de Boer Bram, Hamers Jan P H, Zwakhalen Sandra M G, Tan Frans E S, Beerens Hanneke C, Verbeek Hilde
Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
J Am Med Dir Assoc. 2017 Jan;18(1):40-46. doi: 10.1016/j.jamda.2016.10.013.
Innovative care environments are developed for people with dementia to encourage person-centered care. This study aims to investigate whether residents of green care farms that provide 24-hour nursing care participate more in (physical) activities and social interaction compared with residents of other nursing homes.
Longitudinal observation study.
Nursing homes in the Netherlands (green care farms, traditional nursing homes, and regular small-scale living facilities).
A total of 115 nursing home residents at baseline, 100 at follow-up.
Ecological momentary assessments (n = 16,860) were conducted using the Maastricht Electronic Daily Life Observation Tool. Residents living at green care farms were compared with residents living in traditional nursing homes and regular small-scale living facilities. The following aspects were collected for this study: the activity performed by the participant or occurring in his or her vicinity, the engagement in the activity, the level of physical activity during the activity, the physical environment (location where the activity occurred), and the level of social interaction during the activity.
In total, 9660 baseline observations and 7200 follow-up observations were conducted. Analyses showed that residents of green care farms significantly more often participated in domestic activities (P = .004, SE = 1.6) and outdoor/nature-related activities (P = .003, SE = 0.9), and significantly less often engaged in passive/purposeless activities (P < .001, SE = 1.7) compared with residents of traditional nursing homes. Furthermore, residents of green care farms had significantly more active engagement (P = .014, SE = 0.9), more social interaction (P = .006, SE = 1.1), and came outside significantly more (P = .010, SE = 1.1) than residents of traditional nursing homes. Residents of green care farms were significantly more physically active (P = .013, SE = 0.8) than were residents of regular small-scale living facilities. No other significant differences were found.
Green care farms can be a valuable alternative to traditional nursing homes. They provide an attractive, homelike environment and activities that positively influence engagement and social interaction. Research is needed to study how successful elements of green care farms can be implemented in existing nursing homes.
为痴呆症患者开发创新的护理环境，以鼓励以人为本的护理。本研究旨在调查与其他养老院的居民相比，接受24小时护理的绿色护理农场的居民是否更多地参与（体育）活动和社交互动。
纵向观察研究。
荷兰的养老院（绿色护理农场、传统养老院和普通小型生活设施）。
基线时共有115名养老院居民，随访时为100名。
使用马斯特里赫特电子日常生活观察工具进行生态瞬时评估（n = 16860）。将生活在绿色护理农场的居民与生活在传统养老院和普通小型生活设施中的居民进行比较。本研究收集了以下方面的数据：参与者进行的或在其附近发生的活动、参与活动的情况、活动期间的身体活动水平、物理环境（活动发生的地点）以及活动期间的社交互动水平。
总共进行了9660次基线观察和7200次随访观察。分析表明，与传统养老院的居民相比，绿色护理农场的居民更多地参与家务活动（P = 0.004，标准误 = 1.6）和户外/与自然相关的活动（P = 0.003，标准误 = 0.9），而参与被动/无目的活动的频率显著更低（P < 0.001，标准误 = 1.7）。此外，与传统养老院的居民相比，绿色护理农场的居民有更积极的参与度（P = 0.014，标准误 = 0.9）、更多的社交互动（P = 0.006，标准误 = 1.1），并且外出的次数显著更多（P = 0.010，标准误 = 1.1）。绿色护理农场的居民比普通小型生活设施的居民身体活动水平显著更高（P = 0.013，标准误 = 0.8）。未发现其他显著差异。
绿色护理农场可以成为传统养老院的一个有价值的替代选择。它们提供了一个有吸引力的、像家一样的环境和活动，对参与度和社交互动有积极影响。需要开展研究以探讨如何在现有养老院中实施绿色护理农场的成功要素。
