Bishop Ruth, Underwood Frazer, Fraser Fiona, Burrows Lisa, Shawe Jill
Cornwall Partnership NHS Foundation Trust, Bodmin, UK.
South West Clinical School in Cornwall, Royal Cornwall Hospitals NHS Trust, Truro, UK.
JBI Evid Synth. 2024 Dec 1;22(12):2518-2558. doi: 10.11124/JBIES-23-00437.
The objective of this review was to identify and characterize the use of the natural environment/outdoor space by occupational therapists working in mental health care. This included consideration of the characteristics of the environment used, interventions, mental health conditions being treated, and the outcomes being considered.
Research has demonstrated that there is a link between human health and the environment. The benefits appear to be particularly relevant to people with mental health conditions. Occupational therapists already consider the environment when assessing and developing interventions, and therefore are well placed to consider and use the natural environment in mental health practice. However, the use of the natural environment by occupational therapists working in mental health is unclear.
The scoping review included any publication relating to the use of the natural environment/outdoor space in mental health occupational therapy practice. All forms of the natural environment or outdoor space were included, such as hospital gardens and local parks. There were no geographical, gender, or age restrictions. All mental health diagnoses were eligible for inclusion.
Seven databases were searched: Embase (Ovid), Emcare (Ovid), MEDLINE (Ovid), PsycINFO (ProQuest), AMED (Ovid), Trip Database, and CINAHL (EBSCOhost). Gray literature was also searched using a selection of websites and digital repositories. Papers written in English were searched, with no time limit set on publication. Titles and abstracts were screened by 2 independent reviewers for assessment against the inclusion criteria, followed by a full-text review and data extraction. Data were extracted using the data extraction tool developed by the authors. Findings were presented in a tabular format, accompanied by a narrative summary describing how the results relate to the review objectives and question.
Of peer-reviewed publications, 7 papers used qualitative methods and 7 used mixed methodology. The remaining sources included conference abstracts, unpublished works, a book chapter, and a website article. The environments used included forests, beaches, gardens, and parks. A variety of interventions were delivered in these environments, including gardening and nature-based activities, physical activities, and animal-assisted interventions. Such activity-focused interventions are largely delivered in a group context, thus providing a social element. A diverse range of mental health conditions were treated. Several methods were used to consider the outcomes on the individual, including both qualitative measures and quantitative outcome measurement tools.
The review highlights many characteristics of how the natural environment is being used across mental health services by occupational therapists. A variety of conditions are targeted for such interventions, and several outcome measures have been used to understand impact. This review can support further development and implementation of nature-based approaches in mental health occupational therapy.
本综述的目的是识别和描述心理健康护理领域职业治疗师对自然环境/户外空间的使用情况。这包括对所使用环境的特征、干预措施、所治疗的心理健康状况以及所考虑的结果进行考量。
研究表明，人类健康与环境之间存在联系。这些益处似乎对患有心理健康问题的人尤为相关。职业治疗师在评估和制定干预措施时已经会考虑环境因素，因此在心理健康实践中非常适合考虑并利用自然环境。然而，心理健康领域职业治疗师对自然环境的使用情况尚不清楚。
本范围综述纳入了任何与心理健康职业治疗实践中使用自然环境/户外空间相关的出版物。自然环境或户外空间的所有形式均包括在内，如医院花园和当地公园。没有地理、性别或年龄限制。所有心理健康诊断均符合纳入条件。
检索了七个数据库：Embase（Ovid）、Emcare（Ovid）、MEDLINE（Ovid）、PsycINFO（ProQuest）、AMED（Ovid）、Trip数据库和CINAHL（EBSCOhost）。还使用了一些网站和数字资源库检索灰色文献。检索了用英文撰写的论文，对发表时间没有限制。由两名独立评审员筛选标题和摘要，以根据纳入标准进行评估，随后进行全文评审和数据提取。使用作者开发的数据提取工具提取数据。研究结果以表格形式呈现，并伴有叙述性总结，描述结果与综述目标和问题的相关性。
在同行评审的出版物中，7篇论文使用了定性方法，7篇使用了混合方法。其余来源包括会议摘要、未发表的作品、一章书籍内容和一篇网站文章。所使用的环境包括森林、海滩、花园和公园。在这些环境中开展了各种干预措施，包括园艺和基于自然的活动、体育活动以及动物辅助干预。这种以活动为重点的干预措施大多在团体环境中进行，从而提供了社交元素。治疗了各种各样的心理健康状况。使用了多种方法来考量个体的结果，包括定性测量和定量结果测量工具。
本综述突出了职业治疗师在心理健康服务中使用自然环境的许多特点。针对多种状况开展了此类干预措施，并使用了多种结果测量方法来了解其影响。本综述可为心理健康职业治疗中基于自然的方法的进一步发展和实施提供支持。
