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Landrigan PJ, Britt M, Fisher S, Holmes A, Kumar M, Mu J, Rizzo I, Sather A, Yousuf A, Kumar P. Assessing the Human Health Benefits of Climate Mitigation, Pollution Prevention, and Biodiversity Preservation. Ann Glob Health 2024; 90:1. [PMID: 38186855 PMCID: PMC10768568 DOI: 10.5334/aogh.4161] [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: 08/11/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Background Since the Industrial Revolution, humanity has amassed great wealth and achieved unprecedented material prosperity. These advances have come, however, at great cost to the planet. They are guided by an economic model that focuses almost exclusively on short-term gain, while ignoring natural capital and human capital. They have relied on the combustion of vast quantities of fossil fuels, massive consumption of the earth's resources, and production and environmental release of enormous quantities of chemicals, pesticides, fertilizers, and plastics. They have caused climate change, pollution, and biodiversity loss, the "Triple Planetary Crisis". They are responsible for more than 9 million premature deaths per year and for widespread disease - impacts that fall disproportionately upon the poor and the vulnerable. Goals To map the human health impacts of climate change, pollution, and biodiversity loss. To outline a framework for assessing the health benefits of interventions against these threats. Findings Actions taken by national governments and international agencies to mitigate climate change, pollution, and biodiversity loss can improve health, prevent disease, save lives, and enhance human well-being. Yet assessment of health benefits is largely absent from evaluations of environmental remediation programs. This represents a lost opportunity to quantify the full benefits of environmental remediation and to educate policy makers and the public. Recommendations We recommend that national governments and international agencies implementing interventions against climate change, pollution, and biodiversity loss develop metrics and strategies for quantifying the health benefits of these interventions. We recommend that they deploy these tools in parallel with assessments of ecologic and economic benefits. Health metrics developed by the Global Burden of Disease (GBD) study may provide a useful starting point.Incorporation of health metrics into assessments of environmental restoration will require building transdisciplinary collaborations. Environmental scientists and engineers will need to work with health scientists to establish evaluation systems that link environmental and economic data with health data. Such systems will assist international agencies as well as national and local governments in prioritizing environmental interventions.
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Affiliation(s)
- Philip J. Landrigan
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
- Centre Scientifique de Monaco, MC
| | - Michael Britt
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
| | - Samantha Fisher
- City University of New York, Graduate School of Public Health and Health Policy, New York City, NY, US
| | | | - Manasi Kumar
- Department of Psychiatry, University of Nairobi, Kenya
- Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, US
| | - Jenna Mu
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
| | - Isabella Rizzo
- The George Washington University, Elliot School of International Affairs, Washington D.C., US
| | - Anna Sather
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, US
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Lu S, Liu J, Xu M, Xu F. Horticultural therapy for stress reduction: A systematic review and meta-analysis. Front Psychol 2023; 14:1086121. [PMID: 37564307 PMCID: PMC10411738 DOI: 10.3389/fpsyg.2023.1086121] [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: 11/23/2022] [Accepted: 03/01/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Horticultural therapy has been increasingly accepted as a non-pharmacological stress reduction treatment. Previous studies have demonstrated its therapeutic effects, with the effect varying according to the populations, settings, and interventions of horticultural therapy. This study aimed to provide a comprehensive review of the current literature regarding the effectiveness of horticultural therapy in reducing stress. Methods We selected databases including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, and VIP Data as our data source, and the original search was completed in January 2023. Results Our results showed significantly increased effects of horticultural therapy on psychological indicators compared to a control group, but an insignificant effect on physiology indicators. The result of the subgroup analysis demonstrated that the stress-reducing effects of horticultural therapy were related to the characteristics of the population and indoor and virtual areas were the most effective setting for horticultural therapy. At the same time, a total duration of 100-500 minutes provided better effects of stress reduction. Discussion We also developed a theoretical framework based on a "Participants-Settings-Interventions" structure for horticulture therapy in terms of its stress-reduction effects, to provide a reference for future horticultural therapy activities.
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Affiliation(s)
- Shan Lu
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, China
| | - Jianjiao Liu
- Faculty of Architecture, Building and Planning, Melbourne School of Design, University of Melbourne, Parkville, VIC, Australia
| | - Meijing Xu
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, China
| | - Feng Xu
- Department of Landscape Architecture, College of Horticulture, China Agricultural University, Beijing, China
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Nguyen PY, Astell-Burt T, Rahimi-Ardabili H, Feng X. Effect of nature prescriptions on cardiometabolic and mental health, and physical activity: a systematic review. Lancet Planet Health 2023; 7:e313-e328. [PMID: 37019572 DOI: 10.1016/s2542-5196(23)00025-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/19/2023]
Abstract
Nature prescriptions are gaining popularity as a form of social prescribing in support of sustainable health care. This systematic review and meta-analysis aims to synthesise evidence on the effectiveness of nature prescriptions and determine the factors important for their success. We searched five databases from inception up to July 25, 2021. Randomised and non-randomised controlled studies featuring a nature prescription (ie, a referral or an organised programme, by a health or social professional, to encourage spending time in nature) were included. Two reviewers independently conducted all steps of study selection; one reviewer collected summary data from published reports and conducted the risk of bias assessment. Random-effect DerSimonian-Laird meta-analyses were conducted for five key outcomes. We identified 92 unique studies (122 reports), of which 28 studies contributed data to meta-analyses. Compared with control conditions, nature prescription programmes resulted in a greater reduction in systolic blood pressure (mean difference -4·82 mm Hg [-8·92 to -0·72]) and diastolic blood pressure (mean difference -3·82 mm Hg [-6·47 to -1·16). Nature prescriptions also had a moderate to large effect on depression scores (post-intervention standardised mean difference -0·50 [-0·84 to -0·16]; change from baseline standardised mean difference -0·42 [-0·82 to -0·03]) and anxiety scores (post-intervention standardised mean difference -0·57 [-1·12 to -0·03]; change from baseline standardised mean difference -1·27 [-2·20 to -0·33]). Nature prescriptions resulted in a greater increase in daily step counts than control conditions (mean difference 900 steps [790 to 1010]) but did not improve weekly time of moderate physical activity (mean difference 25·90 min [-10·26 to 62·06]). A subgroup analysis restricted to studies featuring a referring institution showed stronger effects on depression scores, daily step counts, and weekly time of moderate physical activity than the general analysis. Beneficial effects on anxiety and depression scores were mainly provided by interventions involving social professionals whereas beneficial effects on blood pressures and daily step counts were provided mainly by interventions involving health professionals. Most studies have a moderate to high risk of bias. Nature prescription programmes showed evidence of cardiometabolic and mental health benefits and increases in walking. Effective nature prescription programmes can involve a range of natural settings and activities and can be implemented via social and community channels, in addition to health professionals.
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Affiliation(s)
- Phi-Yen Nguyen
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Hania Rahimi-Ardabili
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Xiaoqi Feng
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; The George Institute of Global Health, Sydnet, NSW, Australia.
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Joschko L, Pálsdóttir AM, Grahn P, Hinse M. Nature-Based Therapy in Individuals with Mental Health Disorders, with a Focus on Mental Well-Being and Connectedness to Nature-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2167. [PMID: 36767534 PMCID: PMC9914984 DOI: 10.3390/ijerph20032167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
In times of social and ecological crises, such as COVID-19 with lockdowns and implementing the impact of climate change, mental health degrades. Being outdoors in nature can be health-promoting, can decrease depression, and increase mental well-being. This pilot study investigated the relationships between nature-based therapy, mental health, and individuals' connectedness to nature. We hypothesize that nature-based therapy has a positive impact on individual mental health and connectedness to nature. A mixed-method approach was used to evaluate the effectiveness of nature-based therapy for young psychosomatic patients. The results demonstrated improvements in mental well-being and connectedness to nature through therapy. Additionally, depression scores decreased. Patients reported the importance of the therapist setting the space, the supportive environment, the poems that fostered the nature connection, improvement at the soul level, and overall doing something meaningful. Every patient experienced nature-based therapy as effective. To conclude, the study gives a first insight into the processes of nature-based therapy in the German population at work and the effectiveness of nature-based therapy. Further questions, e.g., season effects, longitudinal effects, and whether patients with low connectedness to nature gain more out of the intervention remain unanswered.
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Affiliation(s)
- Lilly Joschko
- Department of People and Society, The Swedish University of Agricultural Sciences, 234 22 Lomma, Sweden
| | - Anna María Pálsdóttir
- Department of People and Society, The Swedish University of Agricultural Sciences, 234 22 Lomma, Sweden
| | - Patrik Grahn
- Department of People and Society, The Swedish University of Agricultural Sciences, 234 22 Lomma, Sweden
| | - Maximilian Hinse
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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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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Tu HM. Effect of horticultural therapy on mental health: A meta-analysis of randomized controlled trials. J Psychiatr Ment Health Nurs 2022; 29:603-615. [PMID: 35000249 DOI: 10.1111/jpm.12818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/28/2021] [Accepted: 01/05/2022] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mental health assessment is a common topic in horticultural therapy (HT). Some study findings were contrary to positive findings, although several studies have explored the effect of HT on mental health and reported positive results. There is weak evidence in the benefits of HT based on evidence-based medicine. Stronger evidence of the link between HT and mental health will help in policy making by health policy makers and governments. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The purpose of this meta-analysis of randomized controlled trials (RCTs) was to explore the effect of HT on mental health. This study is the first meta-analysis of RCTs to provide critical evidence that HT has a positive effect on mental health. The effect size of HT on mental health was medium (0.55). The included studies had no negative effects on mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: HT should be considered a useful therapy to be integrated in healthcare settings by horticultural therapists to improve mental health. In the HT program, indoor and outdoor plant activities, plant-related arts, crafts and other activities were common interventions to improve specific mental health problems through at least eight sessions. ABSTRACT: Introduction HT has been widely used to promote mental health. However, heterogeneity and sample size issues of randomized controlled trials made it challenging to illustrate effect sizes across the evidence. Aim The purpose of this meta-analysis was to explore the effect of HT on mental health. Methods We used the PRISMA framework. A keyword search of Web of Science, PubMed, ProQuest and Cochrane was performed. The inclusion criteria were HT with RCTs and mental health assessments. A random-effects model was used to perform the meta-analysis. Results A total of 1,056 records were searched, and 18 eligible studies were extracted. The included RCTs had no statistical heterogeneity and publication bias. The meta-analysis showed that the HT experimental groups had a significant and positive impact on mental health compared with the control groups (effect size = 0.55). Discussion HT should be considered for enhancing mental health. The included studies had no negative outcomes and the most common HT intervention was at least eight sessions. Therefore, HT should be considered to enhance mental health. However, the concealed allocation and blinding processes should be improved in future studies. Implications for Practice: This study recommends that HT should be integrated into healthcare settings to improve mental health.
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Affiliation(s)
- Hung-Ming Tu
- Department of Horticulture, National Chung Hsing University, Taichung, Taiwan
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Horticulture therapy affected the mental status, sleep quality, and salivary markers of mucosal immunity in an elderly population. Sci Rep 2022; 12:10246. [PMID: 35715581 PMCID: PMC9205955 DOI: 10.1038/s41598-022-14534-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/08/2022] [Indexed: 11/09/2022] Open
Abstract
Horticultural therapy (HT) has been reported to be beneficial to mental and physical health. This study investigated the effects of HT on the psychological status and mucosal immunity of elderly individuals. Twenty-four participants aged 70-93 were recruited from residential facilities and adult day-care services. Six different HT activities were designed and guided by licensed instructors who performed saliva collection and helped the participants complete the questionnaires before and after each activity. The sleep quality scores were collected during the 6 weeks of HT activities. Saliva was collected and analyzed to determine the concentrations of immunoglobulin A (IgA), lactoferrin, chromogranin A (CgA), α-amylase (AA) and total protein (TP). Comparisons of the questionnaire scores between preactivity and postactivity showed that feelings of satisfaction and happiness were significantly enhanced after each activity. In addition, sleep quality was significantly improved after the 6-week course of HT activities. Regarding mucosal immunity, the preactivity IgA and IgA/TP were significantly increased at week 3 and week 6; in addition, the ratio of lactoferrin/TP was significantly decreased at week 6 compared to week 1. The postactivity AA and CgA levels were significantly enhanced at weeks 2, 3 and 5 compared to the corresponding preactivity levels. In conclusions, HT activities significantly improved the happiness, satisfaction, well-being and sleep quality of the elderly. Moreover, mucosal immunity proteins, including IgA, lactoferrin, CgA and AA, were significantly increased.
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Zhang X, Zhang Y, Zhai J. Home Garden With Eco-Healing Functions Benefiting Mental Health and Biodiversity During and After the COVID-19 Pandemic: A Scoping Review. Front Public Health 2021; 9:740187. [PMID: 34869154 PMCID: PMC8632623 DOI: 10.3389/fpubh.2021.740187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic has led to tremendous impacts on human lives and society, which are not only because of negative effects on people's mental health due to isolation policies and physical distance for mitigating the spread of SARS-CoV-2, but also because the incident post-acute sequelae of the coronavirus will cause mental disorders. A green environment is a health resource, which cannot only benefit human physical and mental health, but also increases biodiversity, contributes to flood mitigation, and cools urban areas. A home garden, as a kind of small green space, can provide ecosystem services with eco-healing functions in reducing mental stress during the isolation period of the COVID-19 pandemic through the garden itself and physical activities in it. Such an eco-healing approach within a mini-therapeutic landscape can also benefit biodiversity by enhancing plant diversity in residence and increasing biodiversity at a large scale. In this article, we propose a conceptual framework describing a home garden as "ecological medicine" with healing functions to improve mental health, as well as indirectly enhancing urban biodiversity. A home garden, as a mini-type of green landscape with biodiversity content, allows people to get close with nature so that it can promote comfortable and natural feelings during the pandemic. Furthermore, such an eco-healing home garden approach benefiting urban biodiversity can meet the challenges in maintaining environmental and mental health in post COVID-19 pandemic recovery, as well as preparing unknown next-surge risks with potential isolation regulations.
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Affiliation(s)
- Xindi Zhang
- Department of Landscape Architecture, Soochow University, Suzhou, China
| | - Yixin Zhang
- Department of Landscape Architecture, Soochow University, Suzhou, China
- Collaborative Innovation Center of Architecture and Urban Environment of Soochow University-Suzhou Yuanke; China-Portugal Belt and Road Cooperation Laboratory of Cultural Heritage Conservation Science, Research Center of Landscape Protection and Ecological Restoration, Soochow University, Suzhou, China
| | - Jun Zhai
- Department of Landscape Architecture, Soochow University, Suzhou, China
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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: 77] [Impact Index Per Article: 25.7] [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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Korah T, Morrison D, Mason D, Diehl ER, Bussing R. Therapeutic Horticulture as a Therapeutic Intervention in Patients Receiving Electroconvulsive Therapy (ECT) Treatment for Major Depressive Disorder. Cureus 2021; 13:e17363. [PMID: 34434684 PMCID: PMC8380433 DOI: 10.7759/cureus.17363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 11/17/2022] Open
Abstract
This study explored the effect of a structured therapeutic horticulture (TH) program on depression symptoms and quality of life indicators for individuals receiving inpatient electroconvulsive therapy (ECT) for major depressive disorders (MDD). Self-reported measures of depressive symptomatology (PHQ9, BDI-II) and quality of life (SF-36) were employed to compare intervention (n = 25) and control groups (n = 27), with the intervention group attending TH sessions for one-hour periods, twice per week, in addition to standard inpatient care associated with ECT received by both groups. All patients were assessed at admission, and after two weeks’ time or prior to discharge, during which the intervention group participated in a minimum of four TH sessions. Sessions were led by a horticultural therapist in an accessible on-campus greenhouse. Both groups improved significantly between assessment times one and two on both measures of depression, with a statistically significant difference in change scores for the BDI-II only, favoring the control over the intervention group (16.5, s.d. 12.78 versus 9.6, s.d. 10.15; p = 0.36). Both groups improved significantly on four of eight SF-36 subscales during the same period. A statistically significant difference in change scores was found for the Role Limitations-Physical Health (RLPH) subscale, where the intervention group improved between assessment periods, whereas the control group worsened (16.0, s.d.48.8 versus -9.3, s.d. 33.4; p = .033). Although quantifying group changes or improvement for individuals receiving intensive treatment for major depressive disorders (ECT) by the addition of an adjunct therapy is difficult, this study provides a basic premise for the consideration of various therapeutic horticulture settings to achieve therapeutic benefits through TH.
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Affiliation(s)
- Tessy Korah
- Psychiatry, University of Florida, Gainesville, USA
| | | | - Dana Mason
- Psychiatry, University of Florida, Gainesville, USA
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Chu HY, Chan HS, Chen MF. Effects of Horticultural Activities on Attitudes toward Aging, Sense of Hope and Hand-Eye Coordination in Older Adults in Residential Care Facilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6555. [PMID: 34207071 PMCID: PMC8296344 DOI: 10.3390/ijerph18126555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
This study investigated the effects of an 8-week horticultural activity intervention on attitudes toward aging, sense of hope, and hand-eye coordination in 88 older adults in residential care facilities. In the experimental group, the mean score for "attitudes toward aging" increased from 3.81 before the intervention to 4.74 points after the intervention (standard deviation SD = 0.24 and 0.27, respectively), and the control group dropped from 3.75 to 3.70 (standard deviations, respectively SD = 0.27 and 0.28). The mean score for "sense of hope" increased from 3.28 before the intervention to 3.81 points after the intervention (SD = 0.49 and 0.26, respectively). In contrast to the control group, the mean score gradually declined from 3.26 to 3.16 points (standard deviation SD = 0.54 and 0.48, respectively). In the test of hand-eye coordination, the time required to complete the cup stacking test significantly decreased from 33.56 to 25.38 s in the experimental group but did not significantly change in the control group. Generalized estimating equation analysis revealed a significant interaction between group and time (p < 0.001). The data trends revealed significant differences in outcomes between the experimental group and the control group. At 3 months after the end of the study, the effect size in the experimental group remained higher than that in the control group.
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Affiliation(s)
- Hui-Ying Chu
- Department of Living Services Industry, Tainan University of Technology, No. 529, Zhongzheng Rd., Yongkang District, Tainan City 71002, Taiwan
| | - Hui-Shan Chan
- Department of Applied Cosmetology, National Tainan Junior College of Nursing, 78 Sec. 2, Minzu Rd., Tainan City 70043, Taiwan;
| | - Mei-Fang Chen
- Department of Nursing, National Tainan Junior College of Nursing, 78 Sec. 2, Minzu Rd., Tainan City 70043, Taiwan;
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Nascimento JCP, Santos KVGD, Dantas JKDS, Dantas DV, Dantas RAN. Non-pharmacological therapies for the treatment of post-traumatic stress disorder among emergency responders: a scoping review. Rev Esc Enferm USP 2021; 55:e03724. [PMID: 34161443 DOI: 10.1590/s1980-220x2020011603724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/30/2020] [Indexed: 03/15/2023] Open
Abstract
OBJECTIVE Identify non-pharmacological therapies for the treatment of post-traumatic stress disorder in emergency responders. METHOD Scope review according to the guidelines of the Joanna Briggs Institute and the PRISMA-ScR protocol. A search was conducted in nine databases, portals of theses and dissertations, and using an electronic search engine. RESULTS In total, 23 studies were selected and analyzed, and then categorized into six thematic fields - therapy with omega 3 food supplement, art therapy, physical exercise therapy, mindfulness-based therapy, therapy with elements of nature, and psychotherapy - which were considered non-pharmacological treatments for this psychopathology among emergency responders, as well as the use of psychotherapy via telehealth as an option for treatment. CONCLUSION More evidence supporting diet therapy is required, while the other therapeutic options presented positive results, finding support in national and international recommendations of treatment and clinical practice.
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Affiliation(s)
| | | | | | - Daniele Vieira Dantas
- Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil
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Mourão I, Mouro CV, Brito LM, Costa SR, Almeida TC. Impacts of therapeutic horticulture on happiness and loneliness in institutionalized clients with mental health conditions. Br J Occup Ther 2021. [DOI: 10.1177/03080226211008719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction Therapeutic horticulture (TH) can be considered a non-pharmacological approach to support psychiatric treatments for the improvement of physical and mental health, but information is lacking on whether it has advantages as compared to more conventional occupational therapies (OTs). Method The study focused on institutionalized 25 clients attending TH among other OTs and 15 clients attending OT other than TH. The measures used were the ‘Subjective Happiness Scale’ (SHS) and the ‘Social and Emotional Loneliness Scale for Adults’ (SELSA-S), along with sociodemographic and clinical data. The study design was descriptive, observational and cross-sectional. Results Scores obtained from the SHS and SELSA-S were generally similar for both groups, although 40% of clients in the TH group perceived relaxation. These are in agreement with previous studies performed with chronic schizophrenia clients reporting that TH might effectively decrease depression/anxiety symptoms, but the feeling of hopelessness and quality of life did not change, probably due to long-term institutionalization and required medication that may limit other effects. Within the TH group, clients preferred specific horticultural tasks and more days/week attending activities decreased loneliness and increased happiness. Conclusion TH interventions as an integrative treatment option merits further study on both process and outcome evaluation, to maximize its effectiveness.
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Affiliation(s)
- Isabel Mourão
- Instituto Politécnico de Viana do Castelo Escola Superior Agrária, Ponte de Lima, Portugal
- Centro de Investigação de Montanha, Braganca, Portugal
| | - Cláudia V Mouro
- Instituto Politécnico de Viana do Castelo Escola Superior Agrária, Ponte de Lima, Portugal
| | - Luís Miguel Brito
- Instituto Politécnico de Viana do Castelo Escola Superior Agrária, Ponte de Lima, Portugal
- Centro de Investigação de Montanha, Braganca, Portugal
| | - Sofia R Costa
- CBMA - Centro de Biologia Molecular e Ambiental, Departamento de Biologia, Universidade do Minho, Braga, Portugal
| | - Telma C Almeida
- Instituto Universitário Egas Moniz; CiiEM - Centro de Investigação Interdisciplinar Egas Moniz; LabPSI - Laboratório de Psicologia Egas Moniz, Caparica, Portugal
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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: 85] [Impact Index Per Article: 28.3] [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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Tu PC, Cheng WC, Hou PC, Chang YS. Effects of Types of Horticultural Activity on the Physical and Mental State of Elderly Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145225. [PMID: 32698351 PMCID: PMC7400358 DOI: 10.3390/ijerph17145225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/12/2020] [Accepted: 07/15/2020] [Indexed: 02/03/2023]
Abstract
This study aimed to evaluate the effect of types of horticultural activities among elderly individuals in a senior citizen learning camp. We arranged four horticultural activities: Grass Doll, Kokedama, Rocky Leaf Prints, and Herb Tasting and Smelling. Twenty-seven senior citizens (60 to 76 years) were recruited to participate. We assessed their physiological and mental state before and after the activities by measuring heart rate variability (HRV), pulse rate, blood pressure, salivary amylase activity (SAA), and Profile of Mood States (POMS). Results showed that SAA was significantly lower after the Rocky Leaf Prints, Herb Tasting and Smelling, and Kokedama. Pulse rate had a downward trend after the four horticultural activities. The ratio of low frequency (LF) over high frequency (HF) results showed that the Rocky Leaf Prints had a larger downward trend, followed by Herb Tasting and Smelling. POMS scores indicated significant improvement for Rocky Leaf Prints and Herb Tasting and Smelling. The types including artistic creation and food tasting were promising methods for psychological relaxation, stress reduction, and vigor enhancement for elderly persons. Findings showed that the impact of activities involving contact with plants was more significant in short-term activities. We hope this study can help plan the horticultural activities of the elderly in the future.
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Affiliation(s)
- Pei-Chun Tu
- Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei 106, Taiwan; (P.-C.T.); (P.-C.H.)
| | - Wen-Chen Cheng
- School of Nursing, Fooyin University, Kaohsiung 831, Taiwan;
| | - Ping-Cheng Hou
- Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei 106, Taiwan; (P.-C.T.); (P.-C.H.)
| | - Yu-Sen Chang
- Department of Horticulture and Landscape Architecture, National Taiwan University, Taipei 106, Taiwan; (P.-C.T.); (P.-C.H.)
- Correspondence: ; Tel.: +886-2-3366-4856
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Are Community Gardening and Horticultural Interventions Beneficial for Psychosocial Well-Being? A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103584. [PMID: 32443769 PMCID: PMC7277687 DOI: 10.3390/ijerph17103584] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/11/2020] [Accepted: 05/16/2020] [Indexed: 12/20/2022]
Abstract
Recent literature has revealed the positive effect of gardening on human health; however, empirical evidence on the effects of gardening-based programs on psychosocial well-being is scant. This meta-analysis aims to examine the scientific literature on the effect of community gardening or horticultural interventions on a variety of outcomes related to psychosocial well-being, such as social cohesion, networking, social support, and trust. From 383 bibliographic records retrieved (from 1975 to 2019), seven studies with a total of 22 effect sizes were selected on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analytic findings on 11 comparisons indicate a positive and moderate effect of horticultural or gardening interventions on psychosocial well-being. Moderation analysis shows a greater effect size in individualistic than collectivistic cultures. A greater effect size was also observed in studies involving community gardening compared to horticultural intervention. Nevertheless, an effect of publication bias and study heterogeneity has been detected. Despite the presence of a large number of qualitative studies on the effect of horticulture/gardening on psychosocial well-being, quantitative studies are lacking. There is a strong need to advance into further high-quality studies on this research topic given that gardening has promising applied implications for human health, the community, and sustainable city management.
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