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Vibholm AP, Pallesen H, Christensen JR, Varning Poulsen D. Nature-based rehabilitation-experiences from patients with acquired brain injury: an explorative qualitative study. Disabil Rehabil 2024; 46:4384-4393. [PMID: 37950396 DOI: 10.1080/09638288.2023.2274874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Nature has been found to improve and promote health and prevent disease. Nature-based rehabilitation (NBR) delivered as part of neurorehabilitation is a developing approach. Yet to date the research is sparse. Following an acquired brain injury (ABI), people often experience impairments that cause limitations in activity and participation in daily life, which can impact the quality of life long-term. NBR delivered in neurorehabilitation has previously been explored from the perspective of occupational therapists and physiotherapists, however, to date patients' experiences are yet to be explored. This study aims to explore patients' experiences and perspectives of NBR delivered as part of standard neurorehabilitation. METHODS This qualitative study had a constructivist and phenomenological design. Semi-structured focus group interviews were carried out across three healthcare settings in Denmark with 17 participants. Data was analysed using content analysis. RESULTS The analysis generated three categories: 1. Outdoor versus indoor environment, 2. The natural environment as a co-therapist, and 3. Interrelatedness. CONCLUSION The study provides insight into participants' experiences of NBR. They reported that interacting with the natural environment as part of neurorehabilitation enhanced activity. Moreover, being in nature increased their self-efficacy, sense of autonomy, community spirit, cooperation, and joy, and led to a feeling of peace.
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Affiliation(s)
- Anne Pernille Vibholm
- Hammel Neurorehabilitation Centre and University Research Clinic, RM, Hospital Unit Viborg, Silkeborg, Hammel and Skive, University of Aarhus, Denmark
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hanne Pallesen
- Hammel Neurorehabilitation Centre and University Research Clinic, RM, Hospital Unit Viborg, Silkeborg, Hammel and Skive, University of Aarhus, Denmark
| | - Jeanette Reffstrup Christensen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Research Unit of General Practice, Aarhus, Denmark
- DRIVEN, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Dorthe Varning Poulsen
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Denmark
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Bettmann JE, Speelman E, Blumenthal E, Couch S, McArthur T. How Does Nature Exposure Affect Adults With Symptoms of Mental Illness? A Meta-Analysis. Int J Ment Health Nurs 2024. [PMID: 39209768 DOI: 10.1111/inm.13400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 07/07/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024]
Abstract
Existing research on the effects of nature exposure on the mental health of adults indicates that spending time in nature reduces depressive symptoms and stress, increases quality of life and mood and improves mental health. This meta-analysis aimed to answer the question: what are the effects of nature exposure on the social, mental and physical health of adults with symptoms of mental illness? The meta-analysis included all studies relevant to the study research questions which collected quantitative data on nature exposure using validated instruments for at least two time points on each participant and which were published between 1990 and 2020. Regarding the impact of nature exposure on adults with symptoms of mental illness, analyses showed significant, moderate effect sizes for all studies and smaller, but significant, effect sizes for studies with control groups Analyses also yielded critical information regarding the effect size of the type of nature dosage, nature setting, nature-based activity, key mental health outcomes and other factors. These findings from the present study results have important implications regarding the potential benefits of nature exposure for adults and its role in healthcare.
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Affiliation(s)
- Joanna E Bettmann
- University of Utah College of Social Work, Salt Lake City, Utah, USA
| | | | - Ellison Blumenthal
- Department of Social Work, University of New Hampshire, Durham, New Hampshire, USA
| | - Scott Couch
- Department of Parks, Recreation, and Tourism, University of Utah, Salt Lake City, Utah, USA
| | - Tara McArthur
- University of Utah College of Social Work, Salt Lake City, Utah, USA
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Gunnarsson AB, Aurin IE, Holmberg S. Being in a meaningful context. Nature and animal-assisted activities as perceived by adults with autism. Aust Occup Ther J 2024; 71:513-526. [PMID: 38410868 DOI: 10.1111/1440-1630.12940] [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: 09/07/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Animal-assisted and nature-based interventions in psychosocial treatment for various groups of clients have been studied internationally. However, there is little knowledge about how young adults with autism experience participation in such types of interventions. This clinical study aimed to describe the feasibility of animal-assisted and nature-based activities on a farm as a complementary intervention for young adults with autism and social withdrawal. METHODS The participants were aged 18-30 years, diagnosed with autism and social withdrawal, with no organised occupation during the previous year. Eleven of 13 participants completed a 12-week intervention in small groups. They took part in interviews before and after, which focused on their current life situation and expectations about, and experiences of the intervention. The feasibility was described in terms of participants' characteristics, attendance, and their experiences of participating in the activity. Data were analysed with descriptive statistics and qualitative content analysis. CONSUMER AND COMMUNITY INVOLVEMENT The intervention was formed in collaboration with participating supervisors, ordinary clinical staff, and a young woman with a user perspective. FINDINGS The level of feasibility was found to be high. The mean participation rate during the activity days was 75% and varied from 50 to 100%. The analysis of the participants' experiences from the activity generated three categories, "Being in a meaningful context", "Creating a comfort zone" and "Developing structure in everyday life", and each of these included sub-categories. CONCLUSION The main categories revealed a dynamic process based in meaningfulness, comfort and structure in everyday life. The positive experiences of undemanding activities, emotional relationships and non-verbal communication with the horses were prominent and might facilitate the development of social interaction. However, the intervention's timeframe of 12 weeks was experienced as too short for long-lasting change.
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Affiliation(s)
- A Birgitta Gunnarsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Research and Development, Växjö, Sweden
| | | | - Sara Holmberg
- Department of Research and Development, Växjö, Sweden
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden
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Figueroa LP, Poskey GA, Rose KK, Pickens ND. Mechanisms of Change in Nature-Based Pediatric Occupational Therapy: The Ecology of Change in Outdoor Therapy Model. Occup Ther Health Care 2024:1-22. [PMID: 38957003 DOI: 10.1080/07380577.2024.2372739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
The purpose of this qualitative constructivist grounded theory study was to develop a model to explain potential mechanisms of change in the nature-based pediatric occupational therapy process, based on analysis of the perspectives of occupational therapy practitioners currently engaging in nature-based practice with children. Using 27 photos and interview data from 22 participants the Ecology of Change in Outdoor Therapy (ECO-Therapy) Model was developed. The model suggests mechanisms of change in nature-based pediatric occupational therapy may involve six iterative phases: Longing for Freedom, Embarking on Adventure, Dancing with Nature, Claiming Self-Agency, Braving Real-Life Challenges, and Growing Adaptive Capacity. The practitioner and child experiencing these phases throughout the nature-based occupational therapy process may lead to improved participation and performance in the child's daily life.
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Affiliation(s)
| | - Gail A Poskey
- Occupational Therapy, Texas Woman's University, Dallas, TX, USA
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Joubert A, Jankowski-Cherrier B, Rossi A, Teyssier L, Suraud V, Presle E, Pommier R, Massoubre C, Verot E. Impact of horticultural therapy on patients admitted to psychiatric wards, a randomised, controlled and open trial. Sci Rep 2024; 14:14378. [PMID: 38909093 PMCID: PMC11193794 DOI: 10.1038/s41598-024-65168-0] [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: 01/15/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
Psychiatric inpatients often endure anxiety. This randomized trial assessed the impact of horticultural therapy on anxiety in adult psychiatric inpatients over four weeks, compared to standard care. Recruiting 211 inpatients from six units were randomized into control (n = 105) and experimental (n = 106) groups. Control received usual care; the experimental group had horticultural therapy alongside usual care. Anxiety, measured using HADS-A scale at four weeks, aimed to establish horticultural therapy's superiority. After four weeks, horticultural therapy significantly reduced anxiety compared to standard care (P < 0.001). These results argue in favor of integrating horticultural therapy into psychiatric nursing practices.Trial registration: No Clinical Trail: NCT02666339 (1st registration: 28/01/2016).
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Affiliation(s)
- Aude Joubert
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Blandine Jankowski-Cherrier
- CHU Saint-Etienne, Pôle de Psychiatrie, Unité d'admission N°3 - Secteur Plaine, 42055, Saint-Etienne, France
| | - Audrey Rossi
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Laure Teyssier
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Valérie Suraud
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Emilie Presle
- Department of Clinical Investigation Centre, CIC 1408-INSERM Clinical Investigation Centre, CIC 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
- Unité de Recherche Clinique, Pharmacologie Clinique, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Romain Pommier
- REHALise, Centre Référent de Réhabilitation Psychosociale de Saint-Etienne, Rehacoor42, CHU de Saint-Etienne, Saint-Etienne, France
| | - Catherine Massoubre
- Laboratoire TAPE-EA 7423, Université Jean Monnet, Service Universitaire CHU Saint-Etienne, Saint-Etienne, France
| | - Elise Verot
- Department of Clinical Investigation Centre, CIC 1408-INSERM Clinical Investigation Centre, CIC 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France.
- Laboratoire Parcours Santé Systémique, Université Claude Bernard Lyon 1, Université de Lyon, P2S UR 4129, 69008, Lyon, France.
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, 42023, Saint-Etienne, France.
- Laboratoire Parcours Santé Systémique, Université Jean Monnet, Université de Lyon, P2S UR 4129, 42270, Saint-Etienne, France.
- Nursing Sciences and Health Technics Department, Faculty of Medicine, Jean Monnet University, 42271, Saint Priest en Jarez, France.
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Banwell N, Michel S, Senn N. Greenspaces and Health: Scoping Review of studies in Europe. Public Health Rev 2024; 45:1606863. [PMID: 38831866 PMCID: PMC11144923 DOI: 10.3389/phrs.2024.1606863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/22/2024] [Indexed: 06/05/2024] Open
Abstract
Objectives Access to greenspaces and contact with nature can promote physical activity and have positive effects on physical and mental health. This scoping literature review aims to examine current evidence linking greenspaces and (a) behaviour change, (b) health outcomes and (c) co-benefits. Methods This review was conducted in accordance with the PRISMA scoping review guidelines. Searches were conducted through PubMed and EMBASE databases for studies published between 2000 and March 2023 with a focus on Europe. Results 122 scientific articles and grey literature reports were identified. Access to greenspaces is positively associated with physical and mental health, and reduced risk of all-cause mortality and some non-communicable diseases. Greenspace quality is associated with increased physical activity and reduced risk of obesity. Nature-based therapies or green prescription are effective in improving mental health outcomes and overall health. Importantly, numerous co-benefits of greenspaces are identified. Conclusion Increasing access to greenspaces for populations with particular attention to greenspace quality is important for co-benefits. Responsible governance and use of greenspaces are crucial to minimize public health risks and human disturbance of nature.
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Affiliation(s)
- Nicola Banwell
- Interdisciplinary Centre for Research in Ethics (CIRE), University of Lausanne, Lausanne, Switzerland
| | - Sarah Michel
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Xiaoxue S, Huang X. Promoting stress and anxiety recovery in older adults: assessing the therapeutic influence of biophilic green walls and outdoor view. Front Public Health 2024; 12:1352611. [PMID: 38686034 PMCID: PMC11057236 DOI: 10.3389/fpubh.2024.1352611] [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: 01/05/2024] [Accepted: 03/14/2024] [Indexed: 05/02/2024] Open
Abstract
Previous research has already provided evidence regarding the favorable impact of green walls and outdoor views on stress reduction and anxiety alleviation. However, there has been limited exploration into the combined effects of green walls and outdoor views on older adults. In this study, a between-subjects experiment was conducted using virtual reality (VR) technology with 23 participants. Following exposure to stressors, each participant underwent four randomized sessions, each lasting 5 min, in various virtual reality (VR) environments, encompassing non-biophilic and biophilic environments (including green walls, outdoor views, and their combination). Throughout the process, we measured physiological indicators of stress responses, including heart rate, heart rate variability, skin conductance levels, and blood pressure, using biometric sensors. Psychological changes in participants, including anxiety levels, were evaluated through the State-Trait Anxiety Inventory, recovery scales, and self-reported emotional assessments. In conclusion, in comparison to non-biophilic environments, older adults consistently exhibited lower stress levels, experienced superior anxiety relief, and demonstrated improved recovery in nature connectedness environments, with a notably faster recovery rate. These findings suggest that the incorporation of nature connectedness principles into the indoor environments of public activity spaces within older adults care facilities can significantly contribute to stress reduction and anxiety alleviation among older adults. Furthermore, these effects appear to be contingent on the specific types of nature connectedness environments. These results can provide substantial evidence to support the design of indoor common activity spaces within older adults care facilities.
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Affiliation(s)
| | - Xuan Huang
- School of Architecture, Southwest Jiaotong University, Chengdu, China
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Kamide H, Arai T. Human-object interaction, connectedness with nature, and life satisfaction: a cross-sectional study. Front Psychol 2024; 15:1360518. [PMID: 38686084 PMCID: PMC11056575 DOI: 10.3389/fpsyg.2024.1360518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/03/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction This study aimed to elucidate the relationship between interactions with everyday objects (e.g., stationery, clothing, and tools) and one's connectedness with nature, environmentally conscious behavior, and life satisfaction. While previous research has predominantly explored the link between awareness of and behavior toward nature with direct education and experience related to the natural environment, we focused on the origins of the objects that surround us, which are inherently derived from nature. Methods We conducted an online survey with 1,102 Japanese participants, who completed an object-interaction measure assessing the two dimensions of care and learning, and measures of connectedness with nature, pro-environmental behavior, and life satisfaction. Results Interactions with everyday objects involving care and learning were significantly associated with a sense of connectedness with nature, pro-environmental behavior, and life satisfaction. Discussion The study highlights that interactions with everyday artifacts are not isolated experiences but are related to broader awareness of and behavior toward the natural world, and with individual life satisfaction. Hence, environmental awareness and actions can extend beyond direct environmental experiences and encompass daily interactions with objects. Future research could examine how cultural factors shape the relationship between human-object interactions, connection with nature, environmentally conscious behavior, and life satisfaction.
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Affiliation(s)
- Hiroko Kamide
- The Center for Interdisciplinary Studies of Law and Policy (CISLP), Graduate School of Law, Kyoto University, Nagoya, Japan
| | - Tatsuo Arai
- Center for Neuroscience and Biomedical Engineering, The University of Electro-Communications, Tokyo, Japan
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Kang M, Yang Y, Kim H, Jung S, Jin HY, Choi KH. The mechanisms of nature-based therapy on depression, anxiety, stress, and life satisfaction: examining mindfulness in a two-wave mediation model. Front Psychol 2023; 14:1330207. [PMID: 38187408 PMCID: PMC10768844 DOI: 10.3389/fpsyg.2023.1330207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Background Nature-based therapy (NBT), which centers around engaging in activities within natural surroundings, has consistently demonstrated therapeutic benefits for mental health. While NBT highlights the potential of nature as a therapeutic resource for promoting mental health, there is limited knowledge regarding its underlying mechanisms. Methods Two hundred seventy-six Korean participants (204 women, mean age = 54.99 ± 23.25 years) participated in a 30-session gardening program held twice weekly for 15 weeks. Structural equation modeling with a two-wave autoregressive cross-lagged model was used to investigate the mediating effects of mindfulness. Results NBT significantly improved the mean scores of all psychological variables. The mediation model was partially confirmed, with mindfulness at post-intervention (T2) mediating the relationship between baseline (T1) depression and anxiety and post-intervention (T2) life satisfaction. However, no significant indirect effect was observed between the path from stress (T1) to life satisfaction (T2). Conclusion Mindfulness is a crucial component for improving mental health outcomes. This study underscores the need to prioritize and emphasize mindfulness practices in NBT.
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Affiliation(s)
- Minjung Kang
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Yeji Yang
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Hyunjin Kim
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Songhie Jung
- Gardens and Education Research Division, Korea National Arboretum, Pocheon, Republic of Korea
| | - Hye-Young Jin
- Gardens and Education Research Division, Korea National Arboretum, Pocheon, Republic of Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
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Yang Y, Kim H, Kang M, Baik H, Choi Y, Jang EJ, Chang EJ, Yun S, Park M, Park E, Yun H, Lee TJ, Kwon YH, Hong KP, Lee AR, Jung S, Ahn TH, Jin HY, Choi KH. The effectiveness of nature-based therapy for community psychological distress and well-being during COVID-19: a multi-site trial. Sci Rep 2023; 13:22370. [PMID: 38102169 PMCID: PMC10724283 DOI: 10.1038/s41598-023-49702-0] [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: 07/21/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
During the COVID-19 pandemic, the world population faced various mental health challenges, highlighting a need for new community-based psychosocial interventions. This study aimed to investigate the effectiveness and feasibility of Nature-Based Therapy (NBT) for the community experiencing psychological distress during the pandemic. A multi-site trial comparing NBT and control groups was conducted in Korea with 291 participants exhibiting mild to severe depression or anxiety. A total of 192 participated in 30 sessions of therapeutic gardening, while 99 remained in the control group. Psychological distress and well-being were assessed using seven measures of depression, anxiety, daily activity, life satisfaction, mindfulness, stress, and loneliness. The effect sizes (Cohen's d) of NBT compared to the control group were medium to large: depression (0.583), anxiety (0.728), daily activity (1.002), life satisfaction (0.786), mindfulness (0.645), stress (0.903), and loneliness (0.695). Multilevel analysis revealed significant Time × Group interaction effects for all measures. Pearson correlation (r = - 0.28 to 0.71) showed that changes in all variables correlated significantly with each other, with small to large effect sizes. Therapeutic alliance at post-test positively moderated the intervention effects on the outcomes. We concluded that NBT is a promising psychosocial intervention for treating psychological distress for community dwellers.
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Grants
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
- KNA1-3-2, 21-5 Korea National Arboretum
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Affiliation(s)
- Yeji Yang
- School of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
- KU Mind Health Institute, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Hyunjin Kim
- School of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
- KU Mind Health Institute, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Minjung Kang
- School of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
- KU Mind Health Institute, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Hyunjin Baik
- Korea Research and Institute for People and Environment, 246, Munjeong-ro, Songpa-gu, Seoul, 05737, Korea
| | - Yunseok Choi
- GRAMDESIGN, 225, Jangmal-ro, Bucheon, 14609, Korea
| | - Eu-Jean Jang
- Institute of Science and Natural Resources, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Eun-Jin Chang
- Department of Counseling Psychology, Korea Baptist Theological University, 190, Bugyuseong-daero, Yuseong-gu, Daejeon, 34098, Korea
| | - Sukyoung Yun
- Department of Smart Green Care, Daegu Catholic University, 13-13, Hayang-ro, Hayang-eup, Gyeongsan, 38430, Korea
| | - Miok Park
- Department of Smart Green City Industry Convergence, Korea Nazarene University, 48, Wolbong-ro, Seobuk-gu, Cheonan, 31172, Korea
| | - Eunyeong Park
- Department of Environmental Landscape Architecture, Joongbu University, 201 Daehak-ro, Chubu-myeon, Geumsan-gun, 32713, Korea
| | - Hojun Yun
- Landscape Yeoleum, 65 Poeun-ro 2ga-gil, Mapo-gu, Seoul, 04026, Korea
| | - Taek-Joo Lee
- Hantaek Botanical Garden, 2, Hantaek-ro, Baegam-myeon, Cheoin-gu, Yongin, 17183, Korea
| | - Yeong-Han Kwon
- Department of Horticultural Design, Shingu College, 377 Gwangmyeong-ro, Seongnam, 13174, Korea
| | - Kwang-Pyo Hong
- Korea Institute of Garden Design, 45, World Cup buk-ro 9-gil, Mapo-gu, Seoul, 03998, Korea
| | - Ai-Ran Lee
- Landscape Urban Planning, Department of Human Environment Design, Cheongju University, 298, Daeseong-ro, Cheongwon-gu, Cheongju, 28503, Korea
| | - Songhie Jung
- Gardens and Education Research Division, Korea National Arboretum, 415, Gwangneungsumogwon-ro, Soheul-eup, Pocheon, 11186, Korea
| | - Tai-Hyeon Ahn
- Gardens and Education Research Division, Korea National Arboretum, 415, Gwangneungsumogwon-ro, Soheul-eup, Pocheon, 11186, Korea
| | - Hye-Young Jin
- Gardens and Education Research Division, Korea National Arboretum, 415, Gwangneungsumogwon-ro, Soheul-eup, Pocheon, 11186, Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea.
- KU Mind Health Institute, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea.
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Sun Q, Loveday M, Nwe S, Morris N, Boxall E. Green Social Prescribing in Practice: A Case Study of Walsall, UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6708. [PMID: 37681848 PMCID: PMC10487442 DOI: 10.3390/ijerph20176708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
This paper presents a case study of Green Social Prescribing (GSP) in Walsall, a medium-sized urban area located in the West Midlands, UK. GSP is a means of enabling health professionals to refer people to a range of local non-clinical nature-based activities, e.g., community gardening and conservation volunteering. As a new practice to address multiple challenges in health and sustainability, GSP has been promoted by the UK government and the NHS in the past few years. There is as yet limited evidence and knowledge about how this approach is implemented at a local level. This paper addresses this gap of knowledge, by exploring how GSP is implemented in Walsall as a case study. Based on extensive engagement and research activities with the local partners to collect data, this paper reveals the local contexts of GSP, the referral pathways, and people's lived experience, discussing the challenges, barriers, and opportunities in delivering GSP at the local level. This study suggests that a more collaborative and genuine place-based approach is essential, and alongside GSP, investment into infrastructure is needed to move the health paradigm further from 'prevention' to 'promotion' so that more people can benefit from what nature can offer.
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Affiliation(s)
- Qian Sun
- School of Design, Royal College of Art, Kensington Gore, London SW7 2EU, UK; (M.L.)
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Gál V, Dömötör Z. The role of connection with nature in empirical studies with physiological measurements: a systematic literature review. Biol Futur 2023; 74:281-294. [PMID: 37851283 DOI: 10.1007/s42977-023-00185-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/24/2023] [Indexed: 10/19/2023]
Abstract
It is well described that exposure to nature reduces physiological stress, and connectedness to nature can have a moderating effect. However, few studies have so far examined the construction of the connection with nature in relation to physiological processes. In this systematic review, we collected studies that used a physiological measure and included a scale to measure connectedness to nature. Our aim was to assess the role of nature relatedness at the level of physiological processes and to summarize the results published so far. Our review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in 3 different databases (PubMed, ScienceDirect and Google Scholar). As keywords, we used all the different questionnaires that measure connectedness to nature, combined with terms related to physiological measures. After final screening, 28 articles met the inclusion criteria for the review. The studies were very diverse in terms of purpose, intervention and methods, so narrative synthesis was conducted without measures of effect. We found evidence for a mediating effect of nature connectedness on the associations between nature exposure and cognitive function, brain activity, blood pressure, cortisol level and mental health. Studies investigating nature relatedness as state-like characteristics have shown that exposure to nature increases the level of connection to nature. Eye-tracking studies have confirmed that this measurement method can be used to investigate nature relatedness at a physiological level, which could be a useful complement to self-report questionnaires in future studies.
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Affiliation(s)
- Vera Gál
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Zsuzsanna Dömötör
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
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13
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Petitt E, Rolander B, Johnsson P. Medical Nature-Based Rehabilitation Program for Individuals with Exhaustion Syndrome: Changes in Quality of Life, Exhaustion Symptoms and Overall Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6677. [PMID: 37681817 PMCID: PMC10487912 DOI: 10.3390/ijerph20176677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
Stress-related health problems have increased sharply over the last two decades and have become a serious issue at all levels of society. In the Jönköping Region in southern Sweden, a nature-based rehabilitation (NBR) program for adults with Exhaustion Syndrome has been developed and then implemented into the Swedish National Healthcare System. The main aim of this study was to investigate the effectiveness of this NBR-program. This was achieved by examining patients' quality of life, exhaustion symptoms and overall health using self-assessment instruments, comparing the results before participation to immediately after, three months after and six months after. With a sample size of 67 participants, the results show a statistically significant improvement for all points. From a public health perspective, and with background knowledge of the nature of the patient group under treatment, the studied program would appear to be effective and economic, having a satisfied patient group as well as a favourable comparison with the outcomes of other research programs. Although the results are promising, as this is a naturalistic field study, there is no control group, and further research is encouraged. We suggest randomised controlled studies, longitudinal studies and investigation of mediators.
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Affiliation(s)
- Eleanor Petitt
- Department of Psychology, Lund University, 221 00 Lund, Sweden
| | - Bo Rolander
- Futurum—The Academy for Health and Care, Region Jönköping, 553 05 Jönköping, Sweden
| | - Per Johnsson
- Department of Psychology, Lund University, 221 00 Lund, Sweden
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14
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Rodríguez-Redondo Y, Denche-Zamorano A, Muñoz-Bermejo L, Rojo-Ramos J, Adsuar JC, Castillo-Paredes A, Vega-Muñoz A, Barrios-Fernandez S. Bibliometric Analysis of Nature-Based Therapy Research. Healthcare (Basel) 2023; 11:healthcare11091249. [PMID: 37174792 PMCID: PMC10178870 DOI: 10.3390/healthcare11091249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/05/2023] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
Unrestrained urbanisation and natural space loss are reducing contact with nature in today's society, producing negative consequences for people's mental and physical health and wellbeing. Nature-based therapies, such as physical activity in natural settings, forest bathing, therapeutic hiking, or experiential learning, reduce anxiety and depressive symptoms and improve the quality of life in both general and specific populations. A bibliometric analysis of research on nature-based therapies was performed by applying the traditional laws of bibliometrics (exponential growth law, Bradford's concentration law, Lotka's law, Zipf's law, etc.) to documents published in journals indexed in the Core Collection of the Web of Science (WoS). Graphical visualisation was performed using the VOSviewer software. Annual publications between 2006 and 2021 presented an exponential growth trend (R2 = 91%). The International Journal of Environmental Research and Public Health (MDPI) and Urban Forestry & Urban Greening (Elsevier) were the most productive and cited journals. Ikei, Miyazaki, and Song are the most cited prolific authors. The USA and South Korea were the countries with the highest scientific production. In recent years, there has been a growing interest in adventure, nature, and forest therapies among researchers. Nature-based therapies have experienced a growing interest in recent years. Positive effects on mental, physical, and emotional health have been found in different populations and research lines, although more studies with different designs and populations are needed.
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Affiliation(s)
- Yeray Rodríguez-Redondo
- Social Impact and Innovation in Health (InHEALTH) Research Group, University Centre of Mérida, University of Extremadura, 06800 Mérida, Spain
| | - Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH) Research Group, University Centre of Mérida, University of Extremadura, 06800 Mérida, Spain
| | - Jorge Rojo-Ramos
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Jose Carmelo Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Antonio Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago 8370040, Chile
| | - Alejandro Vega-Muñoz
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
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15
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Vibholm AP, Christensen JR, Pallesen H. Occupational therapists and physiotherapists experiences of using nature-based rehabilitation. Physiother Theory Pract 2023; 39:529-539. [PMID: 35012422 DOI: 10.1080/09593985.2021.2023927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Nature-based rehabilitation (NBR) is increasingly used within neurorehabilitation. The theoretical base is rooted in traditional neurorehabilitation professions, especially physiotherapy and occupational therapy, and relate to nature-based approaches.Objective: The objective was to explore the therapists' experiences of and rationale for applying NBR in neurorehabilitation when providing NBR to patients with acquired brain injury (ABI). Patients with ABI often experience severe consequences impacting their rehabilitation, activity, participation and quality of life. METHODS Qualitative focus group interviews with therapists were conducted at two Danish rehabilitation hospitals, Hammel Neurorehabilitation and Research Center (HNRC) (Hospital 1) and Vejlefjord Rehabilitation (VFR) (Hospital 2). These are highly specialized neurorehabilitation hospitals for patients in the acute-subacute and subacute-chronic phases. HNRC has several sensory gardens and VFR has a park and an inlet nearby. Content analysis was employed to analyze the interviews. RESULTS An occupational perspective of health was a frame to analyze and conceptualize the results. The analysis produced two main categories: What does nature offer - approach and rationale; Therapeutic rationale for conducting NBR. CONCLUSION The therapists applied known theories and methods; they perceived the natural environment as an extended room for training and activity, as a means for targeted rehabilitation and beneficial to the patients.
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Affiliation(s)
- Anne Pernille Vibholm
- Hammel Neurorehabilitation Centre and University Research Clinic, Rm, Hospital Unit Viborg, Silkeborg, Hammel and Skive, University of Aarhus, Hammel, Denmark
| | - Jeanette Reffstrup Christensen
- Research Unit of General Practice & Research Unit of User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odens, Denmark.,Research Unit of General Practice, Aarhus University, Aarhus, Denmark
| | - Hanne Pallesen
- Hammel Neurorehabilitation Centre and University Research Clinic, Rm, Hospital Unit Viborg, Silkeborg, Hammel and Skive, University of Aarhus, Hammel, Denmark
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16
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Kolandai K, Milne B, McLay J, von Randow M, Lay-Yee R. Anthropause appreciation, biophilia, and ecophilosophical contemplations amidst a global pandemic. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2023; 85:101943. [PMID: 36531128 PMCID: PMC9747233 DOI: 10.1016/j.jenvp.2022.101943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 05/03/2023]
Abstract
In 2020, COVID-19 mitigation measures, including lockdowns and travel bans to curtail disease transmission, inadvertently led to an "Anthropause" - a unique global pause to anthropogenic activities. While there was a spike in ecological studies measuring Anthropause effects on environmental indicators, people's experiences of the Anthropause or its potential to inspire change were hardly considered. Hence, we aimed to measure people's appreciation of the environmental outcomes of the Anthropause, ecophilosophical contemplations about the pandemic, and experiences of lockdown-triggered biophilia (human's innate love for and draw towards nature) and test the hypothesis that these experiences would be consistently more prominent among the already environmentally inclined. To that end, we developed and tested three measures on a representative sample of 993 New Zealanders. Anthropause Appreciation received the highest overall mean ratings, followed by Lockdown-Biophilia and Eco-Contemplation. Pre-existing pro-environmental dispositions and behaviours did not consistently influence our three measures as expected. Demographic variables had little influence, while experiences of financial and mental health impacts due to COVID-19 had no influence. We interpreted the limited influence of explanatory variables as indicative of a degree of uniformity in people's experiences. High appreciation of Anthropause benefits suggests that the public may be supportive of policies and ways of living that can lead to similar outcomes post-pandemic - offering environmental policymakers and communicators a basis for action. Ecophilosophical contemplations and biophilic draw among the public suggest an awareness of the significance of the human-nature relationship - offering a symbolic global keystone for communicating and advocating conservation and the many values of pauses in life to connect with nature. Building women's environmental leadership capabilities and the ongoing greening of Christianity may be essential steps for global post-pandemic environmental behaviour transformations.
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Affiliation(s)
- Komathi Kolandai
- COMPASS Research Centre and Public Policy Institute, University of Auckland, New Zealand
| | - Barry Milne
- COMPASS Research Centre, University of Auckland, New Zealand
| | - Jessica McLay
- Department of Statistics, University of Auckland, New Zealand
| | | | - Roy Lay-Yee
- COMPASS Research Centre, University of Auckland, New Zealand
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17
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The Relationship Between Nature and Immigrants' Integration, Wellbeing and Physical Activity: A Scoping Review. J Immigr Minor Health 2023; 25:190-218. [PMID: 35201532 DOI: 10.1007/s10903-022-01339-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 01/07/2023]
Abstract
Exposure to nature has been suggested to promote immigrants' health and facilitate adaptation. This review summarizes previous research focusing on the relationship between nature and immigrants' integration, wellbeing and physical activity. A search strategy was developed and adapted to seven databases. After removing duplicates, 4861 records were screened, 81 met inclusion criteria. Community gardens and urban parks were the most studied environments. In these settings, embodied experiences (the interactive processes of sensing and cognition) can foster new memories that facilitate adaptation and attachment to new natural environments. Social interaction and reconnecting with pre-migration experiences through specific use patterns can promote cultural continuation, sense of belonging and wellbeing. Other health benefits such as physical activity, disease management and improved nutrition were less frequently studied. Barriers to participation and recommendations for research and practice were also identified. Use of stronger study designs and greater inclusion of immigrant groups in research, design and evaluation of nature-based initiatives is needed.
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18
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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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19
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Baker S, Gilhen-Baker M, Roviello GN. The Role of Nutrition and Forest-Bathing in the Physical Rehabilitation of Physically Inactive Patients: From the Molecular Aspects to New Nature-Inspired Techniques. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:793. [PMID: 36613115 PMCID: PMC9819495 DOI: 10.3390/ijerph20010793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/19/2022] [Accepted: 12/26/2022] [Indexed: 05/07/2023]
Abstract
Physical rehabilitation plays a fundamental role in the management of individuals with disabilities associated with age-related muscle loss or affected by catastrophic conditions such as trauma, surgery, cancer or other severe pathologies. These events have in common an extended period of physical inactivity. Patients who undergo prolonged bed rest often present with a number of complications; for example, muscle loss that can exacerbate existing conditions determined by sarcopenia, which in turn greatly limits physical functions. The main scope of this work is to summarize certain key strategies for the physiotherapeutic management of physically inactive patients, regardless of the reason behind their prolonged bed rest, with a particular focus on physical rehabilitation, nutrition and forest-bathing. The importance of correct nutrition in counter-acting the loss of muscle mass and consequent function is explored alongside a description of the main nutrients that are needed for muscle regeneration. From a biomolecular perspective, some specific molecular mechanisms associated with physical rehabilitation are also reported not only in the context of physical therapy, but also within nature-inspired techniques, such as forest-bathing as well as body self-healing. Combining a targeted physiotherapeutic approach with an appropriate diet as well as nature-based therapy could thus help with the recovery of bed ridden patients.
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Affiliation(s)
- Steven Baker
- Compete Physiotherapy and Rehabilitation Centre, Unit 1 Bridge Mill—Cowan Bridge, Carnforth LA6 2HS, UK
| | | | - Giovanni N. Roviello
- Institute of Biostructures and Bioimaging, Italian National Council for Research (IBB-CNR), Area di Ricerca Site and Headquarters, Via Pietro Castellino 111, 80131 Naples, Italy
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20
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Fisher C. Trauma-Informed Nature Therapy: A Case Study. ECOPSYCHOLOGY 2022. [DOI: 10.1089/eco.2022.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Cheryl Fisher
- California School of Professional Psychology, Clinical Counseling, Alliant International University, San Diego, San Diego, California, USA
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21
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Johansson G, Juuso P, Engström Å. Nature-based interventions to promote health for people with stress-related illness: An integrative review. Scand J Caring Sci 2022; 36:910-925. [PMID: 35604072 PMCID: PMC9790340 DOI: 10.1111/scs.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/05/2022] [Accepted: 05/07/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Stress-related illness is increasing and is a common cause of sick leave. Spending time in nature have a positive effect on health and well-being for instance by reducing stress. Specific programmes with nature-based interventions (NBI) with the intention to involve people in activities in a supportive natural environment have been developed for people with stress-related illness. AIM To identify and summarise scientific studies of NBIs to promote health for people with stress-related illness. METHOD The design used in this study is integrative literature review. Scientific studies focusing on any type of NBI for people with stress-related illness were sought in Cinahl, PubMed, PsycInfo, AMED and Scopus. In total, 25 studies using both qualitative and quantitative designs were included in the review. RESULT The reviewed studies focused on garden or forest interventions. In the majority of the studies, NBIs were performed in groups, including individual activities, and the length of programmes varied. Interventions in natural environments have unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. NBIs offer restoration that reduces stress, improves health and well-being and strengthen self-efficacy and work ability. Connectedness with nature support existential reflections and people with stress-related illness can achieve balance in everyday life. CONCLUSION In conclusion, NBIs may have advantages to promote health for people with stress-related illness and should therefore be considered as an alternative to those affected. Further research from different perspectives, including nursing, is needed to understand the possibilities of NBIs and how they can be integrated into practice.
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Affiliation(s)
- Gunilla Johansson
- Division of Nursing and Medical Technology, Department of Health, Education and TechnologyLuleå University of TechnologyLuleåSweden
| | - Päivi Juuso
- Division of Nursing and Medical Technology, Department of Health, Education and TechnologyLuleå University of TechnologyLuleåSweden
| | - Åsa Engström
- Division of Nursing and Medical Technology, Department of Health, Education and TechnologyLuleå University of TechnologyLuleåSweden
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22
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Serfioti D, Hunt N. Extreme sport as an intervention for physically injured military veterans: the example of competitive motorsport. Disabil Rehabil 2022; 44:7566-7574. [PMID: 34641751 DOI: 10.1080/09638288.2021.1985630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Physically or psychologically injured military veterans are motivated and benefited by physical activity or sport that may involve high levels of achievement. The aim of this study was to provide an in-depth insight into the impact of Competitive Motorsport (CM) on physically injured/disabled veterans' subjective well-being and in turn determine if it improves the quality of their lives. METHODS This is a qualitative study. Two sets of semi-structured interviews were conducted with 14 male British military veterans including a 6-month follow-up. All participants were subjected to a permanent, moderate or severe, physical injury/disability. Data were analysed in accordance with the principles of Thematic Analysis. RESULTS/CONCLUSIONS Five key elements (familiar environment, team spirit, adrenaline rush, competition and equality) made CM a unique experience for physically injured/disabled veterans. Various psychological and physical benefits were found, including an increased sense of accomplishment, opportunity to socialise in a non-clinical environment, embracement of body image and adoption of a healthier lifestyle. Since physical activity and sport are among growing research on alternative interventions for military veterans, they deserve serious consideration as part of the treatment regimens and rehabilitation programmes to improve physically inured/disabled veterans' physical and mental health.Implications for RehabilitationCompetitive Motorsport is an effective means of improving physical health and subjective well-being of physically injured/disabled military veterans.Multiple perceived psychological and physical benefits were identified over time, including motivation for living, embracement of body image and adoption of a healthier lifestyle.Competitive Motorsport deserves consideration as part of the treatment regimens and rehabilitation programmes to improve physically injured/disabled veterans' physical and mental health while facilitating transition to civilian life.
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Affiliation(s)
- Danai Serfioti
- The University of Nottingham, Faculty of Medicine & Health Sciences, School of Medicine, Nottingham, UK
| | - Nigel Hunt
- The University of Nottingham, Faculty of Medicine & Health Sciences, School of Medicine, Nottingham, UK
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23
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Delaney ME, Rian SW, Owenburg N. The Experiences of Counselors-in-Training in A Semester-Long Ecotherapy Course: A Qualitative Study. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2022. [DOI: 10.1080/15401383.2022.2129894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Megan E. Delaney
- Department of Professional Counseling, Monmouth University, West Long Branch, New Jersey, USA
| | - Sage W. Rian
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Nicole Owenburg
- Department of Professional Counseling, Monmouth University, West Long Branch, New Jersey, USA
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24
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Briggs R, Morris PG, Rees K. The effectiveness of group-based gardening interventions for improving wellbeing and reducing symptoms of mental ill-health in adults: a systematic review and meta-analysis. J Ment Health 2022:1-18. [PMID: 36151719 DOI: 10.1080/09638237.2022.2118687] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND There is increasing interest in the association between nature, health and wellbeing. Gardening is a popular way in which interaction with nature occurs and numerous gardening projects aim to facilitate wellbeing among participants. More research is needed to determine their effectiveness. AIM To systematically evaluate the effectiveness of group-based gardening interventions for increasing wellbeing and reducing symptoms of mental ill-health in adults. METHODS A systematic review of Randomised Controlled Trials was conducted following the protocol submitted to PROSPERO (CRD42020162187). Studies reporting quantitative validated health and wellbeing outcomes of the community residing, adult populations (18+) were eligible for inclusion. RESULTS 24 studies met inclusion criteria: 20 completed and four ongoing trials. Meta-analyses suggest these interventions may increase wellbeing and may reduce symptoms of depression, however, there was uncertainty in the pooled effects due to heterogeneity and unclear risk of bias for many studies. There were mixed results for other outcomes. RESEARCH LIMITATIONS/IMPLICATIONS Heterogeneity and small sample sizes limited the results. Poor reporting precluded meta-analysis for some studies. Initial findings for wellbeing and depression are promising and should be corroborated in further studies. The research area is active, and the results of the ongoing trials identified will add to the evidence base.
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Affiliation(s)
- Rebecca Briggs
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland.,Warwick Medical School, The University of Warwick, Coventry, England
| | - Paul Graham Morris
- School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland
| | - Karen Rees
- Warwick Medical School, Health Sciences, The University of Warwick, Coventry, England
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25
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Lymeus F, White MP, Lindberg P, Hartig T. Restoration Skills Training in a Natural Setting Compared to Conventional Mindfulness Training: Sustained Advantages at a 6-Month Follow-Up. Front Psychol 2022; 13:763650. [PMID: 35978765 PMCID: PMC9376351 DOI: 10.3389/fpsyg.2022.763650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
Restoration skills training (ReST) is a mindfulness-based course in which participants draw support from a natural practice setting while they learn to meditate. Well-established conventional mindfulness training (CMT) can improve psychological functioning but many perceive it as demanding and fail to sustain practice habits. Applying non-inferiority logic, previous research indicated that ReST overcomes compliance problems without compromising the benefits gained over 5 weeks’ training. This article applies similar logic in a 6-month follow-up. Of 97 contacted ReST and CMT course completers, 68 responded and 29 were included with multiple imputation data. The online survey included questions about their psychological functioning in three domains (dispositional mindfulness, cognitive lapses, and perceived stress) and the forms and frequencies with which they had continued to practice mindfulness after the course. Former ReST participants continued, on average, to show higher dispositional mindfulness and fewer cognitive lapses compared to pre-course ratings. Improved psychological functioning in one or more domains was demonstrated by 35%, as determined by a reliable change index. Again, analyses detected no indications of any substantive disadvantages compared to the more demanding, established CMT approach. Compared to the CMT group, more ReST participants had also continued to practice at least occasionally (92 vs. 67%). Continued practice was linked to sustained improvements for ReST but not clearly so for CMT. ReST participants thus continued to use the skills and sustained the improvements in psychological functioning that they had gained in the course, further supporting the utility of ReST as a health intervention.
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Affiliation(s)
- Freddie Lymeus
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
- *Correspondence: Freddie Lymeus,
| | - Mathew P. White
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria
| | - Per Lindberg
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
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26
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Yang Y, Ro E, Lee TJ, An BC, Hong KP, Yun HJ, Park EY, Cho HR, Yun SY, Park M, Yun YJ, Lee AR, Jeon JI, Jung S, Ahn TH, Jin HY, Lee KJ, Choi KH. The Multi-Sites Trial on the Effects of Therapeutic Gardening on Mental Health and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138046. [PMID: 35805706 PMCID: PMC9266122 DOI: 10.3390/ijerph19138046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 01/11/2023]
Abstract
Although many people affected by COVID-19 suffer from some form of psychological distress, access to proper treatment or psychosocial interventions has been limited. This study aimed to examine the feasibility and preliminary effects of a therapeutic gardening program conducted during the COVID-19 pandemic. The program consisted of 30 sessions and was conducted at 10 nationwide sites in Korea from June to November 2021. Mental health and well-being were assessed using the Mental Health Screening Tool for Depressive Disorders, Mental Health Screening Tool for Anxiety Disorders, Engagement in Daily Activity Scale, brief version of World Health Organization Quality of Life, and Mindful Attention Awareness Scale. Cohen’s d value was calculated for the effect size, and a multilevel analysis was used to determine the longitudinal effects of therapeutic gardening. The effect sizes for depression, anxiety, daily activities, quality of life, and mindfulness were 0.84, 0.72, 0.61, 0.64, and 0.40, respectively. Multilevel analyses showed that all five mental health variables improved significantly over time as the therapeutic gardening program progressed. Therapeutic gardening is promising and applicable as a nature-based intervention to improve the mental health of individuals experiencing psychological distress especially in the COVID-19 pandemic.
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Affiliation(s)
- Yeji Yang
- School of Psychology, Korea University, Seoul 02841, Korea; (Y.Y.); (E.R.)
- KU Mind Health Institute, Korea University, Seoul 02841, Korea
| | - Eunbin Ro
- School of Psychology, Korea University, Seoul 02841, Korea; (Y.Y.); (E.R.)
- KU Mind Health Institute, Korea University, Seoul 02841, Korea
| | | | - Byung-Chul An
- Division of Forest & Landscape Architecture, Wonkwang University, Iksan 54538, Korea;
| | | | | | - Eun-Yeong Park
- Department of Environmental Landscape Architecture, Joongbu University, Geumsan 32713, Korea;
| | | | - Suk-Young Yun
- Department of Landscape Architecture, Daegu Catholic University, Gyeongsan 38430, Korea;
| | - Miok Park
- Department of Smart Green City Industry Convergence, Korea Nazarene University, Cheonan 31172, Korea;
| | - Young-Jo Yun
- Department of Ecological Landscape Architecture Design, Kangwon National University, Chuncheon 24341, Korea;
| | - Ai-Ran Lee
- Department of Human Environment Design, Cheongju University, Cheongju 28503, Korea;
| | - Jeong-Ill Jeon
- Shingu Botanic Garden, Shingu College, Seongnam 13443, Korea;
| | - Songhie Jung
- Gardens and Education Research Division, Korea National Arboretum, Pocheon 11186, Korea; (S.J.); (T.-H.A.)
| | - Tai-Hyeon Ahn
- Gardens and Education Research Division, Korea National Arboretum, Pocheon 11186, Korea; (S.J.); (T.-H.A.)
| | - Hye-Young Jin
- Gardens and Education Research Division, Korea National Arboretum, Pocheon 11186, Korea; (S.J.); (T.-H.A.)
- Correspondence: (H.-Y.J.); (K.J.L.); (K.-H.C.); Tel.: +82-31-540-1031 (H.-Y.J.); +82-10-9745-2145 (K.J.L.); +82-2-3290-2867 (K.-H.C.)
| | - Kyung Ju Lee
- Integrative Obstetrics & Gynecology, Institute for Occupational & Environmental Health, Korea University, Seoul 02841, Korea
- Correspondence: (H.-Y.J.); (K.J.L.); (K.-H.C.); Tel.: +82-31-540-1031 (H.-Y.J.); +82-10-9745-2145 (K.J.L.); +82-2-3290-2867 (K.-H.C.)
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul 02841, Korea; (Y.Y.); (E.R.)
- KU Mind Health Institute, Korea University, Seoul 02841, Korea
- Correspondence: (H.-Y.J.); (K.J.L.); (K.-H.C.); Tel.: +82-31-540-1031 (H.-Y.J.); +82-10-9745-2145 (K.J.L.); +82-2-3290-2867 (K.-H.C.)
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Problematic mobile phone use inhibits aesthetic emotion with nature: The roles of presence and openness. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03175-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Balanzá-Martínez V, Cervera-Martínez J. Lifestyle Prescription for Depression with a Focus on Nature Exposure and Screen Time: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5094. [PMID: 35564489 PMCID: PMC9104582 DOI: 10.3390/ijerph19095094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 12/10/2022]
Abstract
Recent lifestyles changes have favored increased time in contact with screens and a parallel reduction in contact with natural environments. There is growing awareness that nature exposure and screen time are related to depression. So far, the roles of how these environmental lifestyles affect depressive symptoms and disorders have not been reviewed simultaneously. The aim of this review was to gather the literature regarding the role of nature exposure and screen time in depression. An emphasis was made on clinical samples of patients with well-defined depression and the different methodological approaches used in the field. A second goal was to suggest an agenda for clinical practice and research. Studies were included if they assessed depressive symptoms in patients with a clinical diagnosis of depression. An overview of the published literature was conducted using three scientific databases up to December 2021. Several interventions involving nature exposure have shown positive effects on depressive symptoms and mood-related measures. The most consistent finding suggests that walks in natural environments may decrease depressive symptoms in patients with clinical depression. Less researched interventions, such as psychotherapy delivered in a forest or access to natural environments via virtual reality, may also be effective. In contrast, fewer observational studies and no experimental research on screen time have been conducted in patients with clinical depression. Thus, recommendations for practice and research are also discussed. Scarce research, diverse interventions, and several methodological shortcomings prevent us from drawing conclusions in this area. More high-quality experimental research is needed to establish interventions with proven efficacy in clinical depression. At this stage, it is too early to formulate practice guidelines and advise the prescription of these lifestyles to individuals with depression. The present findings may serve as a basis to develop strategies based on nature exposure and screen time targeting clinical depression.
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Affiliation(s)
- Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, 46010 Valencia, Spain
| | - Jose Cervera-Martínez
- Department of Medicine, University of Valencia, 46010 Valencia, Spain;
- Hospital de Denia-Marina Salud, 03700 Denia, Spain
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Yang Y, Kwan RYC, Zhai HM, Xiong Y, Zhao T, Fang KL, Zhang HQ. Effect of horticultural therapy on apathy in nursing home residents with dementia: a pilot randomized controlled trial. Aging Ment Health 2022; 26:745-753. [PMID: 33818221 DOI: 10.1080/13607863.2021.1907304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: This study aimed to examine (1) the feasibility of the study procedures (i.e. recruitment, retention, attendance, and assessment completion rates), and (2) the effects of horticultural therapy (HT) on apathy, cognitive ability, quality of life, and functional capacity.Methods: This was a parallel-group, match-paired, randomized controlled trial. Thirty-two participants were allocated to either the experimental or the control group. Data were collected at baseline (T0), immediately postintervention (T1), and 3 months postintervention (T2). The Apathy Evaluation Scale-informant version (AES-I); Mini-Mental State Examination (MMSE); Quality of Life in Alzheimer's disease (QoL-AD) scale; Barthel index (BI) were used to measure apathy, cognitive ability, quality of life, and functional capacity, respectively.Results: The recruitment, retention, attendance and assessment completion rates were 22.7%, 87.5%, 100% and 100%, respectively. The between-group differences in AES-I (p = 0.007) and MMSE (p = 0.034) scores were statistically significant at T1. In the experimental group, the AES-I (p = 0.001), MMSE (p = 0.010), and QoL-AD (p = 0.017) scores were significantly different over time. In the post hoc pair-wise analysis, the AES-I scores of the experimental group observed at T1 were significantly lower than that at T0 (p = 0.032). In the control group, the MMSE scores (p = 0.001) were significantly different over time.Conclusion: HT is feasible for residents with dementia and apathy. The HT program effectively reduced apathy and promoted cognitive function, but its effects on quality of life and functional capacity were not observed.
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Affiliation(s)
- Yi Yang
- Department of Nursing, Medical School, Taizhou University, Taizhou, Zhejiang, China
| | - Rick Y C Kwan
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hui-Min Zhai
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yong Xiong
- Nursing Department, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Ting Zhao
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Kai-Ling Fang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Hui-Qing Zhang
- Guangzhou Youhao Senior Apartment, Guangzhou, Guangdong, China
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The benefits of nature-based therapy for the individual and the environment: an integrative review. IRISH JOURNAL OF OCCUPATIONAL THERAPY 2022. [DOI: 10.1108/ijot-06-2021-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
This review aims to identify the commonly used nature-based therapies, the cohorts that benefit from these interventions, and the potential environmental impact of nature-based therapies.
Design/methodology/approach
An integrative review methodology was taken. The literature was analysed and synthesised through thematic analysis.
Findings
Three themes emerged from the analysis: categories of nature-based therapies; benefits of nature-based therapies; and the gains from nature-based therapies are not universal. Evidence of physiological, psychological, social, vocational and quality of life benefits from participation in nature-based therapies was evident in the literature. However, there was insufficient empirical evidence of the benefits for the environment.
Practical implications
Occupational therapists assist populations across the life course. Consequentially, they can be found working in a diverse range of clinical contexts. This review asserts that nature-based therapies could be a positive addition in many of these contexts. Further, while engagement in activities in natural environments is frequently used by occupational therapists practicing within institution environments, there is evidence to support its use in community service models and potentially in public health strategies.
Originality/value
This integrative review brings together evidence on a diverse range of nature-based therapies, cohorts, associated benefits and factors that influence these. The lack of empirical evidence on the benefits of nature-based therapies for the environment is acknowledged as a gap in the literature
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Pijpker R, Veen EJ, Vaandrager L, Koelen M, Bauer GF. Developing an Intervention and Evaluation Model of Outdoor Therapy for Employee Burnout: Unraveling the Interplay Between Context, Processes, and Outcomes. Front Psychol 2022; 13:785697. [PMID: 35310237 PMCID: PMC8929413 DOI: 10.3389/fpsyg.2022.785697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Burnout is a major societal issue adversely affecting employees’ health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research. Aim The study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout. Methodological Approach We build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts. Results We identified six key outdoor intervention elements: (1) physical activity; (2) reconnecting body and mind; (3) nature metaphors; (4) creating relationships; (5) observing natural interactions; and (6) experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist (e.g., number of clients per day), therapy (e.g., privacy issues), and of the clients (e.g., affinity to nature). Conclusion The intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation.
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Affiliation(s)
- Roald Pijpker
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Esther J Veen
- Urban Food Issues, Aeres University of Applied Sciences, Almere, Netherlands
| | - Lenneke Vaandrager
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Maria Koelen
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Georg F Bauer
- Center of Salutogenesis, Division of Public and Organizational Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Can Rehabilitation in Nature Improve Self-Perceived Interpersonal Problems? A Matched-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063622. [PMID: 35329308 PMCID: PMC8949583 DOI: 10.3390/ijerph19063622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/02/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022]
Abstract
Self-perceived interpersonal problems are of central concern for researchers and individuals; they are at the basis of psychopathology and cause for subjective distress. In this study, we examine whether a group-based rehabilitation program in nature may reduce self-perceived interpersonal problems in a heterogeneous group of men declining participation in traditional rehabilitation offers. The intervention consisted of weekly meetings in nature, taking place over the course of nine weeks. Through a matched-control study including 114 participants in the intervention group and 39 in a treatment as usual group participating in traditional rehabilitation offers, we found that there was no statistically significant development in self-perceived interpersonal problems in the nature-based rehabilitation offer. Though promising with regards to a number of mental challenges, including relational challenges, nature-based group-rehabilitation may require a more elaborate and thoroughgoing intervention, including e.g., a therapist and more time to be an effective intervention against interpersonal problems. We conclude that perhaps due to the fundamental aspect of self-perceived interpersonal problems, exposure to nature, and being in a group of men in a similar situation for the duration that this intervention lasted, may not be enough to address such underlying perceptions of self.
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Mascherek A, Weber S, Riebandt K, Cassanello C, Leicht G, Brick T, Gallinat J, Kühn S. On the relation between a green and bright window view and length of hospital stay in affective disorders. Eur Psychiatry 2022; 65:1-22. [PMID: 35189997 PMCID: PMC8988271 DOI: 10.1192/j.eurpsy.2022.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background The salutary effect of window views on greenery for inpatients in hospitals on length of stay and recovery rate has been repeatedly shown, however, not for psychiatric inpatients. The study assessed the association between a window view on green trees or man-made objects and brightness of the room on length of stay in a sample of psychiatric inpatients from one clinic. Methods Data records of 244 psychiatric inpatients (mean age in years 41.8; SD = 11.8; 59.8% female, length of stay varying between 7 and 100 days) that were admitted between May 2013 and October 2018 with affective disorders were examined. Window view was assessed with images taken from each room and classified into showing man-made objects or green trees. The percentage of green within each image was also calculated as greenness of the view. Brightness was assessed with a luxmeter. Results Although no effect was found for the dichotomous measures (man-made objects vs. green trees), a suppression effect emerged for percentage of green and brightness. The results indicate that both greenness of the window view as well as brightness significantly reduce length of stay in psychiatric inpatients with affective disorders. Conclusions The suppression effect likely results from the characteristics of the windows; the greenest rooms also being the darkest. Due to the infrastructure of the ward, greenness and brightness came at the expense of each other. The results generally support the importance of a view into greenery and natural sunlight for recovery.
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Affiliation(s)
- Anna Mascherek
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20246Hamburg, Germany
| | - Sandra Weber
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20246Hamburg, Germany
| | - Kevin Riebandt
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20246Hamburg, Germany
| | - Carlos Cassanello
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20246Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, 14195Berlin, Germany
| | - Gregor Leicht
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20246Hamburg, Germany
| | - Timothy Brick
- Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania16802, USA
| | - Jürgen Gallinat
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20246Hamburg, Germany
| | - Simone Kühn
- Clinic and Policlinic for Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20246Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, 14195Berlin, Germany
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Høegmark S, Andersen TE, Grahn P, Roessler KK. The Wildman Programme – Experiences from a first implementation of a nature-based intervention designed for men with stress and chronic illnesses. Complement Ther Clin Pract 2022; 46:101535. [DOI: 10.1016/j.ctcp.2022.101535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 11/30/2022]
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Hu C, Zhu K, Huang K, Yu B, Jiang W, Peng K, Wang F. Using natural intervention to promote subjective well-being of essential workers during public-health crises: A Study during COVID-19 pandemic. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2022; 79:101745. [PMID: 34908644 PMCID: PMC8661457 DOI: 10.1016/j.jenvp.2021.101745] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 05/03/2023]
Abstract
Essential workers such as medical workers and police officers are first-line fighters during public-health crises, such as COVID-19 pandemic. Every time, they are under heavy stress both physically and mentally. The goal of the present study was to develop a novel nature-based intervention to promote their well-being. A representative sample of essential workers in China was recruited for a five-day intervention program, and were randomly assigned to two groups. The experimental group watched 2-min video clips of natural scenes every day, while the control group watched urban scenes. Results indicated that after five days, the natural stimuli intervention yielded overall improvements in various indices of subjective well-being. Furthermore, analyses of nested longitudinal data confirmed that everyday nature stimuli exposure provided both immediate and repeated restorative benefits. The proposed natural-based intervention is brief and easy-to-use, offering a cost-efficient psychological booster to promote subjective well-being of essential workers during this crisis time.
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Affiliation(s)
- Chenhao Hu
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, 100084, China
| | - Ke Zhu
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, Beijing, 100084, China
| | - Kun Huang
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, Beijing, 100084, China
| | - Bo Yu
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, Beijing, 100084, China
| | - Wenchen Jiang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Zhejiang, 310058, China
| | - Kaiping Peng
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, 100084, China
| | - Fei Wang
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, 100084, China
- Laboratory of Brain and Intelligence, Tsinghua University, Beijing, 100084, China
- The Centre for Positive Psychology Research, School of Social Sciences, Tsinghua University, Beijing, 100084, China
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Salonen K, Hyvönen K, Paakkolanvaara JV, Korpela K. Flow With Nature Treatment for Depression: Participants' Experiences. Front Psychol 2022; 12:768372. [PMID: 35069344 PMCID: PMC8766993 DOI: 10.3389/fpsyg.2021.768372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/08/2021] [Indexed: 12/05/2022] Open
Abstract
This study examined Flow with Nature (FWN) treatment, which is an integrative intervention (rehabilitation) based on eco and environmental psychology, psychotherapeutic theories and professional psychological practice. FWN is intended for depression rehabilitation with the help of social support, nature environments and FWN exercises. Exercises encourage sensing the environment, mindful awareness, psychological processing and focusing on the future. The FWN treatment proceeds in separate stages (horizon, growth and path), which emphasise nature, group (social support) and FWN exercises differently. This study focused on the experiences of the participants in the FWN treatment. Finnish adults who had been diagnosed with clinical depression took part in the FWN treatment (N = 82) and answered feedback questions (by paper, electronic questionnaire or phone discussion). Answers were analysed using theory-based content analysis. Data were collected between spring 2019 and spring 2020. The majority of the participants were women (82%) and on average 44 years old. Content analysis revealed that the participant feedback answers were in agreement with the central theoretical themes of FWN. The participants emphasised the significance of nature, social support and exercises differently. Moreover, the significance of these ingredients differed according to the stages of treatment: in the horizon stage restorative (e.g., fascination) and comprehensive nature experiences (e.g., connectedness with nature), in the growth stage social support (e.g., peer support) and in the path stage environmental self-regulation (e.g., nature as a part of life) were emphasised. These results are in accordance with the objectives of the stages and seem to support the phase-based rationale. The participants’ experiences of the key elements of the intervention, social support and nature environment were experienced mainly positively, which supports their inclusion in future intervention versions. In the future, FWN exercises should be developed to better enable participants’ possibilities for concentration and being present in the moment (mindfulness). Exercises should also be simplified to match the target group’s cognitive abilities.
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Affiliation(s)
- Kirsi Salonen
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Katriina Hyvönen
- Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Jane-Veera Paakkolanvaara
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Kalevi Korpela
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
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Coventry PA, Brown J, Pervin J, Brabyn S, Pateman R, Breedvelt J, Gilbody S, Stancliffe R, McEachan R, White P. Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. SSM Popul Health 2021; 16:100934. [PMID: 34646931 PMCID: PMC8498096 DOI: 10.1016/j.ssmph.2021.100934] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/15/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022] Open
Abstract
Mental health problems are associated with lower quality of life, increased unscheduled care, high economic and social cost, and increased mortality. Nature-based interventions (NBIs) that support people to engage with nature in a structured way are asset-based solutions to improve mental health for community based adults. However, it is unclear which NBIs are most effective, or what format and dose is most efficacious. We systematically reviewed the controlled and uncontrolled evidence for outdoor NBIs. The protocol was registered at PROSPERO (CRD42020163103). Studies that included adults (aged ≥18 years) in community-based settings with or without mental and/or physical health problems were eligible for inclusion. Eligible interventions were structured outdoor activities in green and/or blue space for health and wellbeing. We searched ASSIA, CENTRAL, Embase, Greenfile, MEDLINE, PsycINFO, and Web of Science in October 2019; the search was updated in September 2020. We screened 14,321 records and included 50 studies. Sixteen studies were randomised controlled trials (RCTs); 18 were controlled studies; and 16 were uncontrolled before and after studies. Risk of bias for RCTs was low to moderate; and moderate to high for controlled and uncontrolled studies. Random effects meta-analysis of RCTs showed that NBIs were effective for improving depressive mood -0.64 (95% CI: 1.05 to -0.23), reducing anxiety -0.94 (95% CI: 0.94 to -0.01), improving positive affect 0.95 (95% CI: 0.59 to 1.31), and reducing negative affect -0.52 (95% CI: 0.77 to -0.26). Results from controlled and uncontrolled studies largely reflected findings from RCTs. There was less evidence that NBIs improved physical health. The most effective interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 min. NBIs, specifically gardening, green exercise and nature-based therapy, are effective for improving mental health outcomes in adults, including those with pre-existing mental health problems.
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Affiliation(s)
- Peter A. Coventry
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- York Environmental Sustainability Institute, University of York, York, YO10 5NG, UK
| | | | - Jodi Pervin
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Sally Brabyn
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Rachel Pateman
- Stockholm Environment Institute, Department of Environment and Geography, University of York, York, YO10 5NG, UK
| | | | - Simon Gilbody
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | | | | | - PiranC.L. White
- York Environmental Sustainability Institute, University of York, York, YO10 5NG, UK
- Department of Environment and Geography, University of York, York, YO10 5NG, UK
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South EC, Lee K, Oyekanmi K, Buckler DG, Tiako MJN, Martin T, Kornfield SL, Srinivas S. Nurtured in Nature: a Pilot Randomized Controlled Trial to Increase Time in Greenspace among Urban-Dwelling Postpartum Women. J Urban Health 2021; 98:822-831. [PMID: 34014451 PMCID: PMC8688635 DOI: 10.1007/s11524-021-00544-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
Spending time in nature is associated with numerous mental health benefits, including reduced depression and improved well-being. However, few studies examine the most effective ways to nudge people to spend more time outside. Furthermore, the impact of spending time in nature has not been previously studied as a postpartum depression (PPD) prevention strategy. To fill these gaps, we developed and pilot tested Nurtured in Nature, a 4-week intervention leveraging a behavioral economics framework, and included a Nature Coach, digital nudges, and personalized goal feedback. We conducted a randomized controlled trial among postpartum women (n = 36) in Philadelphia, PA between 9/9/2019 and 3/27/2020. Nature visit frequency and duration was determined using GPS data. PPD was measured using the Edinburgh Postnatal Depression Scale (EPDS). Participants were from low-income, majority Black neighborhoods. Compared to control, the intervention arm had a strong trend toward longer duration and higher frequency of nature visits (IRR 2.6, 95%CI 0.96-2.75, p = 0.059). When analyzing women who completed the intervention (13 of 17 subjects), the intervention was associated with three times higher nature visits compared to control (IRR 3.1, 95%CI 1.16-3.14, p = 0.025). No significant differences were found in the EPDS scores, although we may have been limited by the study's sample size. Nurture in Nature increased the amount of time postpartum women spent in nature, and may be a useful population health tool to leverage the health benefits of nature in majority Black, low-resourced communities.
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Affiliation(s)
- Eugenia C South
- Department of Emergency Medicine, University of Pennsylvania, Blockley Hall, Room 408, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA.
| | - Kathleen Lee
- Department of Emergency Medicine, University of Pennsylvania, Blockley Hall, Room 408, 423 Guardian Drive, Philadelphia, PA, 19104, USA
| | - Kehinde Oyekanmi
- Department of Emergency Medicine, University of Pennsylvania, Blockley Hall, Room 408, 423 Guardian Drive, Philadelphia, PA, 19104, USA
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - David G Buckler
- Department of Emergency Medicine, University of Pennsylvania, Blockley Hall, Room 408, 423 Guardian Drive, Philadelphia, PA, 19104, USA
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Max Jordan Nguemeni Tiako
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Tyler Martin
- Center for Healthcare Innovation, University of Pennsylvania, Philadelphia, PA, USA
| | - Sara L Kornfield
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Sindhu Srinivas
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
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Connection to Nature Boosts Adolescents’ Mental Well-Being during the COVID-19 Pandemic. SUSTAINABILITY 2021. [DOI: 10.3390/su132112297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Growing evidence suggests that connection to nature may be linked to mental health and well-being. Behavioral changes brought about by the COVID-19 pandemic could negatively affect adolescents’ connection to nature, subsequently impacting health and well-being. We explored the relationship between connection to nature and well-being before and during the pandemic through a nationally representative survey of adolescents across the United States (n = 624) between April and June 2020. Survey items focused on connection to nature, mental well-being, and participation in outdoor activities before and during the pandemic. Paired-sample t-tests revealed declines in connection to nature, mental well-being, and participation in outdoor activities during the pandemic. Multiple linear regression analyses examining connection to nature’s mediating role between outdoor activity participation and mental well-being indicated that connection to nature fueled higher levels of mental well-being at both time intervals. Z scores comparing connection to nature’s mediating role between outdoor activity participation and mental well-being between time intervals indicate that during the pandemic, the direct effect of outdoor activities on mental well-being increased, generating a greater impact than before the pandemic. This study illustrates how the health and well-being benefits associated with adolescents’ outdoor activities are reinforced when those activities also foster a stronger connection to nature.
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Littman AJ, Bratman GN, Lehavot K, Engel CC, Fortney JC, Peterson A, Jones A, Klassen C, Brandon J, Frumkin H. Nature versus urban hiking for Veterans with post-traumatic stress disorder: a pilot randomised trial conducted in the Pacific Northwest USA. BMJ Open 2021; 11:e051885. [PMID: 34556516 PMCID: PMC8461737 DOI: 10.1136/bmjopen-2021-051885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To evaluate feasibility and acceptability of a group-based nature recreation intervention (nature hiking) and control condition (urban hiking) for military Veterans with post-traumatic stress disorder (PTSD). DESIGN AND SETTING A pilot randomised controlled trial conducted in the US Pacific Northwest. PARTICIPANTS Veterans with PTSD due to any cause. INTERVENTIONS Twenty-six participants were randomised to a 12-week intervention involving either six nature hikes (n=13) or six urban hikes (n=13). PRIMARY AND SECONDARY OUTCOME MEASURES Feasibility was assessed based on recruitment, retention and attendance. Questionnaires and postintervention qualitative interviews were conducted to explore intervention acceptability. Questionnaires assessing acceptability and outcomes planned for the future trial (eg, PTSD symptoms) were collected at baseline, 6 weeks, 12 weeks (immediately after the final hike) and 24 weeks follow-up. RESULTS Of 415 people assessed for eligibility/interest, 97 were interested and passed preliminary eligibility screening, and 26 were randomised. Mean completion of all questionnaires was 91% among those in the nature hiking group and 68% in those in the urban hiking group. Over the course of the intervention, participants in the nature and urban groups attended an average of 56% and 58%, respectively, of scheduled hikes. Acceptability of both urban and nature hikes was high; over 70% reported a positive rating (ie, good/excellent) for the study communication, as well as hike locations, distance and pace. Median PTSD symptom scores (PTSD Checklist-5) improved more at 12 weeks and 24 weeks among those in the nature versus urban hiking group. CONCLUSIONS This pilot study largely confirmed the feasibility and acceptability of nature hiking as a potential treatment for Veterans with PTSD. Adaptations will be needed to improve recruitment and increase hike attendance for a future randomised controlled trial to effectively test and isolate the ways in which nature contact, physical activity and social support conferred by the group impact outcomes. TRIAL REGISTRATION NUMBER NCT03997344.
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Affiliation(s)
- Alyson J Littman
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, Washington, USA
| | - Keren Lehavot
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
- Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Charles C Engel
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - John C Fortney
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Alexander Peterson
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Alex Jones
- Outdoors for All, Seattle, Washington, USA
| | - Carolyn Klassen
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | | | - Howard Frumkin
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
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McSweeney J, Johnson S, Sherry S, Singleton J, Rainham D. Indoor nature exposure and influence on physiological stress markers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:636-650. [PMID: 31625764 DOI: 10.1080/09603123.2019.1679357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/08/2019] [Indexed: 06/10/2023]
Abstract
Spending time in nature is beneficial for stress reduction and recovery. Using the properties of biophilic design, this study examined the influence of a nature-based indoor environment on physiological stress systems. An experimental study was designed to assess the influence of indoor natural elements on autonomic activity (heart rate variability or HRV), self-reported environmental assessments. No differences in heart rate variability were found between participants assigned to either condition. The room with natural elements was rated more positively than the room without natural elements. Participant preference had more impact on changes in HRV for participants without exposure to natural elements. The results suggest that natural elements in indoor environments may influence the regulation of stress response via environmental preference.Abbreviations: ANCOVA: Analysis of Covariance; ANS: Autonomic Nervous System; AVNN: Average of NN; DST: Digit Span Test; EAS: Environmental Assessment Scale; ECG: Electrocardiograph; fMRI: Functional magnetic resonance imaging; HF: High Frequency; HRV: Heart Rate Variability; INE: Indoor Nature Exposure; NR: Nature-Relatedness Scale; PANAS: Positive and Negative Affect Schedule; SAM: Search and Memory Test; SLSI: Student Life Stress Inventory; SMT: Sentence Making Test.
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Affiliation(s)
- Jill McSweeney
- Centre for Learning and Teaching, Dalhousie University, Halifax, Canada
| | - Shannon Johnson
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Simon Sherry
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Jerome Singleton
- Recreation and Leisure Studies, Dalhousie University, Halifax, Canada
| | - Daniel Rainham
- Institute of Population Health, Dalhousie University, Halifax, Canada
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Creating a transformative space for change: A qualitative evaluation of the RHS Wellbeing Programme for people with long term conditions. Health Place 2021; 71:102654. [PMID: 34419712 DOI: 10.1016/j.healthplace.2021.102654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Our research aimed to evaluate the impact of the RHS Wellbeing (WB) Programme on people with long-term conditions. FINDINGS A thematic analysis identified how the WB programme facilitated improved social connectivity, sense of wellbeing and purpose through the creation of a 'healthy, natural and safe space' predicated on 'person-centred approaches'. Participants felt they were 'part of something larger' which enabled 'transformation of their health and wellbeing'. CONCLUSIONS The WB Programme offered space to grow, heal and reconnect. Losing oneself in a nature-based space can have a lasting transformative impact on individuals.
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Meuwese D, Maas J, Krabbendam L, Dijkstra K. Viewing Nature Lets Your Mind Run Free: Three Experiments about the Influence of Viewing a Nature Video on Cognitive Coping with Psychological Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168842. [PMID: 34444590 PMCID: PMC8392410 DOI: 10.3390/ijerph18168842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 12/29/2022]
Abstract
Viewing nature has restorative qualities that might help people cope with their personal struggles. Three lab experiments (N = 506) studied whether environment (nature vs. built) influences cognitive coping with psychological distress. Psychological distress was induced with an autobiographical recall task about serious regret, whereafter participants were randomly assigned to view a nature or built video. Cognitive coping (i) Quantity, (ii) Content, and (iii) Quality were hereafter assessed as well as extent and vividness of the regretful memory during the video. Results showed a higher cognitive coping Quantity (Study 1 and 3) and a higher cognitive coping Quality (All studies) for the nature (vs. built) condition. Regarding cognitive coping Content, results varied across the studies. Additionally, participants reported to have thought about the experienced psychological distress to a greater extent while viewing the nature (vs. built) video. Yet they did rate viewing nature as more relaxing. We propose a two-step pathway as an underlying mechanism of restoration. In the first step the capacity for directed attention replenishes. Secondly, this renewed capacity is directed towards internal processes, creating the optimal setting for reflection. Hence, viewing nature allows people to truly process whatever is occupying their minds, which is ultimately relieving and beneficial for mental health.
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Affiliation(s)
- Daphne Meuwese
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (J.M.); (L.K.)
- Correspondence:
| | - Jolanda Maas
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (J.M.); (L.K.)
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (J.M.); (L.K.)
| | - Karin Dijkstra
- Research Group Nursing, Saxion University of Applied Sciences, 7513 AB Enschede, The Netherlands;
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Nature-Based Rehabilitation for Patients with Long-Standing Stress-Related Mental Disorders: A Qualitative Evidence Synthesis of Patients' Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136897. [PMID: 34199050 PMCID: PMC8297286 DOI: 10.3390/ijerph18136897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/14/2021] [Accepted: 06/19/2021] [Indexed: 11/17/2022]
Abstract
Stress-related mental disorders contribute to work disabilities globally and are a common cause for sick leave. Nature-based rehabilitation (NBR) is a multi-disciplinary approach offered to this patient group on a limited scale. Qualitative studies provide insight into patients’ experiences of NBR, and there is a need to synthesize and assess the certainty of evidence for patient-experienced benefits. The aim was to identify, appraise, and synthesize studies reporting experiences and perceived benefits of participation in multidisciplinary, group-based NBR of adult patients with long-standing stress-related mental disorders. PubMed, Embase, CINAHL, AMED, APA PsycInfo, and the Cochrane Library were searched from inception to December 2020. Reference lists of relevant publications were searched. After title and abstract screening, full-text articles were retrieved and assessed for inclusion. The methodological quality of the included studies was assessed, and certainty of evidence was appraised according to CERQual. The search yielded 362 unique records; 19 full-text publications were assessed for eligibility, and 5 studies were included in the synthesis. The studies were considered relevant regarding context, population, and intervention, and quality was generally assessed as moderate to high. Extracted texts were inductively coded and organized into 16 descriptive themes and 4 broad, analytical themes: Instilling calm and joy; Needs being met; Gaining new insights; and Personal growth. Experiences and perceived benefits of participating in NBR and spending time in a nature environment were described as positive for recovery. Nine of the descriptive themes were based on explicit results from at least four of the five studies. Confidence in the evidence of the qualitative findings ranged from moderate to low. Moderate-to-low certainty evidence from the included studies suggests that patients with long-standing stress-related mental disorders experience positive health effects from participating in NBR.
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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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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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Dzhambov AM, Lercher P, Browning MHEM, Stoyanov D, Petrova N, Novakov S, Dimitrova DD. Does greenery experienced indoors and outdoors provide an escape and support mental health during the COVID-19 quarantine? ENVIRONMENTAL RESEARCH 2021; 196:110420. [PMID: 33157110 PMCID: PMC8454400 DOI: 10.1016/j.envres.2020.110420] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic has profoundly changed people's ability to recreate in public green spaces, which is likely to exacerbate the psychological impacts of the pandemic. In the current study, we seek to understand whether greenery can support mental health even with insufficient outdoor exposure in times of physical isolation from the outdoor environment. METHODS Between 17 May and 10 June, 2020, we conducted an online survey among 323 students (21.99 ± 3.10 years; 31% male) in health-related programs from two universities in the city of Plovdiv, Bulgaria. Severities of depressive and anxiety symptoms over the past two weeks were measured with the Patient Health Questionnaire 9-item and the Generalized Anxiety Disorder 7-item scale. We employed two self-reported measures of greenery experienced indoors (number of houseplants in the home and proportion of exterior greenery visible from inside the home) and two measures of greenery experienced outdoors (presence/absence of a domestic garden and availability of neighborhood greenery). Restorative quality of the home (the "being away" dimension of the Perceived Restorativeness Scale; PRS) and the neighborhood (the "being away" and "fascination" dimensions of the PRS), engagement with outdoor greenery (frequency of different types of interaction) and perceived social support were treated as mediators. Associations between greenery and mental health were tested using generalized linear regression and logistic regression. Structural equation modelling (SEM) techniques were used to test the theoretically-indicated relations among the variables. RESULTS Clinically-meaningful symptoms of moderate depression and anxiety were reported by approximately 33% and 20% of the students, respectively. The relative abundance of greenery visible from the home or in the neighborhood was associated with reduced depressive/anxiety symptoms and lower depression/anxiety rates. Having more houseplants or a garden was also associated with some of these markers of mental health. As hypothesized, the mental health-supportive effects of indoor greenery were largely explained by increased feelings of being away while at home. Neighborhood greenery contributed to neighborhood restorative quality, which in turn facilitated social support and more frequent engagement with greenery, and that led to better mental health. CONCLUSIONS Students who spent most of their time at home during the COVID-19 epidemic experienced better mental health when exposed to more greenery. Our findings support the idea that exposure to greenery may be a valuable resource during social isolation in the home. However, causal interpretation of these associations is not straightforward.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Matthew H E M Browning
- Department of Park, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
| | - Drozdstoy Stoyanov
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Institute at Medical University - Plovdiv, Plovdiv, Bulgaria
| | - Nadezhda Petrova
- Department of Human Anatomy, Histology and Embryology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria; Department of Plant Physiology and Molecular Biology, Faculty of Biology, University of Plovdiv "Paisii Hilendarski", Plovdiv, Bulgaria
| | - Stoyan Novakov
- Department of Human Anatomy, Histology and Embryology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Donka D Dimitrova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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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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Virtual Reality Representations of Nature to Improve Well-Being amongst Older Adults: a Rapid Review. ACTA ACUST UNITED AC 2021; 6:464-485. [PMID: 33688575 PMCID: PMC7934124 DOI: 10.1007/s41347-021-00195-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/31/2022]
Abstract
Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.
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[Using endurance training in nature as a resource in inpatient psychotherapy]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2021; 67:290-302. [PMID: 33511916 DOI: 10.13109/zptm.2021.67.oa1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Using endurance training in nature as a resource in inpatient psychotherapy Objectives: Although positive effects of nature on mental health are generally well-documented, clinical studies into the deliberate use of nature as a resource in in-patient psychotherapy are missing. The following study examined whether an endurance training intervention in psychosomatic rehabilitation showed differential effects on patients depending on its implementation in an indoor or outdoor nature setting. Methods: Endurance training indoors (ergometer) was compared to training outdoors in the nature (walking) in N = 88 in-patients of a psychosomatic rehabilitation clinic using a linear mixed effects model. Health effects were examined using a standardized questionnaire on somatic symptoms (Giessener Beschwerdebogen GBB-24) and a mood questionnaire (Aktuelle Stimmungsskala ASTS). Seasonal effects were assessed by testing half of the sample in summer and half in winter. Secondary analyses of the linear mixed effects model were run for depression as primary diagnosis which accounted for half of the sample. Results: A nature setting positively predicted improvements on the ASTS positive mood scale (B = 0.34; t(245) = 3.25; p = .001; pBonferroni = .052). No significant interaction was found between the effect of the training setting and depression as primary diagnosis (B = -0.05; t(245) = -0.30; p = .76) in secondary analyses. Conclusions: The results primarily point to an improvement in mood following endurance training in a nature setting. Improvements are independent of depression as the primary diagnosis.
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