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December 2013 E-Newsletter

Searching for horticultur* therapy

Finding research evidence to support the use of horticultural therapy with a specific patient group or a specific health outcome is challenging but the quantity of reported research has increased and the quality of the reported research has improved. To demonstrate, this newsletter features abstracts from a recent search I did using only the search terms ‘horticultur* therapy’. I used Web of Science, one of my favorite databases I use when searching for research articles. In addition to citations, Web of Science analyzes the results in a variety of ways such that you can learn, for example, the journals that publish in your topic of interest, what type of documents are published, even what countries and organizations are publishing in your topic of interest. The following table summarizes some of the search results.
Summary Results of a Search of Web of Science using the Search Terms ‘Horticultur* therapy’
Top 5 Categories Top 5 Research Areas Top 5 Document Types Top 5 Journals Top 5 Publication Years Top 5 Countries Universities
Horticulture (57) Agriculture (62) Article (74) HortScience (25) 2010 (18) USA (55) Kansas State University (12)
Rehabilitation (14) Rehabilitation (14) Meeting Abstract (27) Korean Journal of Horticultural Science Technology (19) 2012 (11) South Korea (26) Konkuk University (12)
Gerontology (9) Geriatrics Gerontology (10) Review (10) HortTechnology (10) 2008 (8) England (11) Virginia Tech University (11)
Psychiatry (5) Educational Research (5) Book Review (4) British Journal of Occupational Therapy (3) 2011 (8) Sweden (5) Texas A&M University (10)
Clinical Neurology (4) Psychiatry (5) Note (3) Gerontologist (3) 1979 (7) Australia (4) Catholic University Daegu (4)
What databases do you find most useful? Have you found search strategies that are especially successfully? We would love to hear from you.

- Candice Shoemaker, PPC Executive Chair

Examples of horticulture therapy literature - research and review

Here are a few examples of research articles:
Title: Does a structured gardening programme improve well-being in young-onset dementia? A preliminary study
Author(s): Hewitt, Peter; Watts, Claire; Hussey, Jacqueline; et al.
Source: BRITISH JOURNAL OF OCCUPATIONAL THERAPY  Volume: 76   Issue: 8   Pages: 355-361   DOI: 10.4276/030802213X13757040168270   Published: AUG 2013
Introduction: Young-onset dementia affects about 1 in 1500 people aged under 65 years in the United Kingdom (UK). It is associated with loss of employment, independence and an increase in psychological distress. This project set out to identify the benefits of a 2 hours per week structured activity programme of gardening for people with young-onset dementia.
Method: A mixed methods (qualitative and quantitative) study of therapeutic gardening for people with young-onset dementia, measuring outcomes for both participants with young-onset dementia and their caregivers, was used. Twelve participants were recruited from a county-wide mental health service for older adults, based on onset of dementia being before the age of 65 years (range 43-65 years). Of these, two participants dropped out and one died during the project. Measures included the Mini Mental State Examination (MMSE), Bradford Well-Being Profile, Large Allen Cognitive Level Screen (LACLS) and Pool Activity Level (PAL).
Findings: Over a 1-year period the caregivers of the people with young-onset dementia found that the project had given participants a renewed sense of purpose and increased well-being, despite cognitive functioning continuing to decline during this period.
Conclusion: This study suggests that a meaningful guided activity programme can maintain or improve well-being in the presence of cognitive deterioration.
Title: Spiritual care of cancer patients by integrated medicine in urban green space: a pilot study
Author(s): Nakau, Maiko; Imanishi, Jiro; Imanishi, Junichi; et al.
Source: EXPLORE-THE JOURNAL OF SCIENCE AND HEALING  Volume: 9   Issue: 2   Pages: 87-90   DOI: 10.1016/j.explore.2012.12.002   Published: MAR-APR 2013
Background: Psycho-oncological care, including spiritual care, is essential for cancer patients. Integrated medicine, a therapy combining modern western medicine with various kinds of complementary and alternative medicine, can be appropriate for the spiritual care of cancer because of the multidimensional characteristics of the spirituality. In particular, therapies that enable patients to establish a deeper contact with nature, inspire feelings of life and growth of plants, and involve meditation may be useful for spiritual care as well as related aspects such as emotion. The purpose of the present study was to examine the effect of spiritual care of cancer patients by integrated medicine in a green environment.
Methods: The present study involved 22 cancer patients. Integrated medicine consisted of forest therapy, horticultural therapy, yoga meditation, and support group therapy, and sessions were conducted once a week for 12 weeks. The spirituality (the Functional Assessment of Chronic Illness Therapy-Spiritual well-being), quality of life (Short Form-36 Health Survey Questionnaire), fatigue (Cancer Fatigue Scale), psychological state (Profile of Mood States, short form, and State-Trait Anxiety Inventory) and natural killer cell activity were assessed before and after intervention.
Results: In Functional Assessment of Chronic Illness Therapy-Spiritual well-being, there were significant differences in functional well-being and spiritual well-being pre- and post-intervention. This program improved quality of life and reduced cancer-associated fatigue. Furthermore, some aspects of psychological state were improved and natural killer cell activity was increased.
Conclusions: It is indicated that integrated medicine performed in a green environment is potentially useful for the emotional and spiritual well-being of cancer patients.
Title: The value of an allotment group for refugees
Author(s): Bishop, Ruth; Purcell, Elizabeth
Source: BRITISH JOURNAL OF OCCUPATIONAL THERAPY  Volume: 76   Issue: 6   Pages: 264-269   DOI: 10.4276/030802213X13706169932824   Published: JUN 2013
Introduction: Refugees experience a number of difficulties when settling in the United Kingdom and may be faced with occupational injustice due to their restricted occupational engagement. This study explores the value of an allotment group for refugees of working age, aiming to explore the role of horticulture and the social environment on health, wellbeing and social inclusion.
Method: This was an exploratory study using qualitative methodology based on ethnographic principles. Data collection included observation of the group, semi-structured interviews with five participants, with four of these participants also taking part in photo-elicitation interviews. Data analysis involved using a 'framework' approach to produce three themes and associated sub-themes.
Findings: Analysis identified firstly gardening as a meaningful activity; secondly, the importance of the social environment and, lastly, the value of occupational engagement for refugees. Further theoretical analysis led to the conclusion that these themes linked to the dimensions of occupation: doing, being, belonging and becoming.
Conclusion: The findings identify how occupational engagement can have a positive impact on the health and wellbeing of refugees, specifically with the use of social and therapeutic horticulture.
Here are a few examples of review articles:

Title: What is the evidence to support the use of therapeutic gardens for the elderly?
Author(s): Detweiler, Mark B.; Sharma, Taral; Detweiler, Jonna G.; et al.
Source: PSYCHIATRY INVESTIGATION  Volume: 9   Issue: 2   Pages: 100-110   DOI: 10.4306/pi.2012.9.2.100   Published: JUN 2012
Horticulture therapy employs plants and gardening activities in therapeutic and rehabilitation activities and could be utilized to improve the quality of life of the worldwide aging population, possibly reducing costs for long-term, assisted living and dementia unit residents. Preliminary studies have reported the benefits of horticultural therapy and garden settings in reduction of pain, improvement in attention, lessening of stress, modulation of agitation, lowering of as needed medications, antipsychotics and reduction of falls. This is especially relevant for both the United States and the Republic of Korea since aging is occurring at an unprecedented rate, with Korea experiencing some of the world's greatest increases in elderly populations. In support of the role of nature as a therapeutic modality in geriatrics, most of the existing studies of garden settings have utilized views of nature or indoor plants with sparse studies employing therapeutic gardens and rehabilitation greenhouses. With few controlled clinical trials demonstrating the positive or negative effects of the use of garden settings for the rehabilitation of the aging populations, a more vigorous quantitative analysis of the benefits is long overdue. This literature review presents the data supporting future studies of the effects of natural settings for the long term care and rehabilitation of the elderly having the medical and mental health problems frequently occurring with aging.
Title: Nature-assisted therapy: Systematic review of controlled and observational studies
Author(s): Annerstedt, Matilda; Wahrborg, Peter
Source: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH  Volume: 39   Issue: 4   Pages: 371-388   DOI: 10.1177/1403494810396400   Published: JUN 2011
Background: Nature’s potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. Methods: This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. Results: The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. Conclusions: This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.
Title: The psychological benefits of indoor plants: A critical review of the experimental literature
Author(s): Bringslimark, Tina; Hartig, Terry; Patil, Grete G.
Source: JOURNAL OF ENVIRONMENTAL PSYCHOLOGY  Volume: 29   Issue: 4   Pages: 422-433   DOI: 10.1016/j.jenvp.2009.05.001   Published: DEC 2009
People have been bringing plants into residential and other indoor settings for centuries, but little is known about their psychological effects. In the present article, we critically review the experimental literature on the psychological benefits of indoor plants. We focus on benefits gained through passive interactions with indoor plants rather than on the effects of guided interactions with plants in horticultural therapy or the indirect effect of indoor plants as air purifiers or humidifiers. The reviewed experiments addressed a variety of outcomes, including emotional states, pain perception, creativity, task-performance, and indices of autonomic arousal. Some findings recur, such as enhanced pain management with plants present, but in general the results appear to be quite mixed. Sources of this heterogeneity include diversity in experimental manipulations, settings, samples, exposure durations, and measures. After addressing some overarching theoretical issues, we close with recommendations for further research with regard to experimental design, measurement, analysis, and reporting.


We are always looking for the following types of information to share: 

  • brief updates of current journal articles
  • training opportunities – conferences, workshops
  • notices of new reports, materials, and resources
  • recommended websites
  • updates from national organizations
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