The Effects of the Ward Environment and Language in Palliative Care: A Qualitative Exploratory Study of Victorian Nurses' Perspectives.

OBJECTIVES: The current study aimed to explore regional nurses' perspectives of how bad news is delivered and the physical, natural, social, and symbolic environments where these conversations occur. BACKGROUND: In regional hospitals within Victoria, Australia, palliative and end-of-life patients are cared for in acute wards that are often busy, noisy, and do not have a palliative psychosocial focus. On the other hand, Palliative Care Units (PCUs) have more home-like dedicated spaces, yet nearly all these facilities are in metropolitan areas. Diagnostic/prognostic (bad news) conversations about life-limiting illnesses often occur at the bedside in both environments. METHOD: Nurses providing palliative or end-of-life care in regional or metropolitan Victorian hospital inpatient wards were invited to interview and recruited through social media and snowballing. Six semi-structured, audio-recorded online interviews were conducted between March and May 2022, and themes were developed using reflexive thematic analysis. RESULTS: Semi-structured online interviews were conducted with six female, registered nurses, four of whom worked in regional Victorian hospitals and two in metropolitan PCUs as Nurse Unit Managers. Three central themes were developed: "conducting family meetings," "palliative care practice," and "the environment matters." CONCLUSIONS: A therapeutic environment for palliative patients and their families consists of home-like ambience and aesthetics and a psychosocial environment created by staff who can provide holistic palliative care. Holistic palliative care requires mentoring and mirroring of expert practice to increase the expertise and capacity of the palliative care workforce in acute general hospital wards.

HEALTHY LANDSCAPES: A REVIEW OF THE RESEARCH ON URBAN LANDSCAPES ASSOCIATED WITH HEALTH AND WELLBEING

Cities shelter more than two thirds of the world's population, and health security in such environments became a challenge. The outbreak of the SARS-COV-2 pandemic revealed the urgency of assessing urban resilience towards major health crises. Major cities are acknowledged for decreasing the health status of their residents through complex drivers, and researchers from various domains have been addressing these issues for the past three decades. The aim of our study focused on highlighting the main methods and indicators used by scholars to assess the impact of urban landscapes on health, and to cluster urban landscapes based on their conclusions. We scoped the scientific literature published in the past 10 years, addressing the issue of health in relation with urban landscapes. We used statistical approaches, API algorithms, and social network analysis for generating and exposing our results. Most studies focused on perception analyses (mainly self-perceived health), literature reviews or environmental quality impacts on health. Green and blue features were considered therapeutic landscapes, while dense built-up spaces were described as harmful. Urban landscapes are acknowledged as enablers or disablers of health, thus planning strategies and regulations should consider the impacts generated by the design and structure of new urban fabrics. © 2023, Editura Universitatii din Bucuresti. All rights reserved.

Nature-based tourism as therapeutic landscape in a COVID era: autoethnographic learnings from a visitor's experience in Iceland.

One of the few silver linings in the COVID pandemic has been a new appreciation for, interest in, and engagement with nature. As countries open, and travel becomes accessible again, there is an opportunity to reimagine sustainable nature-based tourism from a therapeutic landscape lens. Framed within the therapeutic landscape concept, this paper provides an autoethnographic account of a visitor's experience of three different natural landscapes in Iceland shortly after the country's fourth wave of the pandemic. It adds to the understanding of the healing effects of the multi-colored natural landscapes of Iceland. The natural landscapes of interest herein include: the southern part of the Westfjörd peninsula, Jökulsárlón glacial lagoon, and the Central Highlands. In totality, the natural, built and symbolic environments worked in synchronicity to produce three thematic results: restoration, awe and concern, all which provided reduced stress, renewed attention, as well as enhanced physical and psycho-social benefits for the autoethnographic visiting researcher. Implications of these restorative outcomes for sustainable nature-based tourism in a post-COVID era are discussed. This paper highlights how health and tourism geographers can work collaboratively to recognize, protect, and sustain the therapeutic elements of natural landscapes, recognized as a cultural ecosystem service. In so doing, such collaborations can positively influence sustainable nature-based tourism development and consumption through proper and appropriate planning and development of such tourism destinations.

Therapeutic landscapes during the COVID-19 pandemic: increased and intensified interactions with nature

The COVID-19 pandemic has had a drastic impact on the course of everyday life for much of the world's population and many people have experienced an unprecedented increase in anxiety and depression while their access to a range of coping mechanisms has been reduced. For those privileged enough to have nearby and safe access to natural environments, green and blue spaces have become an important enabler of everyday wellbeing. In this paper we explore the role of everyday interactions with nature for the maintenance of wellbeing, during the first and second ‘wave' of infections in the Netherlands. Based on qualitative interviews with 30 participants in spring/summer and autumn of 2020, we detail how relationships with nature in the local surroundings and in the home qualitatively and effectively changed in response to COVID-19 induced confinement, resulting in the becoming-therapeutic of everyday micro-geographies. Amongst our participants, the conditions of semi-lockdown gave rise to increased interactions with nature, both in their outdoor surroundings and in the home. These increased interactions also led to intensified emotional and sensory experiences with nature and a greater sense of familiarity with their surroundings, which strengthened place-attachments and contributed to an increased sense of wellbeing.

Therapeutic landscapes, networks, and health and wellbeing during the COVID-19 pandemic: A mixed-methods study among female domestic workers.

The COVID-19 pandemic has had profound impacts on access to and use of therapeutic landscapes and networks, especially for people who are vulnerable due to economic, social, and work-related disadvantage. For one such vulnerable population, Indonesian female domestic workers (FDWs) in Hong Kong, this study employed a mixed methods approach to examine the associations between perceptions of therapeutic landscapes (TLs), therapeutic networks (TNs), subjective wellbeing, and self-rated health during the COVID-19 pandemic. Data from an online survey were analyzed via structural equation modeling (SEM) and confirmatory factor analysis (CFA) to investigate the direct and indirect associations between TLs, TNs, and health and wellbeing. The findings demonstrate little or no association among FDWs' perceptions of TLs and TNs and FDWs' self-rated health and subjective wellbeing, except for a negative total association between TL and subjective wellbeing. Using insights gleaned from thematic analysis of in-depth interviews with FDWs, we suggest that these unexpected findings are mainly due to restricted access to public places, reduced social gatherings, and the fact that employers rarely granted days off during the lockdown. Although processes at the employer and municipal scales limited FDWs' access to therapeutic places, increased use of digital communications and spaces provided an important source of social and emotional support during the pandemic.

A gendered therapeutic learning landscape: Responding creatively to a pandemic

Crafting has occupied the hands and minds of women over many centuries providing vital connections with cultural skills and with community. While the COVID-19 pandemic has isolated women in their homes, it has also provided opportunities for women to reconnect to crafting through virtual spaces. This paper draws on a thematic analysis of a focus group interview examining the experiences of regional women participating in a crafting group and identifies the ways in which they used craft to support their wellbeing. Drawing on the concept of therapeutic landscapes, the paper highlights that connection in a virtual craft group supports lifelong learning and wellbeing, brings women together in support through a community of women's practice and facilitates opportunities for producing meaningful and commemorative quilting projects This finding has implications for a society experiencing unprecedented levels of stress, mental illness and anxiety about the future.

Mental health and well-being in times of COVID-19: A mixed-methods study of the role of neighborhood parks, outdoor spaces, and nature among US older adults.

The role of parks and nature to support well-being during the COVID-19 pandemic is uncertain. To examine this topic, we used mixed-methods data collected in April-May 2020 from US adults aged ≥55 in the COVID-19 Coping Study. We quantitatively evaluated the associations between number of neighborhood parks and depression, anxiety, and loneliness; and conducted qualitative thematic analysis of participants' outdoor experiences. Among urban residents, depression and anxiety were inversely associated with the number of neighborhood parks. Thematic analysis identified diverse engagement in greenspaces that boosted physical, mental, and social well-being. The therapeutic potential of outdoor and greenspaces should be considered for interventions during future epidemics.

The Reorganization of a Psychiatric Unit During COVID-19: A Reflection for Psychiatric Hospital Design.

OBJECTIVE: The COVID-19 pandemic has impacted healthcare systems worldwide. Although this disease has primarily impacted general medicine intensive care units, other areas of healthcare including psychiatry were modified in response to corona measures to decrease the transmission of the disease. Reflecting on the modifications to the environment provides an opportunity to design psychiatric environments for future pandemics or other demands for healthcare. BACKGROUND: The therapeutic environment of psychiatric wards was modified in Friesland, the Netherlands, in response to COVID-19. During this time, an interdisciplinary team met consistently to contribute to the preliminary design of a new psychiatric hospital. METHODS: During the first 18 months of the pandemic, clinical reflections were made to describe the impact of COVID-19 on the psychiatric care environment. Architects have created a preliminary design of a new psychiatric hospital based on these reflections, monthly collaborative design discussions based on virtual mock-ups and evidence-based design based on theoretical concepts and research. RESULTS AND CONCLUSIONS: This theoretical and reflective study describes how an inpatient psychiatric environment was restructured to manage infection during COVID-19. The therapeutic environment of the psychiatric ward and patient care changed drastically during COVID-19. The number of patients accessing care decreased, patient autonomy was restricted, and the function of designated behavioral support spaces changed to manage the risk of infection. However, these challenging times have provided an opportunity to reflect on theories and consider the design of new hospital environments that can be adapted in response to future pandemics or be restructured for different care functions.

Therapeutic landscapes during the COVID-19 pandemic: increased and intensified interactions with nature

The COVID-19 pandemic has had a drastic impact on the course of everyday life for much of the world’s population and many people have experienced an unprecedented increase in anxiety and depression while their access to a range of coping mechanisms has been reduced. For those privileged enough to have nearby and safe access to natural environments, green and blue spaces have become an important enabler of everyday wellbeing. In this paper we explore the role of everyday interactions with nature for the maintenance of wellbeing, during the first and second ‘wave’ of infections in the Netherlands. Based on qualitative interviews with 30 participants in spring/summer and autumn of 2020, we detail how relationships with nature in the local surroundings and in the home qualitatively and effectively changed in response to COVID-19 induced confinement, resulting in the becoming-therapeutic of everyday micro-geographies. Amongst our participants, the conditions of semi-lockdown gave rise to increased interactions with nature, both in their outdoor surroundings and in the home. These increased interactions also led to intensified emotional and sensory experiences with nature and a greater sense of familiarity with their surroundings, which strengthened place-attachments and contributed to an increased sense of wellbeing. [ FROM AUTHOR] Copyright of Social & Cultural Geography is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Where birds felt louder: The garden as a refuge during COVID-19.

During the COVID-19 pandemic, many countries experienced something of a boom in interest in gardening. Gardens have long been considered as refuges into which we retreat to escape various struggles and challenges. In this study we examine the characteristics and functions of the garden as a refuge during the period of increased garden interest associated with the COVID-19 pandemic. Analysis of qualitative results about garden experiences from 3,743 survey respondents revealed intertwining garden and emotional geographies. Utilising non-representational and therapeutic landscape theories, we found multifarious and heightened experiences of non-material aspects of gardens; that is, the sensory and emotional aspects. People experienced, for example, a sense of joy, beauty, and reassurance, a greater attunement to the natural world and an increased sense of nature connection than they had at other times: birds felt louder. These heightened sensory and emotional experiences had therapeutic benefits, across age and geographical spectrums, during these difficult times. This research improves our understandings of the positive potential of non-material aspects of gardens in the creation of therapeutic landscapes in and beyond COVID-19.

A fragmented sense of home: Reconfiguring therapeutic coastal encounters in Covid-19 times.

A growing body of research suggests positive links between coastal proximity, interaction, human health and wellbeing. In 2020, following the onset of the Covid-19 pandemic, many people in the UK could not engage in their usual coastal practices due to a national lockdown and associated restrictions, including government bans in entering the sea. This paper shares findings from an exploratory study examining how these restrictions shaped the recreational coastal practices, perceptions and emotions of residents in the case study region of Devon, South West England. In-depth semi-structured interviews were conducted with a purposive sample of 12 residents, with varying domestic and employment circumstances in the pandemic. We foreground three key themes identified through an inductive thematic analysis of the interviews: feeling 'at home' with the sea, experiencing a fragmented sense of home with Covid-19, and reconfiguring the coast as a therapeutic landscape. While important to understand the links between coastal proximity, health and wellbeing, we highlight the value of gaining more nuanced insights into the emotional, social, material and temporal dynamics that can re-shape the therapeutic potential of coastal encounter in the largely unprecedented situation of a global pandemic.

Health, Wellness, and Place Attachment During and Post Health Pandemics.

Therapeutic landscapes encapsulate healing and recovery notions in natural and built environmental settings. Tourists' perceptions determine their decision making of health and wellness tourism consumption. Researchers struggle with the conceptualization of the term 'therapeutic landscapes' across disciplines. Drawing on extant literature searched in nine databases, this scoping review identifies different dimensions of therapeutic landscapes. Out of identified 178 literature sources, 124 met the inclusion criteria of identified keywords. We review the contribution and the potential of environmental psychology in understanding tourist behavior to promote health and wellness tourism destinations in a post COVID-19 context. We develop and propose a conceptual framework comprising: (1) perceived goodness of therapeutic landscapes, (2) health and wellness consumption, (3) COVID-19 pandemic perceived health and wellness risk, (4) place attachment, and (5) re-visitation. We propose measurement scales and discuss implications and major issues in the immediate and post the COVID-19 pandemic to inform future research.