Fan Myrian Sze Nga, Li William Ho Cheung, Ho Laurie Long Kwan, Choi Kai Chow, Phiri Lophina, Pacchiani Sara, Antal Brigitta, Cheung Clement Shek Kei, Khaleel Daoud Kamal Abu
The Chinese University of Hong Kong, Rm 831, Esther Lee Building, Hong Kong, China.
Universita Degli Studi Di Milano-Bicocca, Milan, Italy.
Discov Ment Health. 2025 Jul 23;5(1):109. doi: 10.1007/s44192-025-00258-7.
Despite increasing interest in nature-based interventions (NBIs) for mental health, no or very few prior reviews have quantitatively synthesised their effects on children's resilience, a key developmental outcome. This study systematically reviews and meta-analyses available evidence following PRISMA guideline. The Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, Education Resources Information Center, Medline, APA PsycArticles, SPORTDiscus, and Web of Science were searched from inception to November 28, 2024. For additional studies, Google Scholar and references from included studies were searched. The review included randomised clinical trials, controlled trials, and single-group pre-post studies reporting resilience. Findings not synthesised quantitatively were summarised narratively. A total of 13 articles involved 15 studies with 2,571 participants (mean age 15.57 years; range 13 to 17 years; 1315 [53%] female). Random-effect meta-analysis indicated significant moderate-to-large short-term effects of NBIs on children's resilience (standardised mean difference, 0.64; 95% confidence level, 0.36 to 0.91; p <.001). Substantial heterogeneity of intervention effects was observed (I = 98%). This review provides preliminary evidence that NBIs may be associated with short-term improvements in resilience among children, though results should be interpreted cautiously due to study limitations. This early evidence highlights a community-based approach that may support resilience development through nature. Sailing showed some promise as an early observation noted in subgroup analysis and narrative synthesis emphasising nature-human kinship. High-quality trials are needed to evaluate the effects of sailing on resilience and address gaps: the long-term effect of NBIs and their impact on children outside the 13-17 age range. Trail registration: PROSPERO database (CRD42025634371).
尽管基于自然的干预措施(NBI)对心理健康的关注度不断提高,但之前几乎没有或仅有极少的综述对其对儿童复原力(一项关键的发展成果)的影响进行过定量综合分析。本研究按照PRISMA指南对现有证据进行了系统综述和荟萃分析。检索了护理及相关健康文献累积索引、考克兰图书馆、Embase、教育资源信息中心、医学期刊数据库、美国心理学会心理学文摘数据库、体育与运动科学数据库以及科学引文索引数据库,检索时间跨度从各数据库建库至2024年11月28日。为获取更多研究,还检索了谷歌学术以及纳入研究的参考文献。该综述纳入了报告复原力情况的随机临床试验、对照试验和单组前后对照研究。未进行定量综合分析的研究结果以叙述方式进行了总结。共有13篇文章涉及15项研究,2571名参与者(平均年龄15.57岁;年龄范围13至17岁;1315名[53%]为女性)。随机效应荟萃分析表明,NBI对儿童复原力具有显著的中到较大短期效应(标准化均值差为0.64;95%置信区间为0.36至0.91;p <0.001)。观察到干预效应存在实质性异质性(I² = 98%)。本综述提供了初步证据,表明NBI可能与儿童复原力的短期改善相关,不过由于研究局限性,结果应谨慎解读。这一早期证据凸显了一种基于社区的方法,该方法可能通过自然来支持复原力发展。帆船运动在亚组分析和强调自然与人类亲缘关系的叙述性综合分析中作为一项早期观察显示出了一些前景。需要高质量试验来评估帆船运动对复原力的影响并填补空白:NBI的长期效应及其对13至17岁年龄范围之外儿童的影响。试验注册:PROSPERO数据库(CRD42025634371)