A rigorous and determined program of research is required in order to explicit in-depth theories of change in outdoor therapies. Conversely, or maybe concurrently, a holistic theory of integrated relatedness may be developed as a parallel expression of support for nature in therapy while the explanatory science catches up.
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Affiliation(s)
- Nevin J. Harper
- Faculty of Human & Social Development, University of Victoria, Victoria, BC V8W 2Y2, Canada
- Sørlandet Sykehus, 4604 Kristiansand, Norway; (C.R.F.); (L.E.G.)
| | - Carina R. Fernee
- Sørlandet Sykehus, 4604 Kristiansand, Norway; (C.R.F.); (L.E.G.)
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20
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Madsen LS, Jakubec SL, V Nielsen C, Handberg C. The potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation. Disabil Rehabil 2021; 44:3992-4003. [PMID: 33749467 DOI: 10.1080/09638288.2021.1897887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: The aim was to examine the potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation.Materials and methods: Interpretive description was applied as the methodology in a 5-month ethnographic fieldwork study, and guided by social practice theory. In total, 115 people with disabilities were included for participant observation, of which 15 participants were recruited for individual walking interviews.Results: Analysis revealed four overlapping themes. Firstly, "Revisiting the Outdoors" appeared to be an overarching theme, which created a basis for "Building Autonomy" among the participants. The varied outdoor experiences empowered the participants to take a more active role in their rehabilitation. These experiences afforded unique opportunities for "Connecting with Community" and, finally, "Embodied Learning" - that could be transferred to home and to other everyday contexts.Conclusion: Outdoor contexts within community-based rehabilitation appeared to hold strong potential for connecting people with disabilities to communities. Although barriers exist, we argue that revisiting the outdoors supports collective awareness and action with the capacity to influence community attitudes more broadly.IMPLICATIONS FOR REHABILITATIONOutdoor contexts within community-based rehabilitation for people with disabilities capitalise on the features of both indoor and outdoor environments with activities that meet shifting individual priorities and needs.Outdoor contexts within community-based rehabilitation offer people with disabilities empowering experiences that are part of the landscape of everyday life and transfer well to home and other environments.Community-based rehabilitation directly involving outdoor contexts and supported by professional skills provides a crucial bridge from individual rehabilitation to community belonging.
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Affiliation(s)
- Louise S Madsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Sonya L Jakubec
- School of Nursing and Midwifery, Mount Royal University, Calgary, Canada
| | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Region Hospital West Jutland, Central Denmark Region, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Aarhus University, Aarhus, Denmark.,National Rehabilitation Centre for Neuromuscular Diseases, Aarhus, Denmark
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21
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Jones R, Tarter R, Ross AM. Greenspace Interventions, Stress and Cortisol: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062802. [PMID: 33801917 PMCID: PMC8001092 DOI: 10.3390/ijerph18062802] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 02/06/2023]
Abstract
Background: Engaging with nature can profoundly impact psychological and physiological health of persons across the lifespan. Greenspace interventions (GSI) encompass a broad range of strategic, nature-based activities for overall health and wellbeing. Within the past 20 years there has been a growing interest in the access to and management of greenspace to mediate the deleterious impact of acute and chronic stress, particularly, physiologic biomarkers of stress such as cortisol. Objective: This review aims to describe the impact of greenspace interventions on cortisol, to present the current state of the science on GSIs as they impact cortisol, and to uncover any limitations of current research strategies to best inform future research. Methods: A scoping methodology was conducted to systematically study this emerging field and inform future research by mapping the literature based on the GSI category, interventional design, cortisol metrics, and subsequent analysis of cortisol. Conclusion: Considerable heterogeneity in research design, aim(s), interventional strategy, and cortisol metrics were identified from a total of 18 studies on GSIs and cortisol outcomes. While studies demonstrated a potential for the positive association between GSIs and stress relief, more rigorous research is needed to represent GSIs as an intervention to mitigate risks of stress.
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Affiliation(s)
- Reo Jones
- Correspondence: ; Tel.: +1-402-651-1354
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22
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Corley J, Okely JA, Taylor AM, Page D, Welstead M, Skarabela B, Redmond P, Cox SR, Russ TC. Home garden use during COVID-19: Associations with physical and mental wellbeing in older adults. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2021; 73:101545. [PMID: 36540294 PMCID: PMC9756817 DOI: 10.1016/j.jenvp.2020.101545] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/19/2020] [Accepted: 12/08/2020] [Indexed: 05/02/2023]
Abstract
The COVID-19 pandemic has affected many aspects of people's lives. Lockdown measures to reduce the spread of COVID-19 have been more stringent for those aged over 70, at highest risk for the disease. Here, we examine whether home garden usage is associated with self-reported mental and physical wellbeing in older adults, during COVID-19 lockdown in Scotland. This study analysed data from 171 individuals (mean age 84 ± 0.5 years) from the Lothian Birth Cohort 1936 study who completed an online survey approximately two months after lockdown commenced (May/June, 2020), and reported having access to a home garden. The survey also included items on garden activities (gardening, relaxing), frequency of garden usage during lockdown, and measures of self-rated physical health, emotional and mental health, anxiety about COVID-19, and sleep quality. Ordinal regression models were adjusted for sex, living alone, education, occupational social class, anxiety and depressive symptoms, body mass index, and history of diabetes and cardiovascular disease. Neither gardening nor relaxing in the garden were associated with health outcomes. However, higher frequency of garden usage during lockdown was associated with better self-rated physical health (P = 0.005), emotional and mental health (P = 0.04), sleep quality (P = 0.03), and a composite health score (P = 0.001), after adjusting for covariates. None of the garden measures were associated with perceived change in physical health, mental and emotional health, or sleep quality, from pre-lockdown levels. The results of the current study provide support for positive health benefits of spending time in a garden-though associations may be bidirectional-and suggest that domestic gardens could be a potential health resource during the COVID-19 pandemic.
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Affiliation(s)
- Janie Corley
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Judith A Okely
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Adele M Taylor
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Danielle Page
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Miles Welstead
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Edinburgh Dementia Prevention, University of Edinburgh, BioCube 1, Edinburgh, UK
| | - Barbora Skarabela
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Tom C Russ
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, 7 George Square, Edinburgh, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, UK
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The Restorative Potential of Icelandic Nature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239095. [PMID: 33291500 PMCID: PMC7730928 DOI: 10.3390/ijerph17239095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/29/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
This study aimed to investigate if proposed restorative attributes according to attention restoration theory and supportive environment theory could be experienced and identified in Icelandic landscape and contribute to a restorative experience in nature sites in rural Iceland. A prospective mixed-method study was conducted over the period of one year. Seven different nature sites that were considered likely to have restorative qualities were selected for the evaluation i.e., three forest sites, three seashores, and one park in and in the vicinity of Ísafjörður, Iceland. Each site was evaluated regarding how the participants experienced its restorative qualities and how a stay therein affected their mental state. Nature visits were offered once a week, where the participants visited one of the seven locations for two hours. The findings show that the participants perceived and experienced nature sites as having the characteristics of a restorative environment and that staying at the nature sites positively affected their mental state. External conditions, like weather, which can affect nature visits, were rarely a hinderance. Thus, it can be concluded that numerous coastal areas, forests, and parks in Iceland, especially in rural areas, might possess restorative qualities as well. This result shows that wild and open nature in North West Iceland has the characteristics of a restorative environment and can be utilized for health promotion.
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Therapeutic Nature Activities: A Step Toward the Labor Market for Traumatized Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207542. [PMID: 33081308 PMCID: PMC7590045 DOI: 10.3390/ijerph17207542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Globally, the number of refugees is growing. For many refugees, entering the labor market in their new country of residence is challenging. Some remain forever dependent on welfare services, and this not only weakens their chances of integration, but also harms their health and well-being. METHODS This qualitative single case study focused on a group of war-stricken refugees in Denmark. The study investigated the impact of an eight-month horticultural vocational program aimed at improving their ability to complete an education program or to work. A total of 29 interviews were conducted and analyzed using the interpretative phenomenological analysis (IPA) method. RESULTS The natural environment in the eco-village evoked a feeling of safety as well as positive memories in the participants, in contrast to the traumatic memories they had of their flight. Horticultural activities and the positive and respectful attitude from staff initiated a recovery process. New skills were achieved at an individual pace, and feelings of isolation decreased. These findings can be implicated in future interventions.
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Flynn E, Denson EB, Mueller MK, Gandenberger J, Morris KN. Human-animal-environment interactions as a context for youth social-emotional health and wellbeing: Practitioners' perspectives on processes of change, implementation, and challenges. Complement Ther Clin Pract 2020; 41:101223. [PMID: 32823146 DOI: 10.1016/j.ctcp.2020.101223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Human-animal-environment interactions (HAEIs) are increasingly used in interventions for youth with psychosocial challenges, yet research is limited. Staff from an exemplary program that use HAEIs have unique perspectives on the processes involved in youth outcomes. The aim of this study was to elucidate processes of change that may underly HAEIs and key implementation considerations. MATERIALS AND METHODS A phenomenological approach was used to ascertain HAEI staff perspectives of how they have seen HAEIs impact youth. Semi-structured interviews were completed with 24 staff at a mental health treatment program that utilizes HAEIs. RESULTS Six themes were identified, including views that HAEIs had challenges, afforded youth with valuable opportunities, improved mood, facilitated relationships and self-regulation, and strengthened self-conception. CONCLUSION Findings will inform program development; and future research to assess mediating variables and best practices in implementation of HAEIs.
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Affiliation(s)
- Erin Flynn
- Institute for Human-Animal Connection, Graduate School of Social Work, University of Denver, 2148 South High Street, Denver, CO, 80208, USA.
| | - Emma Brandl Denson
- Institute for Human-Animal Connection, Graduate School of Social Work, University of Denver, 2148 South High Street, Denver, CO, 80208, USA.
| | - Megan K Mueller
- Tufts Institute for Human-Animal Interaction, Department of Clinical Sciences, Cummings School of Veterinary Medicine and Jonathan M. Tisch College of Civic Life at Tufts University, 200 Westboro Rd, North Grafton, MA, 01536, USA.
| | - Jaci Gandenberger
- Institute for Human-Animal Connection, Graduate School of Social Work, University of Denver, 2148 South High Street, Denver, CO, 80208, USA.
| | - Kevin N Morris
- Institute for Human-Animal Connection, Graduate School of Social Work, University of Denver, 2148 South High Street, Denver, CO, 80208, USA.
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Gritzka S, MacIntyre TE, Dörfel D, Baker-Blanc JL, Calogiuri G. The Effects of Workplace Nature-Based Interventions on the Mental Health and Well-Being of Employees: A Systematic Review. Front Psychiatry 2020; 11:323. [PMID: 32411026 PMCID: PMC7198870 DOI: 10.3389/fpsyt.2020.00323] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/31/2020] [Indexed: 01/10/2023] Open
Abstract
Mental health in the workplace is a societal challenge with serious economical and human costs. Most prevalent mental disorders in the workforce (e.g., depression), however, are preventable. There is widespread agreement about the favorable effects of nature exposure and consequently, nature-based interventions (NBI) in the workplace have been proposed as a cost-effective approach to promote good health among employees. The objective of the present study was to systematically review scientific evidence on the effectiveness of NBI to promote mental health and well-being among actual employees in actual workplace settings. The review was conducted and presented in accordance with the PRISMA guidelines. The literature search was performed on five databases (PubMed, Embase, CENTRAL, CINHAL, and PsycINFO), hand-searching of field-specific journals, and the reference lists of retrieved papers over the past 5 years up to November (13th, 2018). Studies were eligible for inclusion if they (i) were randomized or nonrandomized controlled trials; (ii) comprised samples of actual employees; (iii) implemented a workplace-based intervention with exposure to nature; (iv) included comparison conditions that displayed a clear contrast to NBIs; and (v) investigated the quantitative effects on mental health or well-being. No restrictions on type of employees or workplace, publication period, or language of the publication were set. Risk of bias was assessed using the Cochrane's RoB2 tool. Narrative synthesis was performed due to large heterogeneity in outcome variables. Of the 510 articles identified, 10 NBIs (nine papers) met the eligibility criteria. The outcomes were grouped in five categories: (i) mental health indices, (ii) cognitive ability, (iii) recovery and restoration, (iv) work and life satisfaction, and (v) psychophysiological indicators. Narrative synthesis indicates consistently positive effects on mental health indices and cognitive ability, while mixed results were found for the other outcome categories. Caution must be given when interpreting the current evidence in this emerging research field because of the diversity of NBIs and the overall high risk of bias in the individual studies. Although in this field often researchers have to balance scientific rigor and ecological validity, there is a need for large, well-designed and rigorously conducted trials grounded in contemporary theories.
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Affiliation(s)
- Susan Gritzka
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Science, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | | | - Denise Dörfel
- School of Science, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jordan L. Baker-Blanc
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Giovanna Calogiuri
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Davies J, McKenna M, Bayley J, Denner K, Young H. Using engagement in sustainable construction to improve mental health and social connection in disadvantaged and hard to reach groups: a new green care approach. J Ment Health 2020; 29:350-357. [PMID: 32036713 DOI: 10.1080/09638237.2020.1714001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The positive impact of the outdoors on physical and mental health is increasingly being evidenced. However, the impact on vulnerable and disadvantaged individuals engaging in group based sustainable building construction has not been examined.Aim: To provide the first pragmatic examination of the impact of engaging in a brief (8 days over 8 weeks) outdoor sustainable construction project on the mental health and social connectedness of hard to reach and disadvantaged groups.Methods: In study 1, 93 young people not in education, employment or training took part whilst study 2 comprised 55 adults who were asylum seekers, long-term unemployed or men with longstanding depression. Self-report data were collected at baseline and towards the end of the programme.Results: Those with poor mental health and social connection at baseline showed statistically and clinically significant improvements in depression, anxiety, resilience and social connection by the end of the brief intervention.Conclusion: Engagement in a group based sustainable construction project can provide significant mental health and social benefits to a range of vulnerable and hard to reach groups with difficulties in these areas. Building on these findings could be important for health and social care policy for marginalised groups.
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Affiliation(s)
- Jason Davies
- Department of Psychology, College of Human and Health Sciences, Vivian Tower, Swansea University, Swansea, UK
| | | | | | | | - Hayley Young
- Department of Psychology, College of Human and Health Sciences, Vivian Tower, Swansea University, Swansea, UK
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‘I want to make myself useful’: the value of nature-based adult day services in urban areas for people with dementia and their family carers. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19001168] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AbstractNature-based adult day services (ADSs) in urban areas are relatively new services in the Netherlands. Since knowledge about these services is still scarce, this study aimed to elucidate their value for people with dementia and their family carers in terms of health and wellbeing. We interviewed 39 people with dementia attending nature-based ADSs in urban areas and their family carers, and 17 providers of these services. Respondents indicated that nature-based ADSs in urban areas positively affected the health and wellbeing of people with dementia. According to them, these services support contact with nature and animals, activity engagement, physical activity, structure, social interactions, healthy eating, a sense of meaning in life and a focus on normal daily life. Respondents further indicated that these services stimulate respite, reassurance and maintenance of family carers’ own activities and social contacts. We conclude that nature-based ADSs in urban areas have a wide range of benefits that might affect the health and wellbeing of people with dementia and their family carers. Worldwide, demand is growing for innovative practices in dementia care. It is therefore worthwhile monitoring the development of dementia care innovations, such as nature-based ADSs, and for countries to exchange lessons learned from these services.
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