Ng Lorraine, Dyer Suzanne M, Dawson Suzanne, Laver Kate
The Caring Futures Institute, Flinders University, Bedford Park, SA, Australia.
Mental Health Services, Southern Adelaide Local Health Network, SA Health, Daw Park, SA, Australia.
Front Dement. 2024 Jun 6;3:1404662. doi: 10.3389/frdem.2024.1404662. eCollection 2024.
Gardens and outdoor spaces are an important part of institutional environments for people with dementia. However, evidence regarding the benefits these spaces have for people with dementia is still limited. This paper presents the evaluation of the redevelopment of an inaccessible outdoor space into a therapeutic garden on a high dependency psychogeriatric unit in an acute hospital.
A Mixed methods evaluation was undertaken. An interrupted time series analysis investigated the impact of the garden on falls and challenging behaviours of patients using routinely collected data. Perspectives of the redeveloped garden were captured through (a) a staff survey and (b) semi-structured interviews with families of patients.
Rates of falls and challenging behaviours dropped at the time of the garden opening but showed increasing rates each month both before and after the garden opened. Most staff believed that the garden provided benefits for patients however limited staff time and concerns over patient safety were barriers to use. Families identified four main themes related to garden use including: (1) being outside (2) occupation and identity, (3) being stimulating, and (4) barriers and facilitators.
The garden was regarded positively by families and staff however, there were barriers that prevented it from being better utilised. Staff concerns over risk were not reflected in falls and challenging behaviour outcomes. Further research into how barriers to garden use may be overcome is justified.
花园和户外空间是痴呆症患者机构环境的重要组成部分。然而，关于这些空间对痴呆症患者益处的证据仍然有限。本文介绍了对一家急症医院高依赖老年精神科病房中一个难以进入的户外空间重新开发为治疗花园的评估。
进行了混合方法评估。中断时间序列分析利用常规收集的数据调查了花园对患者跌倒和攻击行为的影响。通过（a）员工调查和（b）对患者家属的半结构化访谈，获取了对重新开发花园的看法。
花园开放时跌倒和攻击行为的发生率下降，但在花园开放前后每月都呈上升趋势。大多数员工认为花园对患者有益，但员工时间有限以及对患者安全的担忧是使用的障碍。家属确定了与花园使用相关的四个主要主题，包括：（1）置身户外，（2）活动与身份认同，（3）具有刺激性，以及（4）障碍与促进因素。
家属和员工对花园评价积极，但存在一些障碍阻碍了其更好地利用。员工对风险的担忧在跌倒和攻击行为结果中并未体现。有必要进一步研究如何克服花园使用的障碍。
