Fieldhouse, J. and Sempik, J (2014) Green Care and Occupational Therapy in: Creeks Occupational Therapy and Mental Health. The focus in this chapter is on the purpose of gardening as an occupational therapy intervention (OTI). Empowering depressive people can counter feelings of helplessness and low self-esteem. Required fields are marked *. They conclude that this is a suitable area for occupational therapist to lead on. negative emotions, deprecating self-assessment, outcome expectations.) They recommended further research on interventions focused on emotional behaviour change and the techniques used to facilitate participation. Summary: Although horticultural interventions have potential therapeutic effects on patients clinical and psychological outcomes, there is a lack of scientific research based on the experience of elderly post-stroke patients involved in therapeutic gardening during their rehabilitation program. Exclusion criteria included: patients with psychiatric disorders and focal neuropsychological deficit (eg, aphasia, neglect); individuals who could not speak; individuals who were confused; patients who refused to sign informed consent. [24][25] Reported benefits of therapeutic gardening include reducing pain, improving attention, lessening of stress, modulation of agitation, increasing socialization, self-esteem and life satisfaction, lowering the number of medications and the frequency of setbacks. Among them, 14 patients (63%) were diagnosed with ischemic stroke and 8 patients (37%) were diagnosed with hemorrhagic stroke. Furthermore, when speaking about plants also discussion about future patients plans and strategies to manage health and care out of the hospital become possible. Northwest Center early intervention uses a comprehensive approach with family and other caregivers at the center of a childs therapy. [28] A systematic review of controlled trials and observational studies for nature-assisted therapy reported significant improvements in a variety of outcomes among diverse populations of patients, spanning from obesity to schizophrenia. A person-centred approach involves establishing a therapeutic relationship with the depressive client involving trust, empathy and acceptance. The time elapsed since diagnosis ranged between 2 months and 10 years. [3] Many patients report poor quality of life up to a 5-year post-stroke follow-up. They found 69% of people experienced significant increases in wellbeing by the time they left the Ecominds project. Interventions recorded by occupational therapists The routine use of occupational therapy terminology is one of the essential information building blocks that will support the profession to measure, evaluate and demonstrate the effectiveness of [34][36] The study was conducted according to the Declaration of Helsinki, the European Guidelines on Good Clinical Practice. By taking a structured or unstructured interview with the patient and caretaker. This is in line with other studies which demonstrate how comprehensive interventions able to act on cognitive, behavioral and emotional components are more effective than single-focus interventions in engaging patients in care practices. The authors are unaware of any studies involving this clinical population in this activity in the scientific literature. Gardening as an Occupational Therapy Treatment Intervention Thank you for taking the time to respond to this brief, eight question survey. We provide services for eligible children aged 0-3 years old and believe that participation of everyone on the childs team is vital for a childs success. Occupational therapists are able to use these evidence-based health benefits of nature to promote health by utilizing the natural outdoor environment both in interventions and everyday occupational therapy practice. All reported positive effects of gardening as a mental health intervention for service users, including reduced symptoms of depression and anxiety. International Workshop on Infrastructures for Health Care: Patient-Centered Care and Patient Generated Data, JMIR is the new publisher of our Journal of Participatory Medicine (JoPM), The Effects of Coaching Patients to List Questions Before Visiting Cancer Specialists: Retrospective Evaluation of Visit Preparation in a Rural, Underserved Setting, Evolving Patient-Researcher Collaboration: An Illustrative Case Study of a Patient-Led Knowledge Translation Event, Information and Communication Technologies to Support Chronic Disease Self-Management: Preconditions for Enhancing the Partnership in Person-Centered Care. Occupational Therapy uses a range of techniques for making occupations such as gardening easier to partake in. Gardening is a favorite past time of so many, yet the bending, pulling, lifting and digging can wreak havoc on our backs and joints. Available from: https://www.mind.org.uk/media/354166/Ecominds-effects-on-mental-wellbeing-evaluation-report.pdf, Whatley, E, et al (2015) Enabling occupational participation and social inclusion for people recovering from mental ill-health through community gardening. Pacing gardening activities to counter fatigue and lack of motivation often present in depression. Previous studies have shown how overcoming negative emotional barriers due to illness and being gradually able to experience a positive attitude toward the health care pathway with more positive feelings, is crucial to sustain the patient evolution along their health engagement process. Should Hospital Patients Have Bedside Access to Their Complete Medical Records. [4][5], Post-stroke patients usually participate in rehabilitation programs to improve the recovery of their physical and mental functions. They may have other animals, as well as a farm or garden at their facility. Thus, patients reported an increased self-esteem and a better acceptance of their health condition. You may need to modify your gardening technique to avoid extra pressure on your joints. 11 (3), pp 308-321. Gardening can reduce this, Kaplan (1995) stating that nature has an abundance of factors that support the restorative process from stress requiring a less concentrated and tiring attention. Soga, M., Gaston, K., and Yamaura, Y. Physiotherapists scope of practice varies considerably across the world, both in terms of the degree of professional autonomy enjoyed and the range of conditions managed. Notify me of follow-up comments by email. Accessed: 10 January 2018. (2014) The Role of Historical Persian Gardens on the health status of contemporary urban residents. It is a thought process that is ingrained into our brains starting day one of occupational therapy school. Fatigue is often associated with depression especially through applying directed attention to tasks. This paper explores post-stroke patients experience of a person-centered therapeutic gardening intervention within their rehabilitation programs, by: 1) deepening the comprehension of their own psycho-social experience; and 2) evaluating whether therapeutic gardening is perceived by patients as an occasion to foster their engagement toward rehabilitation and self-care. Using gardens to change lives. [10][11][12][13][14], Among the more recent advancements in rehabilitation programs, horticultural therapy is gaining more attention as a way to enhance patients engagement. Ask for help or consider hiring someone to assist with heavier tasks. Thus, when thinking about the contact with plants, patients associated feelings of consecutiveness and understood their interdependencies with other living beings. Their survey of GPs stated that the ecotherapy was a valid and suitable treatment for anxiety (52%) and depression (51%) (University of Essex, 2013). Preventive medicine reports. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings. 4-10% of people in England will have depression at some time (NICE, 2011) with 7.8% being diagnosed alongside anxiety (HSCIC, 2009). Thinking about nature allows you not to be absorbed by your pain and problems. (81-year old female patient), Experiencing nature and green landscapes takes me away from troubles and worries connected to my health. (62-year old male patient). Interviews and diaries unveiled five main themes related to patients experience of being involved in a therapeutic gardening intervention: 1) the restorative effect of nature, 2) therapeutic gardening as a protected self-expression space, 3) the plant as a catalyzer of patients-therapist relationship, 4) the contact with nature as a boost for self-efficacy, 5) therapeutic gardening as a It is of vital importance that therapeutic gardening interventions are appropriately evaluated in order to develop the existing evidence base. This also contributed to improved patients attitude towards self-care and to enhanced feeling of power and control. The activities performed were: planting herbs on an adapted cultivation table, sowing beetroot seeds on a cultivation bench, loosening soil in a flower bed, digging, harvesting tomatoes, collecting seeds, flower arranging for the lunch table, shaping bushes, and pruning trees. Harris (2017) notes that depressive participants were more engaged by the less threatening gardening environment, finding that Nature evoked a calming effect. Moreover, patients described the healing gardening intervention as a bridge between the rehabilitation experience in the hospital facility and the daily life, thus favoring the transition of rules, strategies and skills for disease management acquired during the hospitalization to their usual life context. [22][23] For example, outcomes attributed to patients participation in therapeutic gardening interventions included increased motivation and physical functioning, resulting in greater levels of independence and autonomy. Australian Occupational Health Journal. It can be difficult to find this therapeutic approach. Saved from carryongardening.org.uk. Get in touch. Common mental health disorders: Guidance and guidelines (NICE) [online]. I think it [gardening] is therapeutic. Occupational therapy is aligned to promote health through outdoor participation and model the use of nature in interventions. Grading Occupational Therapy Interventions Our OT brains are all about task analysis, the ability to completely break down an activity and view the minute details that others dont see. The sample as a whole showed a positive attitude towards nature during their rehabilitation program. Search all of the Society for Participatory Medicine website: Your email address will not be published. . [47] It is interesting to note that during therapeutic gardening sessions, post-stroke patients experienced a safe setting where they could discuss the care process with their therapist, thus promoting self-disclosure and open communication about health concerns. Interviews and diaries unveiled five main themes related to patients experience of being involved in a therapeutic gardening intervention: 1) the restorative effect of nature, 2) therapeutic gardening as a protected self-expression space, 3) the plant as a catalyzer of patients-therapist relationship, 4) the contact with nature as a boost for self-efficacy, 5) therapeutic gardening as a bridge between the hospital environment and the outside world. Rebar and Taylor (2017) highlight that engagement in physical activity with mental health needs to be tailored to the individual to be effective to reflect their willingness, commitment and contextual opportunities. Thus, therapeutic gardening appears to be particularly valuable for patients in helping to gain a new normality and to project satisfactory life trajectories for their future. This suggests a person-centred approach is relevant. But, when I see my flowers growing up, I am amazed and I realize that I can do something good. (70-year old female patient), If you take responsibility to care for a plant, you should behave as a mother that takes care of her child. (73-year old female patient), I know Im very limited in what I can do, but I think getting the results gives you a boost I am really proud of my results. (64-year old female patient), While I am working with my plants, me and my therapist often discuss about my progress in rehabilitation and it is useful for me. (79-year old female patient). It provides essential physical exercise. However, there may be something in gardening associated with providing hope for those who may have little else to hope for. At the time of this study, she was a Graduate Student, Department of Rehabilitation Medicine, University of For interested families, we would recommend you contact facilities that offer hippotherapy or equine assisted therapy. Grading gardening activities so they are appropriate and manageable for the individual to maintain interest and motivation, with increasing challenges. This aspect makes therapeutic gardening a person-centered activity which establishes patients attitudes toward, perspectives on, and concerns about their health and health care as a priority to orient clinical interventions. Occupational Therapy sessions at Saras Garden are fun and engaging, using modern and interactive play and therapy equipment. Every session lasted 60 minutes and included manual activities related to taking care of plants under the guide of a specialized therapist . Available from: https://www.kingsfund.org.uk/publications/gardens-and-health, Mind website: What are symptoms of Depression. NICE (2011). Copyright: 2016 Serena Barello, Guendalina Graffigna, Julia Menichetti, Matteo Sozzi, Mariarosaria Savarese, A. Claudio Bosio, and Massimo Corbo. The bathing section of the Klein-Bell Activities of Daily Living Scale was administered to 19 physically disabled subjects before and after bathing training was completed by occupational therapists. Interviews were audio-recorded and transcribed verbatim. Choice allows depressive people to take ownership in remediating their symptoms by gardening (and choosing tasks) when they feel it might be beneficial within a safe, flexible and structured environment. Nature was also depicted as something fundamentally linked to human spirituality, thus allowing individuals to come in touch with their genuine essence. Serena Barello, Guendalina Graffigna, Julia Menichetti, Matteo Sozzi, Mariarosaria Savarese, A. Claudio Bosio and Massimo Corbo However, for many mental health conditions, there are barriers such as volition and fatigue, that need to be overcome in order to engage. I had seed flowers and vegetables: Delphinium, Zinnias, and salad. [19][20][21][22][23][24][25][26][27] These benefits may be important factors in improving patient engagement, quality of life and reducing the costs of health care. Questions were developed in order to explore subjective representations and meanings associated with the contact with nature, the experience of being involved in the therapeutic gardening intervention, and its potential to foster patients engagement in care management (for a detailed overview of the interviews guide see Table 1). [39][40] The researchers participated in regular discussions during data collection, in order to cross-validate the interpretation and to ensure trustworthiness of data analysis. 22. An occupational therapist can help you teach how to properly sit, bend, rich and lift, using the largest and the strongest joints, Patient inclusion criteria were: adults aged 50 or more; confirmed diagnosis of cerebral stroke, either ischemic or hemorrhagic; first acute event; being still physically active and interested in engaging in gardening sessions; Mini Mental State Exam score > 24/30; Cumulative Index Rating Scale < 5; ability to converse in Italian; willingness to participate to the study; and cognitive capabilities and medical condition conducive to participation. They deduce that this was a result of the disruption to the participants ruminations and the effortless attention involved in engaging in gardening. | June 21, 2016. When I see my healthy plant and I feel it is alive, it gives me hope for my future. (69-year old female patient). Informed written consent for participation in the study was obtained from each participant, including permission to audio-tape, transcribe, and analyze the interviews. [1] Patients with stroke often experience anxiety, depression, lack of meaningful activities and life purposes, and restriction of social participation within their daily lives. Any effective intervention should be appropriate to the degree of depression as symptoms are variable. The results are discussed in relation to meaningful occupations through occupational characteristics, such as doing, being, becoming, and belonging. The sharing of knowledge and enthusiasm for gardening by the practioner utilises the therapeutic use of self (Kielhofner,2009) This may facilitate support and communication in the intervention. In most of the cases, the responsibility of taking care of something alive (ie, plants) was experienced as close to having more control of their life and healing. University of Essex (2013) / MIND Ecominds: Effects on Mental Wellbeing. Data were analyzed according to the qualitative phenomenological approach. . Nature was experienced by patients as a space in which human beings can connect spiritually both within themselves and outside themselves. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. This exploratory study was aimed to obtain a deeper understanding of post-stroke patients experience of performing part of their rehabilitation program in a therapeutic garden. At this time, it is of vital importance that therapeutic gardening interventions are appropriately evaluated in order to develop the existing evidence base. Conclusions: The occupational therapists found that gardening provided clinical opportunities for skills training and health resources. Whenever possible, the harvest of vegetables, seasonal fruits, flowers and herbs was provided. The hospitalization was experienced by patients as a loss of control on their life. The therapeutic gardening intervention featured 10 bi-weekly sessions along the standard patients physical rehabilitation process that consisted 2 daily sessions of physical therapy lasting 45 minutes each for 5 days a week. May 23, 2016 - These gardening activities are designed to support your rehabilitation, recovery, health and well being over the coming weeks, months and years. (2016) Gardening is beneficial for health: A meta-analysis. American Journal of Occupational Therapy. The activities in the garden ranged from simple to heavier and complicated, and were adapted to the patients level of activity based on the judgement of the therapist who worked with the patients during the sessions. Jan 31, 2021 - Explore Mandy {Seniors Flourish} Occup's board "Occupation Based OT ideas", followed by 11280 people on Pinterest. This makes me feel relaxed. (79-year old female patient), Thinking of green has a soothing effect on me. (69-year old female patient). unable to garden and work in her yard and her inability to participate in this chosen occupation has led to frustration and depression. This study included 22 Italian participants, all of whom had been patients who have been involved in therapeutic gardening activities. The occupational therapist is able to combine the effects of the equine movement with other standard intervention strategies to work on fine motor control, sensory integration, feeding skills, play skills, attention and self-regulation skills, and functional daily living skills in a progressively challenging manner. Thus, in this study, all potential participants were approached to take part, irrespective of age or length of time spent in the rehabilitation hospital. Published: June 21, 2016. Copyright for this article is retained by the authors, with first publication rights granted to the Journal of Participatory Medicine. When you say green I suddenly think about grass and peaceful landscapes. Kaplan, S. (1995) The restorative benefits of nature: Toward an integrative framework. The act of nurturing and taking responsibility for the plants may counter the self-focus often evident in depression. Harris, H. (2017) The social dimensions of therapeutic horticulture. In other words, enacting gardening behaviors, although framed in the script of the healing protocol, offered patients some degree of freedom and the occasion to subjectively interpret the assigned task of caring for plants in their own way, by expressing their spontaneous attitudes and skills while interacting with nature. There are so many of the senses addressed when a child is outside in the dirt. Consult an Occupational or Physiotherapist. By The American Occupational Therapy Association (AOTA) offers tips on Healthy Gardening: Start with a small garden to keep things more manageable. After each gardening session, all the patients were asked to fill a diary about the activity just concluded, to assess their experience and to express their feelings. For instance, measures of patient engagement [42] in the rehabilitation process or of psychological adjustment to illness [49] might be valuable indexes to assess the clinical and psychosocial effectiveness of therapeutic gardening. Kielhofner, G. et al (2009) Therapeutic Use of Self: A Nationwide Survey. They state that the emotional aspects are an important aspect of behaviour change for engagement but have been under considered (e.g. It will take you no more than five minutes to complete. Before beginning this activity [the gardening] I thought I would have failed.
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