Grete Grindal Patil

Therapeutic horticulture in clinical depression: a prospective study of active components

AIM This paper is a report of a study conducted to assess change in depression severity, perceived attentional capacity and rumination (brooding) in individuals with clinical depression during a therapeutic horticulture programme and to investigate if the changes were mediated by experiences of being away and fascination. BACKGROUND Individuals with clinical depression suffer from distortion of attention and rumination. Interventions can help to disrupt maladaptive rumination and promote restoration of depleted attentional capacity. METHOD A single-group study was conducted with a convenience sample of 28 people with clinical depression in 2009. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, and at 3-month follow-up. Assessment instruments were the Beck Depression Inventory, Attentional Function Index, Brooding Scale, and Being Away and Fascination subscales from the Perceived Restorativeness Scale. FINDINGS Mean Beck Depression Inventory scores declined by 4.5 points during the intervention (F = 5.49, P = 0.002). The decline was clinically relevant for 50% of participants. Attentional Function Index scores increased (F = 4.14, P = 0.009), while Brooding scores decreased (F = 4.51, P = 0.015). The changes in Beck Depression Inventory and Attentional Function Index scores were mediated by increases in Being Away and Fascination, and decline in Beck Depression Inventory scores was also mediated by decline in Brooding. Participants maintained their improvements in Beck Depression Inventory scores at 3-month follow-up. CONCLUSION Being away and fascination appear to work as active components in a therapeutic horticulture intervention for clinical depression.

Health benefits of a view of nature through the window: a quasi-experimental study of patients in a residential rehabilitation center

Objective: To examine the health benefits of a bedroom window view to natural surroundings for patients undergoing a residential rehabilitation programme. Design: Longitudinal quasi-experiment. Setting: A residential rehabilitation centre. Subjects: Two-hundred and seventy-eight coronary and pulmonary patients provided data at all measurement points during the programme. Intervention: Blind, quasi-random allocation to a private bedroom with a panoramic view to natural surroundings or with a view either partially or entirely blocked by buildings. Main measures: Self-reported physical and mental health (SF-12), subjective well-being, emotional states, use of the private bedroom and leisure activities. Results: For women, a blocked view appeared to negatively influence change in physical health (time × view × gender interaction, F(4,504) = 2.51, P = 0.04), whereas for men, a blocked view appeared to negatively influence change in mental health (time × view × gender interaction, F(4,504) = 5.67, P < 0.01). Pulmonary patients with a panoramic view showed greater improvement in mental health than coronary patients with such a view (time × view × diagnostic group interaction, F(4,504) = 2.76, P = 0.03). Those with a panoramic view to nature more often chose to stay in their bedroom when they wanted to be alone than those with a blocked view (odds ratio (OR) = 2.32, 95% confidence interval (CI) 1.08–5.01). Conclusion: An unobstructed bedroom view to natural surroundings appears to have better supported improvement in self-reported physical and mental health during a residential rehabilitation programme, although the degree of change varied with gender and diagnostic group.

Therapeutic horticulture in clinical depression : A prospective study

Clinically depressed persons suffer from impaired mood and distortion of cognition. This study assessed changes in depression severity and perceived attentional capacity of clinically depressed adults (N = 18) during a 12-week therapeutic horticulture program. The Beck Depression Inventory (BDI) and Attentional Function Index (AFI) were administered at baseline, twice during (4 and 8 weeks), and immediately after the intervention (12 weeks), and at a 3-month follow-up. Experiences of being away and fascination related to the intervention were measured at 4, 8, and 12 weeks. The mean BDI score declined 9.7 points from pretest (27.3) to posttest (p < .001) and were clinically relevant (ΔBDI ≥ 6) for 72% of the cases. The mean AFI score increased 10.2 points from pretest (68.8) to posttest (p = .06). The greatest change in BDI and AFI scores occurred in the initial weeks of the intervention. The reduction in BDI scores remained significant and clinically relevant at the 3-month follow-up (N = 16). The decline in depression severity during the intervention correlated strongly with the degree to which the participants found that it captured their attention. Therapeutic horticulture may decrease depression severity and improve perceived attentional capacity by engaging effortless attention and interrupting rumination.

Adaptation to Windowlessness: Do Office Workers Compensate for a Lack of Visual Access to the Outdoors?

If office workers lack a view to natural features outdoors, do they compensate by bringing plants and pictures of nature indoors? The authors used cross-sectional survey data from 385 Norwegian office workers to investigate whether such compensation occurs. The authors found that workers without windows had roughly five times greater odds of having brought plants into their workspaces than workers with windows, independent of age, gender, type of office, job demands, control over work, and personalization. Windowless workers also had three times greater odds of having brought pictures of nature into their workspaces. The authors consider implications of the findings for environmental design that offers contact with nature to people who spend much of their time indoors.

A Prospective Study of Existential Issues in Therapeutic Horticulture for Clinical Depression

Two studies with single-group design (Study 1 N = 18, Study 2 N = 28) addressed whether horticultural activities ameliorate depression severity and existential issues. Measures were obtained before and after a 12-week therapeutic horticulture program and at 3-month follow-up. In both studies, depression severity declined significantly during the intervention and remained low at the follow-up. In both studies the existential outcomes did not change significantly; however, the change that did occur during the intervention correlated (rho > .43) with change in depression severity. Participants’ open-ended accounts described the therapeutic horticulture experience as meaningful and influential for their view of life.

Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: a cluster randomized controlled trial

The prevalence of neuropsychiatric symptoms in cognitively impaired nursing home residents is known to be very high, with depression and agitation being the most common symptoms. The possible effects of a 12‐week intervention with animal‐assisted activities (AAA) in nursing homes were studied. The primary outcomes related to depression, agitation and quality of life (QoL).

Green exercise as a workplace intervention to reduce job stress: results from a pilot study

BACKGROUND Stress and mental fatigue are major health threats to employees in office-based occupations. Physical activity is widely used as a stress-management intervention for employees. Moreover, experiences in contact with nature have been shown to provide stress-reduction and restoration from mental fatigue. OBJECTIVES In a pilot study designed as a randomized controlled trial we investigated the impact of a green-exercise intervention on psychological and physiological indicators of stress in municipality employees. METHODS Fourteen employees (7 females and 7 males, 49±8 yrs) volunteered in an exercise-based intervention in workplace either outdoors in a green/nature area or in an indoor exercise-setting. The intervention consisted of an information meeting and two exercise sessions, each including a biking bout and a circuit-strength sequence using elastic rubber bands (45-minutes, at about 55% of HR reserve, overall). Main outcomes were perceived environmental potential for restoration, affective state, blood pressure (BP) and cortisol awakening response (CAR AUC(G) and CAR AUC(I)) and cortisol levels in serum. Measurements were taken at baseline and in concomitance with the exercise sessions. Furthermore, affective state and self-reported physical activity levels were measured over a 10-weeks follow-up period. RESULTS Compared with the indoor group, the nature group reported higher environmental potential for restoration (p <  0.001) and Positive Affect (p <  0.01), along with improved CAR AUC(I) (p = 0.04) and, marginally, diastolic BP (p = 0.05). The nature group also reported higher ratings of Positive Affect at follow-up (p = 0.02). Differences at post-exercise were not found for any of the other components of affective state, systolic BP, CAR AUC(G) and cortisol levels measured in serum. CONCLUSIONS Green-exercise at the workplace could be a profitable way to manage stress and induce restoration among employees. Further studies on larger samples are needed in order to improve the generalizability of the results.

Is Green Exercise for All? A Descriptive Study of Green Exercise Habits and Promoting Factors in Adult Norwegians

Background: Physical activity (PA) in natural environments, known as green exercise (GE), can provide health benefits above and beyond PA in other environments, but little is known about the extent to which GE is an accessible form of weekly PA across different social groups. This study aims to examine the “GE phenomenon” in Norway, and evaluate possible differences in GE habits and perceived factors that promote GE across sub-groups of this population. Methods: 2168 adults from all over Norway reported weekly GE and other forms of PA, specific forms of GE, and perceived factors that promote GE. Data were examined in the overall sample and in relation with the respondents’ PA status and sociodemographic characteristics. Results: GE, especially “walking in the forest” and “activities by/on the sea”, was the most popular form of weekly PA, even among those with low PA levels. GE was fairly represented across all social groups, and especially among the elderly, those who live with spouse/partner and those who live in the west regions of Norway, while no associations were found in relation to sex, centrality, education level or household income. “Time flexibility” and “PA-supportive places” were generally perceived as the most important factors that promote GE across all social groups. “Accessibility to nature” was generally perceived relatively little important, though a gradient was observed in relation to age, education level and household income. Conclusions: GE is an important source of weekly PA and health among adult Norwegians, especially in sub-groups of interest for public health such as the elderly, those with lower socio-economic status and those who live in non-urban areas. More should be done to understand and address the inequities relative to the perceived accessibility to nature.

Nature contact and organizational support during office working hours: Benefits relating to stress reduction, subjective health complaints, and sick leave

BACKGROUND Improving social support, and providing nature contact at work are potential health promoting workplace interventions. OBJECTIVE The objective was to investigate whether nature contact at work is associated with employees health and participation, and to study whether the possible associations between nature contact and health can be explained by perceived organizational support. METHOD Data were collected through a web-based, cross-sectional survey of employees in seven public and private office workplaces in Norway (n = 707, 40% response rate). Multiple linear and logistic regression analysis were performed on 565 participants fulfilling inclusion criteria. RESULTS A greater amount of indoor nature contact at work was significantly associated with less job stress (B = -0.18, CI = -0.318 to -0.042), fewer subjective health complaints (B = -0.278, CI = -0.445 to -0.112) and less sickness absence (B = -0.061, CI = -0.009 to -0.002). Perceived organizational support mediated the associations between indoor nature contact and job stress and sickness absence, and partly mediated the association with subjective health complaints. Outdoor nature contact showed no reliable association with the outcomes in this study. CONCLUSIONS Extending nature contact in the physical work environment in offices, can add to the variety of possible health-promoting workplace interventions, primarily since it influences the social climate on the workplace.

Restorative Elements at the Computer Workstation: A Comparison of Live Plants and Inanimate Objects With and Without Window View

The objective of the study was to test whether live plants on computer workstations with and without window view had restorative effects. Guided by Stress Recovery Theory and Attention Restoration Theory a mixed randomized experiment was conducted exploring restorative effects of plants, including mediating effects of perceived fascination. Eighty-five participants carried out a 1-hr work session with repeated tasks demanding directed attention in an office with one of three interior conditions: live plants, inanimate objects and control, all with and without a window view. Plant presence led to greater perceived fascination, but perceived fascination was not related to either self-reported restoration or directed attention capacity. The presence of plants during work did not have superior restorative effects compared with inanimate objects, neither with nor without access to a window view. However, environmental enrichment with either plants or inanimate objects at the computer workstation seemed to provide a restorative potential, which should be investigated further.