Department of Rehabilitation Services, Khoo Teck Puat Hospital, Singapore, Singapore.
Department of Nursing, Khoo Teck Puat Hospital, Singapore, Singapore.
J Am Med Dir Assoc. 2024 Dec;25(12):105296. doi: 10.1016/j.jamda.2024.105296. Epub 2024 Oct 9.
Horticultural therapy (HT) has garnered growing interest because of its psychological and physical benefits. Previous reviews have demonstrated its therapeutic effects in older adults with cognitive impairment or mental illnesses. However, its impact on older adults without dementia has not been synthesized. This systematic review studied the effects of HT on the physical and psychosocial functions of older adults without dementia.
Systematic review and meta-analysis.
Older adults without dementia ≥60 years of age.
Randomized controlled trials and quasi-experimental studies were systematically searched in 7 databases. The Cochrane Risk of Bias Tool version 2 and the Risk of Bias in Non-randomized Studies of Interventions tool were used to assess study quality. A random-effects meta-analysis with Hedges' g was conducted to estimate the effect size, and Cochran's Q test and I were used to evaluate heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation approach was applied to determine the overall quality of evidence.
Twenty-seven studies, including 11 randomized controlled trials and 16 quasi-experimental studies comprising 1629 older adults from 11 countries, were included. HT tended to improve psychosocial outcomes in older adults, particularly in terms of self-efficacy (g = 0.52; 95% CI, 0.26-0.79) and self-esteem (g = 0.52; 95% CI, 0.26-0.79). In terms of physical benefits, HT appeared to have a greater impact on aerobic endurance, with a large effect size (g = 0.84; 95% CI, 0.54-1.15), compared to agility, which showed a smaller effect size (g = 0.45; 95% CI, -0.90 to -0.01).
This review demonstrated that HT could provide psychosocial and physical benefits to older adults without dementia. These benefits include slight improvements in self-efficacy, self-esteem, aerobic endurance, and agility. However, the certainty of this evidence is very low due to the quasi-experimental design and potential bias in outcome measurements. Further research with well-designed clinical trials is necessary to confirm its effectiveness.
园艺疗法（horticultural therapy，HT）因其具有心理和生理益处而受到越来越多的关注。先前的综述已经证明了其在认知障碍或精神疾病的老年患者中的治疗效果。然而，其对没有痴呆的老年人的影响尚未得到综合评估。本系统综述研究了 HT 对没有痴呆的老年人的身体和社会心理功能的影响。
系统综述和荟萃分析。
年龄≥ 60 岁的没有痴呆的老年人。
系统检索了 7 个数据库中的随机对照试验和准实验研究。使用 Cochrane 偏倚风险工具 2 版和干预措施非随机研究偏倚风险工具评估研究质量。采用随机效应荟萃分析和 Hedges' g 估计效应大小，并采用 Cochran's Q 检验和 I²评估异质性。应用推荐评估、制定与评价分级方法评估证据的总体质量。
纳入了 27 项研究，包括 11 项随机对照试验和 16 项准实验研究，涉及来自 11 个国家的 1629 名老年人。HT 倾向于改善老年人的社会心理结局，尤其是在自我效能感（g = 0.52；95%CI，0.26-0.79）和自尊（g = 0.52；95%CI，0.26-0.79）方面。在身体获益方面，HT 似乎对有氧运动耐力的影响更大，效应量较大（g = 0.84；95%CI，0.54-1.15），而对敏捷性的影响较小，效应量较小（g = 0.45；95%CI，-0.90 至 -0.01）。
本综述表明，HT 可以为没有痴呆的老年人提供社会心理和身体方面的益处。这些益处包括自我效能感、自尊、有氧运动耐力和敏捷性的轻微改善。然而，由于准实验设计和结局测量的潜在偏倚，该证据的确信度非常低。需要进一步开展设计良好的临床试验来证实其有效性。
