Rehabilitation, Aged and Extended Care, College of Medicine and Public Health, Flinders University, Bedford Park, Australia.
NHMRC Cognitive Decline Partnership Centre, The University of Sydney, Australia.
Gerontologist. 2020 May 15;60(4):e254-e269. doi: 10.1093/geront/gnz055.
Despite acknowledged benefits of residents in nursing homes spending time outdoors, little is known about factors related to their use of outdoor space. This systematic review summarizes reported barriers and enablers to nursing home residents' use of outdoor spaces.
Multiple databases were searched to May 2018. Qualitative or mixed methods studies describing barriers/enablers to use of outdoor areas by residents of nursing homes (aged 65 years and older), as reported by residents, staff, or family members were included. Study quality rating, thematic analysis, and stratified analyses were performed and confidence in findings assessed using GRADE-CERQual.
Twenty-four studies were included. Nineteen collected data from residents, 15 from staff/caregivers, 7 from families. Major themes and key findings concerned: design of the outdoor area (importance of garden greenery and built features), safety concerns and staffing issues, weather and seasons (appropriate shade and shelter), design of the main building (easy to open doors and nearby access points) and social activities.
Providing gardens with seasonal plants and interactive features, weather protected seating, manageable doors at accessible thresholds, planned social activities, and appropriate clothing are fundamental to facilitate nursing home residents' access to the outdoors. Cultural change at an organizational level, addressing perceptions of safety as a barrier is important. Incorporation of the recommendations in this review by architects, facility managers, and policy makers in the design and management of nursing homes, may increase use of outdoor areas and improve the quality of life of residents.
The protocol is registered in Prospero (CRD42018100249).
尽管公认居民在养老院中花费时间在户外活动有诸多益处，但对于他们使用户外空间的相关因素却知之甚少。本系统评价总结了与养老院居民使用户外空间相关的障碍和促进因素。
我们于 2018 年 5 月之前检索了多个数据库。本研究纳入了描述养老院（年龄≥ 65 岁）居民使用户外区域的障碍/促进因素的定性或混合方法研究，这些研究是由居民、工作人员或家属报告的。我们对研究质量进行了评分、进行了主题分析，并使用 GRADE-CERQual 评估了研究结果的可信度。
共纳入了 24 项研究。其中 19 项研究的数据来源于居民，15 项来源于工作人员/护理人员，7 项来源于家属。主要的主题和关键发现包括：户外区域的设计（花园绿化和建筑特色的重要性）、安全问题和人员配备问题、天气和季节（适当的遮阳和遮蔽物）、主楼的设计（易于打开的门和附近的入口）以及社交活动。
为花园提供季节性植物和互动设施、为户外座位提供防风保暖措施、在无障碍门槛处设置易于操作的门、规划社交活动和提供合适的衣物，这些措施对于促进养老院居民进入户外活动场所至关重要。在组织层面进行文化变革，将安全问题视为障碍并加以解决非常重要。建筑师、设施管理人员和政策制定者在设计和管理养老院时采用本评价中的建议，可能会增加居民对户外区域的使用，并提高他们的生活质量。
本研究方案已在 PROSPERO（CRD42018100249）中注册。
